Abstract:
Higher prevalence rates of mental health problems have been found in areas affected by armed conflict among children. To mitigate the impact of war on children’s mental health, studies have identified strong evidence of a buffering effect for a range of systemic factors, such as social support, family functioning, and community cohesion. International guidelines for mental health and psychosocial support promote the need to include these factors in interventions, in order to holistically address the social ecology of the child. Despite this, no know study has systematically reviewed the evidence-base for systemic psychosocial interventions. This review aims at examining the effectiveness of systemic family, school and community based interventions for children affected by war. A systematic search was conducted using 3 databases. Comparable studies underwent a meta-analysis, and the remaining studies findings were analyzed using a narrative synthesis. This review included 15 studies of family, school and community based interventions in low-, middle- and high-income countries. Results of the meta-analyses showed that school-based interventions significantly improved depressive symptoms, but no significant improvement was found for anxiety. The narrative synthesis found mixed results whereby school-based interventions in some studies showed to be effective in reducing PTSD, functional impairment, and other symptoms, while other studies did not show any significant effect for the same outcomes. Similar results were found for different moderators. Despite preliminary effectiveness of systemic interventions for child and adolescent mental health in conflict-affected settings, gaps in quality and quantity of evidence remains and should be targeted in future research.
