4 - (SYM 125) MHPSS Systems Strengthening in the Time of War: Integration of the CETA System of Care Within International Medical Corps' Humanitarian Response in Ukraine

Background. Since the invasion in Ukraine, the United Nations Office for the Coordination of Humanitarian Affairs (2023) has reported 17.6 million people in need of humanitarian assistance with an estimated 9.6 million people (1) at risk of mental health issues, including acute stress, anxiety, depression, substance use, and post-traumatic stress. Common Elements Treatment Approach (CETA) is a transdiagnostic, CBT approach for treating mental health and psychosocial needs. The global mental health team at Johns Hopkins (JHSPH) conducted an RCT of CETA (2,3,4) among veterans and internally displaced persons in Ukraine showing the effectiveness of CETA to treat anxiety, depression, substance use, and post-traumatic stress disorder.

Methods/Design. JHSPH joined together with International Medical Corps (IMC) to provide psychosocial and mental health programming in the geographic regions of Kyiv, Bucha, Chernihiv, Odesa, Lviv, and Kharkiv. CETA was chosen due to its evidence and ability to address multiple problems across severity levels.

Results. To date, 37 social workers and psychologists received in-person training on the CETA psychosocial intervention and 16 were trained in full CETA. After the live trainings, providers received weekly peer-led CETA supervision with oversight from a CETA trainer to practice their newly learned skills and receive case consultations. A total of nine supervisors were trained in peer-led supervision and 5 supervision groups were formed across six regions.  IMC’s six MHPSS site coordinators were trained in safety, assessment, and referral to ease integration into the wider IMC MHPSS programming. We will highlight setting up a system of CBT interventions within a disaster setting in conjunction with an NGO, as well as present case studies of trainee challenges given the context.  We will also present the clinical learning trajectory across providers in Ukraine, and across elements of CBT. Finally, we will present qualitative results from the trainees on the CETA approach.

Conclusions. As CBT for comorbid disorders advances, data on trainee uptake of elements and integration into non-structured systems is critical. The set-up of an MHPSS system in a war context takes significant adaptations and requires balancing learning with prevention of provider burn-out. Feedback has shown that a flexible model addressing the range of severity and comorbidity in the context of conflict can not only provide clients with needed services but also provides stability and support for providers in times of uncertainty.