Example 2

Capacity-Building for > 500 trainees 10% Human Resources 39% Financial Resources Comprehensive PSS MH Case Management for > 6700 Beneficiaries 43% Human Resources 27% Financial Resources Community Based PS Outreach & Psychosocial Center / Safe Spaces for > 1900 Beneficiaries 40% Human Resources 27% Financial Resources Transition to national partner organization Assessment Management Supervision Coordination Monitoring Evaluation Documenation 7% HR & Financial Resources Staff Stress Counseling Mainstreaming PSS MH into other sectors

 Approach: BPSS, PH, Ecological, ADAPT model Guidelines: IASC, PH and CM models & (standards), AGDM, CBA, CM approach: combination broker & intensive - Identification and Assessment  Definintion: - Links clients to PSS MH service systems, helps to navigate the system purpose:- Coordinates access to, and delivery of, various PSS MH care services - Client-centered, comprehensive, culturally sensitive, participatory and community-based - Facilitate transfer between layers, continuity of care, step care approach - Integration of support and service systems - Monitors access & availability of support and services, evaluates impact of services & quality

 Identification  PSS MH Assessment  Referral  Match PSS MH + needs to  Available assistance, support systems and services  If possible Follow up  Corresponds to 4W code 9.3

 Staffing: PSS MH Case managers doing purely case management primarily in a broker function and basic counseling if necessary intensive CM  Location: in polyclinics, PhCs in areas with identified high needs  Training: 3 months theoretical training and shadowing 3 months on the job training and follow up Integrated supervision and continuous training  Supervision: Regular clinical individual and group supervision

 Beneficiaries: Refugees and displaced (all ages), free  Services provided:- Counseling (in clinic, outreach, phone hotlines) - Intake, scheduling, reception - Comprehensive assessments, home visits - Joint service plan with clients based on goals - Referrals to all possible support and services - Coordination and follow up with services - Mapping of support and services - Follow up with client and outcome evaluation - Training (Identification, Referral, PFA to referral partners), Awareness raising, Advocacy

 Number of Beneficiaires: per month  Benchmarks: Performance, Case load and service, catchment area access index  Monitoring and Evaluation: Mixed method (quantitative, qualitative)  Methods/Tools- Idioms based measure, K10, Res 2, FGs, WHO/UNHCR tools, CM evaluation  Results- Significant improvement in WB & MH - CM satisfaction tested  Mobility / Outreach:Home visits and link to community outreach volunteers  Link to other servicesBasic needs, protection, PS support /sectors: and Specialized services  Costs:

Textbook format including:  Approach  Complete Procedures and Process  Forms

1. What does it mean to be a Refugee? Introduction to UNHCR 2. PSS concepts and multilayered response 3. Introduction to IASC guidelines, Overview case management system acc. to multilayered system 4. PFA 5. PFA for children 6. Identification Training 7. Principles of Communication 8. Ethical considerations in PSS MH care for refugees 9. General introduction to case management and case management routines 10. Introduction to phone counseling 11. Introduction to comprehensive PSS MH assessments 12. Interviewing skills

13. Dealing with difficult cases (suicidal and aggressive) 14. Introduction to programme referrals 15. Introduction to home visits 16. Introduction to monitoring and documentation systems 17. Introduction to the Community Outreach Programme and Community Based PSS 18. General introduction to mental health and mental disorders  Introduction to Mood disorders  Introduction to Anxiety disorders  Introduction to Adjustment disorders  Introduction to Somatoform disorder  Introduction to Psychotic disorders  Introduction to Seizures and epilepsy  Overview of management of mental disorders

 Identification and referral quality matters since it helps prioritization  Initial response to high priority cases  Settings matters for using goal formulation as evaluation tool  Benchmark ratio staff : beneficiary matters for ensuring follow up  Qualified monitoring matters for documentation quality  Shortcomings:  Understanding MH CM as a process  Quality monitoring of referral services  Proper Follow up  Defining Closure  Benchmark and M&E standards

 Group 1: PSS MH Case Management Providers  Group 2: Organizations referring to PSS MH Case Management  Group 3: Organizations providing Case Management other than PSS MH Case Management (e.g. CP, GBV CM) AIM  Agree on a common language  Agree on principles  Inform discussion on best practice

 Why are you interested in PSS MH Case Management?  Does your organization provide PSS MH Case Management?  What is the approach and definition?  What are the services / activities involved?  Does your organization refer to PSS MH Case Management?  Whom do you refer?  What do you expect?

 Approach to & definition of CM  Staffing, structure of team, roles  Location / Structure  Training (Length, Content, Theoretical, Practical & On the Job)  Supervision  Beneficiaries, Fees, Services provided & referrals  Number of Beneficiaires over a period  Benchmarks  Assessment, Monitoring and Evaluation  Method  Results  Mobility / Outreach  Link to other services / sectors  Costs  Materials developed What and why

 Who else is working on Mental Health Case Management – MH CM (approaches, experiences, results, materials developed)?  Would the products, materials developed by IMC and UNHCR be of interest to others and in which form?

 Would it be good to compare between different programs in a more structured way to describe and explore? 1. What has been done (according to a format) and why (across 4-5 different programmes) 2. Similarities and differences 3. Strengths/challenges or advantages and disadvantages 4. Lessons Learnt

Group discussions 1) 1) Format for MH CM programme description (e.g. approach, definition, staffing, beneficiaries, services, training, M&E, benchmarks, costs) 2) 2) Dimensions and Questions for comparison across different programmes 3) 3) Possible ways and process to facilitate comparison, discussion and documentation (how, who, where, when?)

 Approach  Staffing  Location / Structure  Training and Supervision  Services provided  Number of Beneficiaires  Monitoring and Evaluation  Method  Results  Mobility / Outreach  Link to other services / sectors  Costs  Materials developed Programme 1Programme 2Programme 3 Explain why the program was developed in this way within this context Lessons learnt perceived advantages and disadvantages Compare across programmes Identify best / good practices criteria and apply within context  Approach  Staffing  Location / Structure  Training and Supervision  Services provided  Number of Beneficiaires  Monitoring and Evaluation  Method  Results  Mobility / Outreach  Link to other services / sectors  Costs  Materials developed  Approach  Staffing  Location / Structure  Training and Supervision  Services provided  Number of Beneficiaires  Monitoring and Evaluation  Method  Results  Mobility / Outreach  Link to other services / sectors  Costs  Materials developed

 What is a good approach for CM in which context?  What are benchmarks?  Beneficiaries – integrated vs. exclusive?  How much training and supervision is necessary for what?  How are CM programmes evaluated and what are the results?  Which materials exist that are interesting to share?

 Should we develop some guidance on (good) practice in MH CM?  1. Are there best/good practice criteria – do we need to discuss what is good / best practice?  2. Would it make sense to develop (further) some kind of best/good practice criteria within post-conflict, low resource settings?  3. What are example criteria?

 Presentations of different programmes according to jointly agreed structure  Preparing short papers  Discussion along jointly agreed questions and comparison dimensions  Extracting lessons learnt  Discuss best/good practice checklist/criteria  Documentation of workshop outcome in a joint document  Publication as best/good practice document

Best Practice: - Methods & techniques that, though experience and research, have consistently and reliably shown results superior, more efficient or more effective than those achieved with other means, and which are used as benchmarks to strive for - Based on repeatable procedures that have proven themselves over time for large numbers of people Good Practice: - More effective at delivering a particular outcome than most other techniques or methods when applied to a particular condition or circumstance - Ideally, with proper processes, checks, and testing, a desired outcome can be delivered with fewer problems and unforeseen complications  No practice that is best for everyone or in every situation  Commitment to using best practices is a commitment to using all knowledge & technology at one's disposal to ensure success