Care for the Caregiver: Mental Health For Frontline Workers

We will provide essential and comprehensive mental health and psychosocial support services to frontline workers in humanitarian and emergency crises.

Research has shown that caregivers are critical to the humanitarian response, but their own needs are often severely overlooked. Research highlights that globally caregivers are experiencing high levels of trauma and stress symptoms and yet, overwhelmingly, caregivers feel their psychosocial wellbeing are not supported. International emergency and disaster response agencies have identified that staff burn out and the high-stress working environment is major challenges for staff, leadership, and the overall quality of program implementation. These findings suggest that when staff members are stressed, the quality of services provided to their beneficiaries is compromised. Caregivers are very often facing extreme, sometimes even life threatening, work conditions with minimal to no opportunities for relocation.  They face crises every day as they work long hours to provide services to their vulnerable beneficiaries, leading to lower mental health functioning and higher burn out.

Playing to Live (PTL) and TPO-Uganda seek to fill this dire need for increased mental health and psychosocial support (MHPSS) services for front line staff in emergencies and crises through an innovative care for the caregiver (CFC) pilot program. This pilot program will support the MHPSS needs of national and refugee staff working in Uganda’s South Sudanese refugee crisis. This innovation will support caregivers through culturally appropriate workshops, support groups, and individual psychosocial services. Key topics will include but are not limited to self-care, coping techniques, debriefing, peer-support, and overall wellness support. Results are expected to include decreased stress, increased coping skills, and increased knowledge and capacity to advance their ability to provide care to their beneficiaries.

Additionally, this project seeks to address the paucity of research on this area and identify best practices for a global scale. We hypothesize, “If caregivers receive MHPSS services specific to their needs, the quality of service provision to their beneficiaries will increase.” If proven true, a large-scale campaign will be established to provide caregivers more MHPSS support.  We believe the impact of this innovation will have a multifaceted impact on humanitarian development.

A Care for the Caregiver program is not an entirely new concept, but research and evidence-based practices are virtually unknown leaving practitioners and facilitators with little guidance. Our solution aims to build a program that will lead globally in understanding best practices for supporting the mental health and psychosocial support needs of this important population, with research to support the reason for why these programs are so vital. This innovation will additionally look at longer term behavioral programs as opposed to one off trainings. 

We will provide the Care for the Caregiver program to frontline workers providing services in remote and hard to reach areas across Ugandan refugee settlements. The expected target settlements, Bidi Bidi, Rhino Camp, and Adjumani, require long commutes to get to and often have limited access to resources. Technology will be essential to send training modules, activity outcomes, supervision handouts, and beyond so that the development and implementation team remain in communication.

Within the next 12 months, we will have developed and tested this program with 50 staff for a six month implementation. The development process will involve building community collaboration, engagement, and buy in. The pilot will have a comprehensive qualitative and quantitative research plan. Together this 12 month process will allow us to complete the prototype phase.

Following the implementation of the prototype process, we will complete a full-scale pilot and program implementation. We will work collaboratively with national and international aid organizations to grow this program across Ugandan refugee settlements over the next three years. The program's beneficiaries will become the program facilitators, which will allow for fast and effective growth across aid organizations allowing for increased support to participants. The results and process evaluation will be disseminated globally in order advocate and allow for feedback. We will seek to implement a culturally and contextually adapted program in two other contexts within five years.

We have established a strong partnership with TPO-Uganda and connections with key organizations in Uganda currently working within the targeted refugee settlements for this project. This innovative Care for the Caregivers program will work with field workers from the organizations that we are currently aligned with including TPO to provide high-quality services to beneficiaries. Through these strong collaborations, beneficiaries will be actively engaged and retained during the extent of the program and beyond. The goal of this work is to build a program that matches the culture and community needs and to empower community members through a behavior change initiative. 

The Playing to Live team is comprised of clinical mental health professionals and public health professionals. This team specializes in expressive arts therapy and evidence-based mental health practice. Additionally, we are global mental health professionals who specialize in building programs that target the psychosocial and mental health needs of low resource communities. TPO-Uganda is one of the leading mental health organizations working within the refugee crisis comprised of psychologists, researchers, and social workers. They are active leaders and innovators in this crisis situation and are knowledgeable about the cultural and mental health needs of the frontline workers as beneficiaries. 

Following the successful prototype and pilot implementation of this project, TPO and PTL will use this program as a revenue source by charging organizations for the service, similar to TPO's model with their current one time training. This model will allow for an increased independence from donations and grants. The 'fee for service' will be determined based on the organization's size and ability to finance the services. Since the program's focus is to provide support within a resource limited environment, if an organization is unable to pay for the program, grants and donations will be sought. 

We believe in the rights of all humans. We believe that frontline workers are working to ensure that refugees are provided these basic rights. We believe in their work and believe in the importance of supporting these caregivers. We believe in our solution to support frontline workers MHPSS needs. We believe that this work is exponentially enhanced through the collaboration and support of a diversity of innovators and leaders. We seek to continue to expand our work and innovation and learn and grow from feedback and collaboration from SOLVE. We believe in SOLVE. 

We have obtained interest and commitment on an inter-agency level, but a key barrier at this stage is funding. In order to reduce the impact of this barrier, we have broken this project down into phases so that work can continue as we continue to seek funding. We are unable to begin this stage of our work until funding has been granted. Additionally, we would like to look at this project from an economic, health, and development process, and we currently are majority health professionals. We hope that SOLVE will open the doors to continue to build this interdisciplinary team.