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During and after emergencies and humanitarian crisis, there are large numbers of people who are impaired for prolonged periods by distress. Grief and acute stress are usually transient psychological reactions to adversity and loss, but prolonged states of anxiety and depression may also be triggered by extreme stressors. These chronic problems undermine the functioning of individuals and their communities, which can be essential for their survival and is essential for socioeconomic recovery. In these periods of crisis, the health systems also tend to be overwhelmed and unable to meet the demand for basic services, and often the existing supportive care systems in the communities have also been damaged.


Problem Management (PM+) was found effective in two randomised controlled trials, (RCTs) funded by Elrha’s Research for Health in Humanitarian Crises (R2HC) programme and by Grand Challenges Canada. PM+ can improve mental health, functioning and psychosocial well-being of people in humanitarian settings. It is a scalable, manualised, evidence-based intervention that can be used by both the health and social sector to reduce distress and improve functioning. It has proven to be effective in diminishing depression and anxiety and improving people’s functioning and self-selected, culturally relevant outcomes. Some of its very distinct and innovative features include:

  • a transdiagnostic intervention, addressing a range of client identified emotional (eg depression, anxiety, traumatic stress, general stress) and practical problems
  • designed for low-resource settings
  • designed for people in communities affected by any kind of adversity (eg violence, disasters), not just focussing on a single kind of adversity
  • it is empowering as it teaches adult participants to self-manage their distress for sustainable, long-term solutions.


In collaboration with eight humanitarian organisations, the project enabled them to implement PM+ in their agencies, through a capacity building intervention using PM+ and thereby providing evidence based care.
The capacity building workshops focused on (a) cultural adaptation of the manual, (b) training of trainers in an apprenticeship training and supervision approach, with a strong emphasis on on-the-job learning, and (c) regular measurement of outcomes.
The outputs of the capacity training workshop included:

  • an availability of 20 PM+ trainers, clinical supervisors, programme supervisors
  • PM+ implementation plans in the partnering humanitarian organisations
  • a roster of independent PM+ trainers that can be consulted by agencies that do not have PM+ trainers
  • a community of practice on the intervention
  • three qualitative case studies on the experience of implementing PM+.

Latest Updates

Delivering PM+ Supervision in Hard to Reach Areas

27 Mar 2019

Dr Ashley Nemiro shared insights on delivering Problem Management Plus supervision in hard to reach areas to ensure the proper use of the WHO evidence-based manualised psychological intervention in Northern Syria.


Providing Problem Management Plus (PM+) Through Volunteers

14 Nov 2018

Well into the second phase of the project, the organisations who participated in the problem management plus (PM+) training were busy disseminating PM+ across the globe by training staff, supervising role-plays, and starting to provide PM+ sessions to clients.


From training to action: Moving into Phase II of PM+

08 Aug 2018

What makes PM+ a scalable intervention that can be used in humanitarian contexts is that it can be delivered by paraprofessionals (high school graduates with no mental health experience), using the principle of task shifting/task sharing for people in communities affected by any kind of adversity (e.g. violence, disasters), not just focusing on a single kind of adversity.


PM+, Supporting people through Adversity

11 Jul 2018

Problem Management Plus (PM+), a new tool created by the World Health Organization (WHO) as a scalable sustainable solution to respond to growing needs to provide psychological support to persons in distress situations, while facing a paucity of specialized mental health staff. So what is PM+? And why is it important?


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