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Mental Health and Psychosocial Support Programme (MHPSS)

MIDRIFT HURINET in partnership with Danish Institute Against Torture (DIGNITY) is implementing a programme on Mental Health and Psychosocial Support in Nakuru County, Kenya. Our work on Violence Prevention has shed light on the problem of Gender-Based Violence (GBV) in the informal settlements of Nakuru County and the need for mental health and psychosocial support (MHPSS) in these communities. To respond to this need, MIDRIFT implemented three pilot phases aimed at strengthening access to MHPSS for individuals affected by violence.
Currently, the partnership is implementing a project whose overall objective is strengthening access to MHPSS services to survivors of GBV and other forms of violence in Nakuru County. The interventions have included the introduction of the Problem Management Plus (PM+) and Psychosocial First Aid (PFA) to provide basic Community Based Psychosocial Counselling and capacity building relevant department of Health staffs including Community Health Promoters to implement MHPSS activities.
The project takes advantage of MIDRIFT HURINET’S capacity and experiences related to the implementation of the PM+ and the PFA approaches gathered through the pilot phases. This is complemented with continued efforts to increase awareness on mental and GBV and strengthening of referral networks to ensure referrals of clients to appropriate holistic care both to the community health worker and to external structures offering relevant services such as specialized treatment, legal advice, and existing livelihood programmes. Furthermore, the present project plan to introduce a peer-to-peer system with the purpose of enhancing the empowerment of survivors to support their peers and claim their rights.

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The Problem Management Plus (PM+) Intervention)

This brief psychological intervention for adults applies an approach that we call Problem Management Plus (PM+). In addition to 2 assessment sessions, intervention sessions take place once a week for five weeks. All sessions are individual.
The intervention also allows for involving family or friends if this is what the client wants. The approach involves problem management (PM) (also known as problem-solving counselling or problem-solving therapy) plus (+) selected behavioral strategies. Hence the term PM+. In combining these strategies, this programme aims to address both psychological problems (e.g. stress, fear, feelings of helplessness) and, where possible, practical problems (e.g. livelihood problems, conflict in the family and so on).
PM+ aims to reduce problems that clients identify as being of concern to them. Given the briefness of this intervention, it will not deal with the full range of difficulties that someone may experience following adversity. As a result, it may be best used in addition to other appropriate supports. The IASC (2007) Guidelines on Mental Health and Psycho-social Support in Emergency Settings describe other relevant supports and services applicable to emergencies. PM+ is useful for a range of emotional problems. It does not involve diagnosing mental disorders, even though it is likely to help people with mood and anxiety disorders.
Throught the PM+ manual developed by WHO in partnership with World Vision, they use the term “problem management” rather than “problem-solving counselling”. This is because clients are likely to face many problems that may be difficult to solve. For example, they may have little or no control over problems, such as war, communal violence or chronic poverty. By using the term “management”, we hope that helpers and clients understand that when problems are challenging to solve there may still be ways to provide relief from their impact.


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