Introduction Key Definitions Terminology Literature Review Frameworks Ensuring Inclusion Tools, Resources, and Annexes Group Pull-outs
Ensuring Inclusion
This toolkit was designed to complement, not duplicate, the Youth MHPSS Toolkit. Therefore, the two resources should be used in tandem when designing MHPSS interventions. To support use of these tools together, please see the following that highlights which resource to go to and where:
- Multisectoral Integration: The sector pullout from the Youth MHPSS Toolkit provides illustrative presentations of how MHPSS programming has been integrated into education; gender and GBV; health; violence prevention, peace, and security; and youth employment.
- Population Deep Dives: The MHPSS Toolkit for Marginalized and Underrepresented Groups includes pullouts that discuss the literature and lessons from the field specific to each group: LGBTQI+ people, persons with disabilities, victims of torture, and Indigenous Peoples.
Assessment: Identifying and Understanding the MHPSS Needs of Marginalized and Underrepresented Populations and Designing Program Objectives
Assessing the MHPSS needs of marginalized and underrepresented populations is essential for designing effective programs that address their unique challenges and promote their well-being. Conducting a comprehensive needs assessment to gather data and insights about the specific MHPSS needs of marginalized and underrepresented groups in the local communities is a prerequisite for robust, human-centered MHPSS interventions. The assessment should include both quantitative and qualitative methods, such as surveys, interviews, focus group discussions, and observation. It should explore various dimensions, including cultural, social, economic, and political factors that influence mental health and psychosocial well-being.
It is important to make sure that assessments are conducted in a way that captures the mental health needs of local marginalized and underrepresented populations and can inform mental health programming in the development context. The assessment phase should guide how key mental health concepts are adapted for the local population, what terminology should be used, and how people describe mental health and psychosocial concerns. For more information on do no harm considerations, please see the complete toolkit.
Contextualizing and Adapting MHPSS for Marginalized and Underrepresented Groups
Contextualizing and/or adapting MHPSS programming requires community-informed and intersectional approaches. Youth from marginalized and underrepresented groups, and non-youth stakeholders, should be provided with opportunities to engage in iterative program contextualization and cultural adaptation activities as part of supporting local ownership of MHPSS programming. Youth in marginalized and underrepresented populations comprise diverse individuals and groups whose experiences of mental health inequities are shaped by their intersectional identities. This involves aspects of age, race, color, sex, sexual orientation, gender identity, disability, ethnicity, Indigeneity, language, social origin, religion, migration status, survivorship, and other social categories. Individual youth with multiple marginalized and underrepresented identities may face overlapping or compounded social systemic risks for distress, traumatic experiences, and mental health conditions. Different youth have different needs.
Culture bias—interpreting, judging, or acting based on one’s own cultural standards—can occur in MHPSS through the unchecked use of presumed universal categories (e.g., youth, community, risk), as well as through the implementation of standardized interventions or tools with little or no consideration for local communities’ cultural ways of expressing wellness and distress or engaging in self-help and mutual support. Contextualization helps to mitigate cultural bias and avoid the use of culturally inappropriate interventions that can cause unintended harm.
Context drives adaptation: Adaptation is the process of developing a new version of a program strategy, intervention, or tool to make it more suitable to the context where it will be used. For more information on do no harm considerations, please see the complete toolkit.
Selecting Evidence-Based Interventions
Inclusive development’s principle of “Nothing about Us without Us” means that marginalized and underrepresented groups are key participants in the design process (selecting interventions, project locations, and key partners), because they can make sure interventions are relevant, acceptable, effective, and responsive to their needs. This section includes criteria for selecting evidence-based interventions, discussions of what works in MHPSS program design, and resources.
Once you select the intervention, tailor it for the local population. When necessary, make adaptions or changes to secure equitable inclusion. This requires adapting the interventions to the unique circumstances of the target group. Make sure all interventions are inclusive, respectful, and promote empowerment and resilience within the community. For more information on do no harm considerations, please see the complete toolkit.
Inclusion of Marginalized and Underrepresented Populations in MEAL Systems for MHPSS Programming
Use the following key considerations for securing inclusion for marginalized and underrepresented groups within MHPSS monitoring, evaluation, adapting and learning (MEAL) systems alongside the MEAL guidance provided in the Youth MHPSS Toolkit:
- Adapt indicators: The IASC Common M&E Framework for MHPSS in Emergency Settings (version 2.0) includes specific guidance on adapting indicators to reflect program participants. The table presented below is an application of the guidance provided in the IASC Common M&E Framework, using standard indicators from the IASC Common M&E Framework and UNICEF’s MHPSS Framework.
- Disaggregate the data: When appropriate, data should be disaggregated to reflect representation across marginalized and underrepresented groups. However, this may be difficult in contexts where membership in a particular group carries legal consequences. The safety and protection of program participants should always be the priority.
- Conduct an inclusive development analysis: Inclusive development analyses should be conducted to identify marginalized groups and their needs, including mental health and psychosocial needs. For more information see USAID’s Guide to Inclusive Development Analyses.
- Secure disability analysis: MEAL systems should integrate disability analysis in multisectoral and interagency assessment to make sure all members of the community have access to MHPSS programs, including persons with disabilities.
- Disseminate findings: Publishing program evaluations, research articles, and implementation science findings is how programs contribute to strengthening the evidence base, which results in improved evidence-based programming for marginalized and underrepresented groups. Findings should also be shared directly with marginalized and underrepresented groups and the organizations that service them in language that is accessible.
For more information on ensuring inclusion during the USAID Program Cycle, including budgeting and staffing, please access the toolkit below.