University of Bath

Displaced populations’ access to mental health services in Uganda and Bangladesh

Exploring displaced people’s access to mental health services through research with Rohingya displacees in Bangladesh and South Sudanese displacees in Uganda.

By carrying out qualitative research with both displacees and healthcare providers into practices, experiences and factors shaping displacees’ access to mental healthcare, the study will identify barriers and opportunities for improving mental health provision and support. Recognising that health inequalities affect displaced populations in gendered ways, we will pay particular attention to gender as a significant determinant of both mental health needs and access to services.

Choice of case studies

In Bangladesh and Uganda, influxes of refugees from neighbouring conflicts in recent years make them ideal case studies for exploring the effectiveness of humanitarian healthcare assistance in the post-emergency phase. In both contexts, mental health services, largely provided by humanitarian agencies, include educating displacees about psychosocial support, holding one-on-one and group counselling sessions. This project is designed to provide the essential pilot work for identifying feasible, equitable and sustainable options for targeting the mental health of displacees, to allow for a future large grant (e.g., UKRI GCRF) that will directly test methods to improve mental health outcomes for these groups.

Project outline

At each research site, interviews will be conducted with displacees who have accessed mental health services exploring factors that mediate their access, their experience of such services and perception of the adequacy and appropriateness of existing interventions. To get a deeper understanding about displacees’ (male and female) mental health practices and needs, we will also collect data about their perception of the causes underlying mental health issues, community-based practices around treatment, and how traditional and cultural strategies for treating mental health issues are influenced by experiences of displacement.

Alongside this, interviews will be carried out with service providers and actors involved in policymaking in these contexts. The research explores how humanitarian and development organisations are currently engaging with refugee mental health, their perceptions about gendered needs, practices and access, and what challenges they experience in providing support.

In the second half of the project, two workshops will be organised with institutional actors and displacee participants to disseminate findings and engage with them in producing knowledge to improve displacees’ access to mental health services and outcomes. Through these workshops we aim to develop a stake-holder advisory group to support the development of the follow-on larger grant application that will aim to trial methods of improving displacees’ access to these services.

Project Team

Initial phase

1 OCT 2019  to  31 DEC 2019

During this initial phase of the project, the research team will conduct a literature review and analyse policy documents and available reports relevant to the research topic. The team will also refine the methodology, finalize the fieldwork plan and research design. In addition, the team will establish contact with organizations working with the displacees who can facilitate access to the camps for fieldwork.

Fieldwork

1 JAN 2020  to  30 APR 2020

The Co-Investigators will start fieldwork in Uganda and Bangladesh with members of partner organizations, researchers and research assistants. In the initial period (1-15 January 2020), three days of training will be held to finalize questionnaires for interviewing institutional actors and displacees, and discuss ethical conducts in data collection. In the second phase, we will complete data collection and transcription of the data gathered through interviews. We will organise one workshop in each country with the institutional actors in the middle of this phase to share preliminary findings and initiate policy engagement.

Analysis

1 MAY 2020  to  31 JUL 2020

In the final phase, the research team will complete analysing the data and compiling findings. A second stakeholder workshop will be organised for further engagement with policy makers and health service providers. By the end of June, policy briefs will be produced and translated into different languages (Bengali, Rohingya and Arabic) as appropriate for disseminating in Bangladesh and Uganda.

The team will finalize drafts of two publications: one will focus on the intersections and differences between institutional practices, displacees’ practices and their experience of accessing providers; the other will focus on interplay between gender dynamics and accessibility. We will also begin work on a larger GCRF research proposal, for which this project serves as a ‘pump-priming’ activity.