Attachments
Evaluation report on the pilot implementation of the intervention ‘Between Us’
Introduction
Since the beginning of Russia’s invasion of Ukraine, millions of Ukrainians have been displaced, have been exposed to violence and other potentially traumatic events, and face daily adversities that increase the risk of mental health and psychosocial problems.
Results from an assessment of mental health and psychosocial problems and needs conducted by HIAS revealed that 18 months into the war, 35% of respondents reported poor well-being and quality of life with 26% of respondents reporting symptoms indicating depressive symptoms. Epidemiological data collected during the war also indicate a high burden and prevalence of common mental disorders among Ukrainians.
Women in Ukraine were disproportionately affected by mental health and psychosocial problems. Common mental health and psychosocial problems included chronic anxiety, moral exhaustion, and fatigue. Despite this elevated burden, research has also documented the high levels of resilience, sociocultural resources, and coping strategies buffering these risk factors.
Prior to the 2022 Russian invasion of Ukraine, there existed a large treatment gap in services for people with mental health and psychosocial problems. The war in Ukraine has exacerbated this lack of access and by significantly disrupting health service delivery and reducing access to mental health and psychosocial support services available through the national health and social services system. Furthermore, the unique stressors and context of the war necessitate services that are tailored to the needs of individuals displaced and otherwise affected by the war as well as the resources that are available. One recommended strategy to overcome these barriers and limitations of existing services is to prioritize community-based services that leverage existing social resources, strengthen social connectedness and peer support, and are not reliant on services and facilities that may be non-functional, overwhelmed, and/or not accessible to communities in conflict settings. These recommendations are consistent with those that have emerged from existing mental health and psychosocial needs assessments in Ukraine. While community-based interventions are limited in Ukraine, available evidence and models of community-based MHPSS support the feasibility of these interventions and their ability to bridge gaps in access and utilization of MHPSS.
Informed by these needs and recommendations and building on HIAS’ global experience with adaptations for community-based mental health and psychosocial support (MHPSS) interventions, we decided to utilize an intervention designed with displaced and migrant communities in Latin America to support the mental health and psychosocial needs of women. The intervention, Between Us (originally ‘Entre Nosotras’), was funded by the United States Agency for International Development (USAID) under the Health Evaluation and Applied Research Development (HEARD). This research was intended to fill a gap that exists in MHPSS research in LMICs, and especially in humanitarian contexts, that highlights a need for flexible processes to facilitate rigorous design and evaluation of adaptable community-focused intervention. Between Us is a five-session, 2 hours each, community and strengths-based MHPSS intervention that aims to mobilize social support, strengthen community connectedness, and promote collective action to increase safety and well-being of women. This report describes the adaptation, piloting, and evaluation of the Between Us intervention in Ukraine.