Embedding Cognitive Processing Therapy in the DRC Health System

WHAT IS THE HUMANITARIAN NEED?

• Interagency Standing Committee Guidelines on Mental Health and Psychosocial Support in Emergency Settings (IASC) state that ‘the psychosocial and social impacts of emergencies may be acute in the short term, but they can also undermine the long-term mental health and psychosocial well-being of the affected population.
• Data and field experience from ongoing IRC programs show that many survivors of sexual violence (SV) experience substantially reduced ability to function, including in performing basic tasks and activities. Survivors also describe mental health (MH) problems including mood disorders, anxiety, withdrawal, and stigmatization, yet services to address these symptoms are currently unavailable.

WHAT IS THE INNOVATIVE SOLUTION?

After almost two decades of conflict and brutal sexual violence, high levels of trauma, depression and anxiety hinder recovery of many women and girls in Eastern DRC. However, mental health services are not available to the majority of conflict-affected populations in the DRC. This pilot will demonstrate how a mental health therapy can be provided in an efficient, cost-effective manner through the primary health care system and will achieve learning on how to make mental health services available more widely for survivors of gender-based violence, leading to improved healing and recovery
Innovation Phases Description:
This project responds to an important gap with a specific therapy and structure, adapted to the DRC context and that can be implemented to scale in resource-poor humanitarian contexts by a broad range of individuals, including those with minimal education. The project will test the feasibility of this embedded model with the vision of ultimately diffusing it via the Ministry of Public Health to health structures across DRC.
An important level of demand for, and acceptance of, MH services is demonstrated by the high level of participation in CPT carried out as part of the impact evaluation in the DRC, indicating that making the therapy more widely available at community-level would benefit traumatised populations more generally.

WHAT ARE THE EXPECTED OUTCOMES?

CPT allows for more rapid recovery for survivors of SV and thus positive social outcomes. Integrating CPT into the primary health care system allows for the provision of targeted MH services through health workers, with the potential to make this therapy available to a large number of beneficiaries. The health focus is a key element of the humanitarian focus of this proposal, as health services often continue even in unstable environments, and even when suspension is unavoidable, they are commonly the first to recommence service provision following a humanitarian crisis.