Improving Mental Health Services for Survivors of Sexual Violence in the DRC

Abstract:

This case explores the implementation and evaluation of mental health treatment for victims of conflict-related gender-based violence (GBV) in the Democratic Republic of the Congo (DRC) by the International Rescue Committee (IRC), a humanitarian organization based in New York City. Following the contextual background, the case traces the IRC’s work developing a psychosocial support program for GBV survivors starting in 2002. When the Applied Mental Health Research Group (AMHR) at Johns Hopkins University Bloomberg School of Public Health evaluates the program in 2008, the IRC begins to consider the potential for its work to inform similar interventions. In 2011, the IRC team collaborated with AMHR to implement two concurrent randomized control trials (RCTs): one on the mental health effects of Cognitive Processing Therapy (CPT) and the other on the mental health and financial impact of a social and economic empowerment intervention called the Village Savings and Loans Association (VSLA). While the time and resources that went into completing the trials expanded the monitoring and evaluation capacity within the IRC and added important evidence to the lean body of global mental health literature, conducting the studies stretched the IRC’s local staff thin and required clarification of priorities and purpose. Had the RCTs had been worth it, and for whom? How could the study findings contribute to improving services for vulnerable populations in the region and beyond? 

Teaching Note available through Harvard Business Publishing.

Theory of Change for VSLA
Source: Study of Effectiveness of a Social-Economic Intervention for Sexual Violence Survivors in Eastern DRC, November 2014.
Theory of Change for CPT
Source: Group Cognitive Processing Therapy: A Specialized Mental Health Intervention that Supports Improvements in Well-being for Sexual Violence Survivors. Johns Hopkins Bloomberg School of Public Health, International Rescue Committee.

Learning Objectives: A productive class discussion will allow students to appreciate the challenge of meeting human resource needs to provide mental health care, the complexity of implementation and empirical study of mental health services, and the ethics and challenges of conducting randomized controlled trials in conflict settings.

Keywords: public health, human resources, health care delivery, information management, mental health, scale-up, resource-limited settings, health care policy, data collection, public administration

Acknowledgements: This case was prepared with assistance from Kelly Holz.
Last updated on 01/24/2018