Mental health and psychosocial support interventions for populations affected by ongoing armed conflict: a scoping review

Introduction: Over 2 billion people worldwide are affected by ongoing armed conflict. The wide-ranging impact of conflict on populations’ mental health is well documented. However, less is known about the scope of mental health and psychosocial support (MHPSS) interventions implemented during periods of active armed conflict. This scoping review assesses the scope of published original articles and summarises existing evidence on MHPSS interventions for populations (civilians, internally displaced persons and veterans/ex-combatants) affected by ongoing armed conflict. It further outlines evidence gaps and proposed strategies to strengthen research and evaluation systems for MHPSS in these settings. Methods: The scoping review was conducted in accordance with the framework for scoping reviews described by Arksey and O’Malley (2005) and followed the guidelines for scoping reviews provided in the Preferred Reporting Items for Systematic reviews and Meta-Analyses, extension for Scoping Reviews (Tricco et al., 2018). Results: A total of 47 papers were included in the scoping review: 19 exclusively focused on children and adolescents, 14 exclusively on adults and 14 on both children/adolescents and adults. Across all population groups, only 12 papers investigated trauma-focused interventions. Many studies reported statistically significant positive outcomes in both adult civilians and ex-combatants with respect to decreased post-traumatic stress disorder, depression and anxiety symptomatology and improved psychosocial functioning, well-being and quality of life. Results were mixed in children/adolescents and when examining aggression, drug dependence and social/interpersonal skills in ex-combatants. Conclusion: The wide heterogeneity of research designs, results and clinical instruments used to assess changes in mental health and psychosocial outcomes across studies indicates the need for improved research standards when evaluating MHPSS interventions in ongoing conflict settings.