Evidence based mental health interventions for children in fragile and conflict affected settings: expanding reach and system strengthening

Millions of children and adolescents living through armed conflict and displacement face heightened risks of post-traumatic stress reactions, depression, anxiety, and behavioural problems.1 Decades of research show that evidence based mental health and psychosocial support (MHPSS) interventions can reduce mental distress even in active fragile and conflict affected settings.2 However, despite growing evidence of effectiveness, interventions are often relegated to short term research or pilot projects with short funding cycles, external management, and poor coordination, rarely translating into sustainable, high quality MHPSS systems in fragile and conflict affected settings. In war torn and displacement settings—such as internally displaced people or refugee camps and informal settlements—national health and social care systems often cannot meet the rising mental health demand. For example, among Syrian refugee children in Lebanon, a telephone delivered common elements treatment approach showed promising reductions in anxiety, depression, and trauma symptoms but reached only a fraction of those in…