Testing the effectiveness and acceptability of online supportive supervision for mental health practitioners in humanitarian settings: a study protocol for the caring for carers project.

BACKGROUND: Local humanitarian workers in low and middle-income countries must often contend with potentially morally injurious situations, often with limited resources. This creates barriers to providing sustainable mental health and psychosocial support (MHPSS) to displaced individuals. Clinical supervision is an often neglected part of ensuring high-quality, sustainable care. The Caring for Carers (C4C) project aims to test the effectiveness and acceptability of online group-based supportive supervision on the well-being of MHPSS practitioners, as well as service-user-reported service satisfaction and quality when working with displaced communities in Türkiye, Syria, and Bangladesh. This protocol paper describes the aim, design, and methodology of the C4C project. METHOD: A quasi-experimental, mixed-method, community-based participatory research study will be conducted to test the effectiveness of online group-based supportive clinical supervision provided to 50 Syrian and 50 Bangladeshi MHPSS practitioners working with Syrian and Rohingya displaced communities. Monthly data will be collected from the practitioners and their beneficiaries during the active control (six months) and supervision period (16 months over two terms). Outcomes are psychological distress (Kessler-6), burnout (the Copenhagen Burnout Inventory), compassion fatigue, compassion satisfaction, and secondary traumatic stress (Professional Quality of Life Scale), perceived injustice, clinical self-efficacy (Counseling Activity Self-Efficacy Scale), service satisfaction, and quality (Client Satisfaction Questionnaire and an 18-item measure developed in this project). A realist evaluation framework will be used to elucidate the contextual factors, mechanisms, and outcomes of the supervision intervention. DISCUSSION: There is a scarcity of evidence on the role of clinical supervision in improving the well-being of MHPSS practitioners and the quality of service they provide to displaced people. By combining qualitative and quantitative data collection, the C4C project will address the long-standing question of the effectiveness and acceptability of clinical supervision in humanitarian settings.

Validation of Bengali perceived stress scale among LGBT population.

BACKGROUND: Lesbian, gay, bisexual and transgender (LGBT) population encounter more stressful life circumstances compared to general population. Perceived Stress Scale (PSS) can be a useful tool for measuring their stress. However, psychometric properties of PSS have never been tested on LGBT population. METHODS: This cross sectional study employed a two-stage sampling strategy to collect data from 296 LGBT participants from six divisional districts of Bangladesh. Exploratory (EFA) and confirmatory factor analysis (CFA) were carried out on PSS 10 along with analysis of reliability and validity. RESULTS: EFA revealed a two-factor structure of PSS for LGBT population explaining 43.55% - 51.45% of total variance. This measurement model was supported by multiple fit indices during CFA. Acceptable Cronbach's alpha indicated internal consistency reliability and high correlations with Self Reporting Questionnaire 20 demonstrated construct validity of PSS 10 for LGBT population. CONCLUSION: This study provided evidence of satisfactory psychometric properties of Bengali PSS 10 in terms of factor structure, internal consistency and validity among LGBT population.

Mental health and suicide risk among homosexual males in Bangladesh.

BACKGROUND: Homosexual individuals are at high risk of suicide, but there is a shortage of data from developing countries to confirm this. Estimates on mental health and suicide risk among male homosexuals in Bangladesh are needed to generate awareness and to plan services accordingly. METHOD: We assessed mental health and suicidal behavior of 102 self-identified homosexual males from a community-based organization that works with the sexual minority population. RESULTS: One-third of the participants (32.4%) had experienced attempted suicide, and almost half (47.1%) had a history of suicidal ideation and self-harm (40.2%). Compared to a heterosexual sample, homosexual males had poorer mental health as they scored higher on Beck Hopelessness Scale (Cohen's d = 0.29) and General Health Questionnaire (GHQ) (Cohen's d = 0.57). The results revealed positive correlations between self-harm, suicidal ideation and suicide attempt scores. Participants with history of suicide attempt, suicide ideation and self-harm reported worse general health, more social dysfunction, and severe depression than those without such history. CONCLUSION: Suicidality and mental health conditions among homosexual males in Bangladesh have appeared to be alarming. Given the concerns, we offer some recommendations for practitioners and social workers who are serving this population in Bangladesh.

Reliability and validity of the Perceived Stress Scale in Bangladesh.

With validation studies conducted all over the world, the 10-item Perceived Stress Scale (PSS-10) has become a robust and widely used instrument for assessing the appraisal of stress. The present study was aimed at validation and testing for psychometric properties of the PSS-10 on the Bangladeshi population. Three hundred and fifteen adult (aged 18-64 years) from eight divisional districts of Bangladesh participated in this study. A good fit of the two-factor structure of the scale was indicated by multiple indices (χ2/df, root mean square error of approximation, comparative fit index, and standardized root mean square residual) on confirmatory factor analysis. The full scale demonstrated internal consistency, test-retest reliability and construct validity. The two factors also demonstrated acceptable psychometric properties. The psychometric properties of the Bengali PSS-10 demonstrated in this study suggest the PSS-10 as a valid and reliable instrument for use in Bangladesh and among Bengali-speaking populations.