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Mental health difficulties are associated with high levels of disability worldwide and are a significant barrier to economic development. Low-income countries lack sufficient economic and human resources to meet the mental health needs of the population and there is a need for increased investment in efforts to address depression in these countries owing to the substantial human misery, lost health and economic costs.
Mental health difficulties have been shown to be elevated in displaced and refugee populations. Across all continents Africa is home to the largest number numbers of refugees and two countries, Uganda and Rwanda, are the largest recipients of refugees from the Democratic Republic of the Congo.
Refugee populations have been shown to experience elevated levels of daily stressors and concerns have been raised about the medicalisation of social adversity. Empowering the “natural” social support systems already in place amongst Congolese refugee populations has been highlighted as a key strategy for supporting their mental health and wellbeing.
Community Based Sociotherapy (CBS) is delivered in 15 weekly group sessions of 3 hours duration. Group members are facilitated to focus on phases of safety, trust, care, respect, new life orientations and memory. The social space of the group is governed by principles including democracy, equality and confidentiality, aiming for participants to regain their capacity to relate and connect to others so that they can experience again the vitality of humanity and feel mentally healthy. As such, CBS helps to foster ‘communities of support’.
The Treating depressive symptomatology in Congolese Refugees in Uganda and Rwanda: Adapting and Evaluating Community-based Sociotherapy aims to: 1) adapt assessment measures, and the content of CBS to address the needs of refugee populations in Uganda and Rwanda; 2) assess the efficacy, fidelity and cost- effectiveness of adapted CBS (aCBS) to reduce the depressive symptoms of Congolese refugees, and the mediating role of daily stressors and social capital upon these changes; 3) develop implementation guidance for adapting, delivering, supervising and monitoring aCBS for refugees across diverse settings.
In addressing these aims, the project will build research capacity for evaluating complex interventions in Rwanda and Uganda. The knowledge generated through the project will lead to important social and economic impact at both the local and global level by enhancing knowledge about a scalable and inclusive form of intervention aimed at supporting the mental and wellbeing of refugees