NIHR Global Health Research Group: A package of care for the mental health of survivors of violence in South Asia

Funding agency: National Institute for Health Research, UK

Duration: April 2018- 2020

Research investigators: Prof Abhijit Nadkarni, Prof David Osrin, Prof Glyn Lewis, Dr Delan Devakumar, Dr Jenevieve Mannell, Prof Cathy Zimmerman, Dr Ligia Kiss, Dr Laura Asher, Prof Louise Howard, Dr Sian Oram, Dr Melanie Abas, Prof Varuni de Silva, Dr Lida Ahmad

Host institute: Sangath, Goa (India)

Our multidisciplinary group of established and early career researchers will develop a comprehensive, adaptable package of care to improve the mental health of survivors of violence against women (VAW), modern slavery, and civil conflict in resource-constrained settings in India, Sri Lanka, and Afghanistan. Important commonalities exist between the mental health needs of survivors of different forms of violence. VAW describes physical, sexual, emotional, or economic intimate partner, domestic, and non-partner violence. It affects 42% of women in South Asia. Modern slavery describes forced marriage, forced labour and commercial sexual exploitation. It affects 40 million people worldwide, with the greatest burden in Asia. Conflict in Afghanistan and Sri Lanka, amidst discriminatory gender norms, has exposed a majority of women to abuse, trauma and poor mental health. These forms of violence are gendered, culturally and generationally recapitulated, and strongly associated with mental illness, particularly depression, anxiety, post-traumatic stress disorder, and suicidal thinking. Reductions in prevalence and severity of these conditions will be our target outcomes in groups whose gender and age reflect local burden of violence. Alongside psychological therapies, the range of necessary non-clinical responses includes crisis counselling, shelter, legal and financial negotiation, social work, and community support networks. In developing a package of care adaptable to different forms of violence in resource-limited settings, we will identify and review promising models, refine them contextually through user engagement, pilot and collate them.

Specific aims:

  1. To identify and select candidate component interventions, understand the mental health needs of survivors of violence, co-develop with survivors and providers a package of care that fills gaps in practice and policy, and determine whether interventions are feasible to deliver, acceptable to survivors and providers, and potentially transferable.
  2. To build an international multidisciplinary group committed to developing early career researchers in Afghanistan, India, Sri Lanka, and the UK by supporting them through a sequence of complex intervention development.

Within 3 years, our innovative international group will have designed and piloted a package of contextually-appropriate, multidisciplinary interventions for depression, anxiety, post-traumatic stress disorder (PTSD), and suicidal ideation in survivors of violence for government and non-government organizations to use according to the needs of users and providers.

Research funded by the National Institute for Health Research (NIHR)

This project is funded by the National Institute for Health Research (NIHR), ‘NIHR Global Health Research Group on a package of care for the mental health of survivors of violence in South Asia, at University College London Institute for Global Health’. The views expressed are those of the author(s) and not necessarily those of the NIHR or the Department of Health and Social Care.

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