Applying the Interpersonal Framework to the Mental Health Experiences of Urban Internally Displaced Persons in Mozambique.

OBJECTIVE

Internally displaced persons (IDPs) are at high risk for mental disorders, yet few have access to treatment. In northern Mozambique, a violent insurgency has displaced more than 1 million people to neighboring provinces. In this qualitative study, the authors explored how interpersonal counseling (IPC), an evidence-based intervention for common mental disorders currently being scaled in Mozambique, could be tailored to the psychosocial needs of IDPs.

METHODS

Six focus groups and five in-depth interviews were conducted with stakeholders (N=53), including IDPs, community leaders, program implementers, and humanitarian organization representatives. A thematic codebook was developed, refined, and applied to all data. The four problem areas of the interpersonal framework-grief, life transitions, interpersonal disagreements, and loneliness-guided the analysis to inform IPC adaptation.

RESULTS

Three of the four problem areas (grief, life transitions, and interpersonal disagreements) were relevant to this population, although they often co-occurred and intersected, complicating identification of a single focal problem area-a core element of IPC. Grief was pervasive but often ambiguous when loved ones were missing, creating tension between mourning and hope. Role transitions were also salient: many mothers faced sudden single parenthood, and adolescents left school to assume adult responsibilities. Disagreements between IDPs and local residents were also common.

CONCLUSIONS

The interpersonal framework was highly relevant for IDPs, although adaptation may be required to address overlapping and context-specific challenges of displacement.