Journal Article

Clinical mental health supervision in a humanitarian context in LMICs: PEACE model for community engagement

Mozumder, Muhammad Kamruzzaman, Jahan, Sabiha, Rosenbaum, Simon, Wells, Ruth, Faruk, Md. Omar, Kurt, Gülşah, Némorin, Shaun, Zarate, Ariel

2025

Overview

Background The Caring for Carers (C4C) project aims to assess the effectiveness and acceptability of an online, group-based supervision program for mental health practitioners working with displaced communities in Bangladesh and in Türkiye and Northwest Syria. This paper highlights the integration of Rohingya perspectives to ensure responsiveness to the unique needs of displaced populations through the supervision program. Methods Adopting a community-based participatory research (CBPR) approach, the project engaged Rohingya community members in every phase to ensure the program’s relevance to local needs. A Rohingya Advisory Committee (RAC) was formed to integrate Rohingya perspectives and conducted in-depth interviews (IDI) and focus group discussions (FGD) with two female MHPSS service users and five male community members, respectively. As recommended by Kiger and Varpio (2020), thematic analysis was employed within a constructivist framework that acknowledged cultural variations in mental health perceptions. The C4C project employed several strategies to engage community members and integrate their perspectives. Stakeholder consultations involved MHPSS service users and community members, the RAC conducted workshops for supervisors, and engaged regularly with the project team providing insights on cultural and practical challenges and collaborating to adapt supervision program materials. Results FGD and IDI with service users and community members provided a first glimpse into the community’s needs, and experiences, whereas the advisory committee provided lived experiences, meaning of displacement, and ancestral background. The project team invested in a respectful relationship with the advisory committee, working collaboratively to reflect on each other’s perspectives through regular meetings and adding content and strategies to the supervision processes. Voices from the community informed the supervision program by elucidating contextual markers, cultural and situational understanding, appreciation, curiosity, experiential information, historical background, and perspectives on mental health needs as well as services. Conclusions Incorporating strategies and perspectives from the community, we aimed to provide a framework of community engagement termed as PEACE (Participation, Expertise, Agency, Connection, and Empowerment) along with enabling and challenging factors. Plain English summary Involving mental health service users and community members for which the services have been developed is a crucial stage to ensure mental health services are culturally sensitive. This is even more important for those representing forcefully displaced communities amid limited or no opportunities to contribute to the development and delivery of these services. Often, the voices of these communities are less sought raising concerns over the suitability and acceptability of the services. Community-based participatory initiatives help to include the voices of refugee or displaced communities in research and clinical practice. We aimed to collaborate with with Rohingya refugee community members living in Cox’s Bazaar, Bangladesh to ensure mental health services adequately capture their needs. A Rohingya Advisory Community (RAC) was formed in an effort to understand their needs and opinions to be able to provide culturally sensitive mental health services. Researchers initiated and continued discussions with the RAC for over 2 years. The RAC engaged in several activities such as workshops and presentations to help design a program to support Bangladeshi mental health practitioners to provide mental health care taking the cultural into account. Based on the discussion, we aimed to share a framework- PEACE, to guide meaningful participation in low-and-middle income countries. PEACE stands for Participation , respecting community Expertise , promoting Agency , building genuine Connections , towards Empowerment . In addition, we also discussed potential challenges such as lack of trust and resources, human rights violations to foster meaningful participation. Finally, we emphasized that models of participation from Western countries must be guided by the knowledge of community people who have better cultural, social, and political understanding.

• Publisher: BioMed Central,BioMed Central Ltd,Springer Nature B.V,BMC
• Subject: Clinical supervision / Collaboration / Community / Community engagement / Community voice / Data collection / Displaced persons / Global health / Health services / Humanitarian contexts / Humanitarianism / Medical research / Medicine / Medicine & Public Health / Mental health / Mental health care / Nature Inclusive Health Research Awards Collection for the Journal of Research Involvement and Engagement / Participation / Participatory research / Post traumatic stress disorder / Rohingya people / Supervision