Task Sharing and Remote Delivery of Brief Interpersonal Counseling for Venezuelan Migrants and Refugees Living in Peru during the COVID-19 Pandemic: A Mixed-Methods Pilot Study.

Refugees and migrants experience an elevated risk for mental health problems and face significant barriers to receiving services. Interpersonal counseling (IPC-3) is a three-session intervention that can be delivered by non-specialists to provide psychological support and facilitate referrals for individuals in need of specialized care. We piloted IPC-3 delivered remotely by eight Venezuelan refugee and migrant women living in Peru. These counselors provided IPC-3 to Venezuelan refugee and migrant clients in Peru (n = 32) who reported psychological distress. Clients completed assessments of mental health symptoms at baseline and one-month post-intervention. A subset of clients (n = 15) and providers (n = 8) completed post-implementation qualitative interviews. Results showed that IPC-3 filled a gap in the system of mental health care for refugees and migrants in Peru. Some adaptations were made to IPC-3 to promote its relevance to the population and context. Non-specialist providers developed the skills and confidence to provide IPC-3 competently. Clients displayed large reductions in symptoms of depression (d = 1.1), anxiety (d = 1.4), post-traumatic stress (d = 1.0), and functional impairment (d = 0.8). Remote delivery of IPC-3 by non-specialists appears to be a feasible, acceptable, and appropriate strategy to address gaps and improve efficiency within the mental health system and warrants testing in a fully powered effectiveness study.

Did internal displacement from the 2010 earthquake in Haiti lead to long-term violence against children? A matched pairs study design.

BACKGROUND: Empirical evidence is limited and contradictory on violence against children after internal displacement from natural disasters. Understanding how internal displacement affects violence is key in structuring effective prevention and response. OBJECTIVE: We examined the effect of internal displacement from the 2010 Haitian earthquake on long-term physical, emotional, and sexual violence against children and outlined a methodological framework to improve future evidence quality. PARTICIPANTS AND SETTING: We analyzed violence against adolescent girls and boys within the nationally representative, Haiti Violence Against Children Survey. METHODS: We pre-processed data by matching on pre-earthquake characteristics for displaced and non-displaced children and applied 95 % confidence intervals from McNemar's exact test, with sensitivity analyses, to evaluate differences in violence outcomes between matched pairs after the earthquake. RESULTS: Internal displacement was not associated with past 12-month physical, emotional, and sexual violence two years after the earthquake for girls and boys. Most violence outcomes were robust to potential unmeasured confounding. Odds ratios for any form of violence against girls were 0.84 (95 % CI: 0.52-1.33, p = 0.500) and against boys were 1.03 (95 % CI: 0.61-1.73, p = 1.000). CONCLUSIONS: Internal displacement was not a driver of long-term violence against children in Haiti. Current global protocols in disaster settings may initiate services after the optimal window of time to protect children from violence, and the post-displacement setting may be central in determining violence outcomes. The combination of specific data structures and matching methodologies is promising to increase evidence quality after rapid-onset natural disasters, especially in low-resource settings.