Introduction Key Definitions Terminology Literature Review Frameworks Ensuring Inclusion Tools, Resources, and Annexes Group Pull-outs
Introduction
There is a growing recognition that we have a global mental health crisis that demands a multisectoral and coordinated response to promote mental health and psychosocial well-being, prevent mental health needs from escalating into mental health conditions, and make sure the care and treatment of mental health are accessible and relevant to the stated mental health challenge, while maintaining a high standard of care.
Marginalized and underrepresented communities often experience greater mental health symptoms or need due to political, social, and economic exclusion in host countries and countries of origin. Limited access to care these groups experience in their communities due to the same factors, including the stigma of mental health, further complicate this reality. This toolkit will complement existing materials and resources by focusing on marginalized and underrepresented communities’ mental health, exploring specific considerations for assessing their mental health needs, and facilitating access to Mental Health and Psychosocial Support services, including identifying those that are culturally and contextually relevant and responsive to their stated mental health needs.
Why is this toolkit needed?
In 2020–2021, the United States Agency for International Development (USAID) commissioned YouthPower2: Learning and Evaluation (YP2LE) to develop Integrating Mental Health and Psychosocial Support into Youth Programming: A Toolkit (briefly, Youth MHPSS Toolkit). This new toolkit is a complement and an accompaniment to that first toolkit, establishing guidance and tools for working with marginalized and underrepresented communities, inclusive of youth in those communities, around the globe.
This toolkit supports the implementation of USAID’s YouthPower toolkit, the Youth MHPSS Toolkit, by focusing on what is needed to make sure marginalized and underrepresented youth communities are able to access quality MHPSS programs that are responsive to their stated mental health needs and culturally and contextually relevant. The Youth MHPSS Toolkit explores ways USAID programs can support marginalized and underrepresented communities with mental health or psychosocial needs in countries where USAID is present, including conflict-affected areas. USAID can achieve inclusive development by making sure we address mental health needs, especially as we work to advance programming for marginalized and underrepresented communities. The toolkit was developed with the USAID Program Cycle in mind and helps provide recommendations for implementing partners and USAID staff.
Who is the intended audience?
This toolkit, developed under YP2LE, is a reference for USAID Mission and headquarters staff, as well as national and international partners involved in designing, managing, and evaluating MHPSS programming and strategies for youth.
What are the intended contexts and populations?
The toolkit is for MHPSS programming for marginalized and underrepresented groups and those in vulnerable situations in both LMIC and humanitarian contexts. It helps the user select the right tool(s) given their implementing context, project time frame, and the target population’s needs, which should always drive the selection of MHPSS interventions, services, and activities. This toolkit applies USAID’s inclusive development approach to MHPSS for marginalized or underrepresented groups to provide helpful guidance, tips, and resources on where to start and how to program effectively. Because many of the tools developed for conflict-affected settings were created for humanitarian action, the toolkit may use the term humanitarian, but the materials are relevant to various contexts. The toolkit provides brief descriptions of the tools, noting what ages and/or populations the tools are intended for.
How will this toolkit help me?
The toolkit provides strategies and tools to design and implement MHPSS programs that secure inclusive development for marginalized and underrepresented youth in LMICs and conflict-affected areas. It explores ways USAID programs can support marginalized and underrepresented communities with MHPSS programming. The toolkit provides guidance and procedures for MHPSS programming by:
- Discussing mental health programming, including the most effective, evidence-informed, and evaluated programs specific to circumstances, and considerations for working with marginalized and underrepresented groups as identified through a review of gray and academic literature that “guides” users in development of MHPSS programming for marginalized and underrepresented groups (Section 2)
- Helping the user link their programming to relevant sustainable development goals and a human rights-based approach to mental health for marginalized and underrepresented populations, including relevant United Nations (UN) resolutions and instruments (Section 3)
- Linking back to the Youth MHPSS Toolkit YouthPower produced in 2021
How was this toolkit developed?
A team of consultants with professional background and expertise in MHPSS for each of the marginalized and underrepresented groups highlighted in the toolkit developed this resource. Each consultant conducted a literature review for their population and carried out consultations with implementing agencies, those with lived experiences, and global thought leaders in mental health. The YP2LE team designed this toolkit to complement, not replicate, the Youth MHPSS Toolkit that YouthPower produced in 2021. The team engaged members from marginalized and underrepresented groups through stakeholder consultations and reviews of the draft toolkit.
What are the main takeaways?
Main takeaways from this toolkit include:
- Mental health affects everyone: Every person has mental health, which can fluctuate from thriving to time-limited distress, chronic conditions, and severely disabling conditions that affect a person’s daily functioning. For those who are members of marginalized and underrepresented populations, it is not their inclusion in a marginalized or underrepresented group that contributes to mental health challenges. Instead, a wide range of factors affect their mental health—distressing events in everyday life, chronic abuse and neglect, a lack of positive coping mechanisms, including systematic and environmental factors such as discrimination and second-order impacts of marginalization.
- The importance of family and community: When supporting people from marginalized and underrepresented communities, it is important not only to support the individual but also their family system and community.
- Mental health can be integrated across sectors: Mental health programming is multi-sectoral and can be integrated across sectors. Thus, the principles conveyed in this toolkit can be applied across sectors.
- Common mental health challenges in marginalized and underrepresented groups include depression, suicide, substance misuse, and anxiety. These common mental health challenges are found within the general population; however, marginalized and underrepresented groups often feel excluded from mainstream mental health services and have a harder time benefiting from MHPSS services and treatments.
The online version is an abbreviated version of the full toolkit.