Components of Psychosocial Treatments for Perinatal Mental Health Problems in Conflict and Post-Conflict Settings: A Scoping Review.
TL;DR
A scoping review mapped the existing literature to identify core components, delivery methods, and structures of psychosocial treatments for PMHP in conflict and post-conflict regions, and examined how trauma and violence were addressed.
Abstract
Perinatal mental health problems (PMHP) are a critical public health concern, profoundly affecting mothers and their infants by impairing maternal well-being and mother-infant bonding. The burden is especially high in conflict-affected settings, where trauma, violence, and ongoing adversity amplify risk. This scoping review mapped the existing literature to identify core components, delivery methods, and structures of psychosocial treatments for PMHP in conflict and post-conflict regions, and examined how trauma and violence were addressed. Following Joanna Briggs Institute guidance, 150 studies were included, encompassing randomized controlled trials, observational studies, and intervention protocols from various conflict-affected contexts. Interventions varied widely in content and delivery, yet two overarching categories emerged: education/training and therapeutic components. Educational elements included psychoeducation, information on gender-based violence and human immunodeficiency virus, perinatal health education, and caregiving training. Therapeutic elements encompassed supportive counseling, cognitive techniques, behavioral activation, problem-solving, social support, goal setting, interpersonal skills, acceptance-based strategies, and mind-body practices. Some interventions incorporated creative modalities such as drama, music, video, vocational, or alternative therapies. Given shortages of mental health specialists and strained healthcare systems, most interventions used low-intensity models delivered by non-specialists. However, these interventions primarily focused on issues related to motherhood and childcare, while trauma-related psychological consequences, despite their salience in conflict settings, remained unaddressed. Moreover, ongoing violence and risks for mothers and infants were rarely considered in post-conflict interventions. Further research is urgently needed to develop trauma-informed, contextually adapted psychosocial interventions for perinatal mental health in conflict-affected regions.