Building Resilience in Families, Communities, and Organizations: A Training Program in Global Mental Health and Psychosocial Support.

This article describes the Summer Institute in Global Mental Health and Psychosocial Support, a brief immersion training program for mental health, health, and allied professionals who work with populations that have endured severe adversities and trauma, such as domestic and political violence, extreme poverty, armed conflict, epidemics, and natural disasters. The course taught participants to apply collaborative and contextually sensitive approaches to enhance social connectedness and resilience in families, communities, and organizations. This article presents core training principles and vignettes which illustrate how those engaging in such interventions must: (1) work in the context of a strong and supportive organization; (2) appreciate the complexity of the systems with which they are engaging; and (3) be open to the possibilities for healing and transformation. The program utilized a combination of didactic presentations, hands-on interactive exercises, case studies, and experiential approaches to organizational team building and staff stress management.

Preventing Torture in Nepal: A Public Health and Human Rights Intervention.

In this article we address torture in military and police organizations as a public health and human rights challenge that needs to be addressed through multiple levels of intervention. While most mental health approaches focus on treating the harmful effects of such violence on individuals and communities, the goal of the project described here was to develop a primary prevention strategy at the institutional level to prevent torture from occurring in the first place. Such an approach requires understanding and altering the conditions that cause and sustain "atrocity producing situations" (Lifton 2000, 2004). Given the persistence of torture across the world and its profound health consequences, this is an increasingly important issue in global health and human rights.

Mental health concerns among African immigrants.

African immigrants represent a rapidly expanding group of immigrants in the United States. In New York City, Africans constitute the fastest growing segment of immigrants but the needs and practices of African immigrants in the U.S. remain poorly understood. A community based organization (CBO) serving African immigrants in Staten Island, NY began a health screening program in 2008 with the goal of promoting access to primary care. Over 18 months, 296 visits were recorded at African Refuge health screenings, representing a total of 87 people who averaged just over 3 visits per person. The screenings identified mental health among the top three medical problems of clients but referral to mental health services was rare. Dedicated services are required to better screen for mental health concerns and refer African immigrants to mental health care.

A family approach to severe mental illness in post-war Kosovo.

This study describes the effects of a psychoeducational multiple-family group program for families of people with severe mental illness in post-war Kosovo that was developed by a Kosovar-American professional collaborative. The subjects were 30 families of people with severe mental illnesses living in two cities in Kosovo. All subjects participated in multiple-family groups and received family home visits. The program documented medication compliance, number of psychiatric hospitalizations, family mental health services use, and several other characteristics, for the year prior to the groups and the first year of the groups. The families attended an average of 5.5 (out of 7) groups, and 93% of these families attended four or more meetings. The uncontrolled pre- to post-intervention comparison demonstrated decreases in medication non-compliance and hospitalizations, and increases in family mental health service use. The program provided training for mental health professionals, led to policy change in the Ministry of Health, and resulted in dissemination to other community mental health centers. This study provides preliminary evidence that a collaboratively designed and implemented psychoeducational, multiple-family program is a feasible and beneficial intervention for families of people with severe mental illness in impoverished post-war settings.

Guidelines for international training in mental health and psychosocial interventions for trauma exposed populations in clinical and community settings.

OBJECTIVE: To develop consensus-based guidelines for training in mental health and psychosocial interventions for trauma-exposed populations in the international arena. PARTICIPANTS: The Task Force on International Trauma Training of the International Society for Traumatic Stress Studies. EVIDENCE: The Task Force engaged in a 1-year dialogue on the practice of international training, drawing upon field experience, literature review, and consultation with key informants. CONSENSUS PROCESS: This statement was prepared on the basis of shared dialogue, consensus decision making, and a writing process involving all Task Force members. It was then disseminated for review to more than 200 professionals of more than 60 service and academic organizations. Written and oral suggestions from over 80 persons were incorporated and revisions made on the basis of consensus. CONCLUSIONS: The generated guidelines addresses four dimensions: (1) values, (2) contextual challenges in societies during or after conflicts, (3) core curricular elements, and (4) monitoring and evaluation. The guidelines can improve international training.