The war in Ukraine is causing extreme emotional suffering for some, resulting in a high demand for psychological help. How can the gap between mental health care supply and demand be bridged? For that, the municipality of Kyiv sought contact with the city of Amsterdam. "The municipality of Amsterdam and the GGD approached me and my VU colleague Iryna Frankova with this question. Then we decided to conduct a Problem Management Plus (PM+) training in Kyiv city hall," says Marit Sijbrandij, professor of Clinical Psychology at VU Amsterdam. Her colleague Frankova works as a researcher in the same department and originates from Kyiv.
World Health Organization
Besides her work at VU, Sijbrandij is active as co-director of the World Health Organization's (WHO) Collaborating Centre for Research and Dissemination of Psychological Interventions. According to WHO guidelines, it is important to involve non-specialist healthcare providers in the relief effort during complex emergencies. Sijbrandij explains: "Within clinical psychology, we have a lot of knowledge about effective interventions for common psychological complaints in crises, such as depression, post-traumatic stress and anxiety. There are effective programmes for these interventions, which WHO wants to make accessible to a wider audience." That is what Sijbrandij and her colleagues are committed to, which put them in touch with the Kyiv municipality.
PM+ is a short programme of five sessions in which participants learn skills to manage stress, solve problems, become active and strengthen their social support. It has proven effective for people with depression, anxiety and stress. This accessible intervention is used, for example, with refugees and residents of war zones.
"To give PM+, you don't need a background as a psychologist or psychiatrist," says Sijbrandij. As a result, the effect may be slightly less strong than other interventions, but it ensures that many more people can be reached. "Since the trainers have no background in counselling, they are supervised by a psychotherapist," Sijbrandij adds. "In serious cases, such as suicidal thoughts, the trainer can refer the participant to professional help."
Refugees
Sijbrandij was involved in the first studies on the effectiveness of PM+ in Kenya and Pakistan. "When the Syrian refugee crisis was at its height in 2015, I wondered whether this would also be a suitable method for refugees," Sijbrandij says. "They often have poor access to healthcare, partly because of a language barrier. Refugees can provide this training to fellow refugees, which improves access to care."
Sijbrandij highlights that PM+ has a clear protocol and that several municipalities are interested in implementation. For example, GGD Hollands Midden is now also working with PM+ for Ukrainian refugees. "The programme is suitable because it allows people to access it from peers in their native language, without depending on available health professionals," she says. "The language and the connection with a peer make a big difference."
Training Academy
The VU has now become a centre of expertise for PM+ and is trying to meet the high demand to provide training. "We are in the process of setting up a training academy, where local partners can also provide training and we have a coordinating role." For this, VU researchers are collaborating with humanitarian organisations and other academic institutions. With a training academy, they want to build global capacity so that more people in crisis situations can access the help they need.