Outcomes of integrating livelihood into mental health and psychosocial support program among survivors of torture: A mixed-method study from western Nepal.

INTRODUCTION

From 1996 to 2006, Nepal experienced a decade-long armed conflict that adversely impacted survivors of torture. The conflict posed threats to various facets of their lives, such as men-tal health, socio-economic status, human rights, and the process of reintegration into their original communities. This study was done with the survivors of torture from the armed conflict.

OBJECTIVE

This study aims to generate evidence on the impact of livelihood support (supporting individuals with earning their livelihood through business development, farming/animal husbandry and mi-cro-entrepreneurship) upon mental health and psychosocial wellbeing as well as social empower-ment of survivors of torture.

RESULTS

In total, 44 out of 46 torture survivors reported improvement in their mental health and psychosocial well-being after the livelihood intervention was instituted. Significant reduction in the severity of symptoms of depression (21.7% to 2.3%), anxiety (15.2% to 6.8%), and post-traumatic stress disorder (44.4% to 4.5%) was observed with medium to high effect size. Similarly, improvement in social relationship, economic status, and autonomy (increase in self-confidence and motivation) were noticed post-intervention.

DISCUSSION AND

CONCLUSION

Our study concludes that the livelihood intervention has significantly contributed to economic uplift, improved mental health, psychosocial well-being, social empowerment and quality of life among the survivors of torture. The data provide preliminary evidence of positive outcomes from integrating a livelihood program into an MHPSS (Mental Health and Psychosocial Support) program. Although the lack of a control group prevents us from isolating the specific impacts of the livelihood program, our qualitative data indicate that the intervention is well-received, culturally rel-evant, and promising. The study has yielded certain recommendations for further research.