From healing to leading: a case study of a community-led mental health program for forcibly displaced people.
There are over 120 million forcibly displaced people in the world, with numbers steadily increasing. The majority of refugees and asylum seekers are displaced in urban settings with fragmented access to health services, and those living in countries without refugee protections face particularly dire circumstances. High rates of trauma exposure and related mental disorders persist alongside structural barriers to care, underscoring an urgent public health equity challenge. This community case study describes the Cope program, a refugee community-led mental health and psychosocial support (MHPSS) initiative implemented by the Refugees and Asylum Seekers Information Center (RAIC) in Jakarta, Indonesia. Using an apprenticeship model, community members transition from program participants to trained, supervised facilitators across three phases (n = 30 at baseline, n = 16 at endline). Pre- post-assessments using validated measures found significant reductions in depressive symptoms (52%), anxiety symptoms (50%), and Post-traumatic Stress Disorder (PTSD) symptoms (46%) from baseline to endline, with large effect sizes. These findings demonstrate that community-led, culturally grounded MHPSS programming can produce meaningful mental health gains among protractedly displaced populations in non-signatory countries. Beyond individual-level outcomes, the Cope model illustrates how Refugee-Led Organizations (RLOs) can serve as sustainable pillars of inclusive health system delivery-a critical consideration for governments, UNHCR, and global health actors working to advance universal health coverage for displaced populations.
Authors
Cohen Cohen, Yau Yau, Kennedy Kennedy, Saxby Saxby, Moarefizadeh Moarefizadeh
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