RT Journal Article
SR Electronic
T1 Development and Piloting of a Mental Health Prevention and Referral Program for Veterans and Their Families in Ukraine
JF Global Health: Science and Practice
JO GLOB HEALTH SCI PRACT
FD Johns Hopkins University- Global Health. Bloomberg School of Public Health, Center for Communication Programs
SP e2200488
DO 10.9745/GHSP-D-22-00488
VO 11
IS 3
A1 Nguyen, Amanda J.
A1 Russell, Tara
A1 Skavenski, Stephanie
A1 Bogdanov, Sergiy
A1 Lomakina, Kira
A1 Ivaniuk, Iryna
A1 Aldridge, Luke R.
A1 Bolton, Paul
A1 Murray, Laura
A1 Bass, Judy
YR 2023
UL http://www.ghspjournal.org/content/11/3/e2200488.abstract
AB Key FindingsThe Common Elements Treatment Approach Psychosocial Support (CPSS) program was developed with iterative feedback from Ukrainian veterans and their families to normalize veterans’ stress and distress, develop skills in cognitive coping, and provide referral to more intensive mental health services for those at high risk for suicide and/or with a higher burden of symptoms.The development process resulted in a mental health and psychosocial support prevention and promotion program that was designed to be implemented in nonclinical environments to reduce barriers to mental health services and to be integrated into different health and social service systems to support referral to more intensive treatment, as needed.The CPSS program is an acceptable and potentially effective brief psychosocial prevention program that can be implemented by trained veteran providers in Ukraine.Key ImplicationsPsychosocial support (PSS) programs should be developed based on input from multiple stakeholders, including the target population and providers.PSS programs need to be part of a broader continuum of the mental health and psychosocial care system, including referral pathways for mental health services for high-risk cases and those who need more mental health services.Background:While growing evidence exists for the effectiveness of mental health interventions in global mental health, the evidence base for psychosocial supports is lacking despite the need for a broader range of supports that span the prevention–treatment continuum and can be integrated into other service systems. Following rigorous evaluation of the Common Elements Treatment Approach (CETA) in Ukraine, this article describes the development and feasibility testing of CETA Psychosocial Support (CPSS), a brief psychosocial prevention and referral program for Ukrainian veterans and their families.CPSS Development:CPSS development used evidence-based CETA intervention components and was informed by a stakeholder needs analysis incorporating feedback from veterans and their families, literature review, and expert consultations. The program includes psychoeducation, cognitive coping skill development, and a self-assessment tool that identifies participants for potential referral. After initial development of the program, the intervention underwent: (1) initial implementation by skilled providers focused on iterative refinement; (2) additional field-testing of the refined intervention by newly trained providers in real-world conditions; and (3) a formal pilot evaluation with collection of pre-post mental health assessments and implementation ratings using locally validated instruments.Results:Fifteen CPSS providers delivered 14 group sessions to 109 participants (55 veterans, 39 family members, and 15 providers from veterans’ service organizations). After incorporating changes related to content, process, and group dynamics, data from the pilot evaluation suggest the refined CPSS program is an acceptable and potentially effective brief psychosocial prevention and promotion program that can be implemented by trained veteran providers. Forty percent of participants required safety or referral follow-ups.Conclusion:The iterative, inclusive development process resulted in an appropriate program with content and implementation strategies tailored to Ukrainian veterans and their families. Brief psychosocial programs can fit within a larger multitiered mental health and psychosocial continuum of care that supports further referral.