Case Study: SH+ for refugee women in Uganda
CONTEXT AND NEEDS
In Rhino Camp settlement (northern Uganda), South Sudanese refugee women faced heightened psychological distress due to trauma, conflict and displacement. Access to mental health services was extremely limited. The WHO developed Self-Help Plus (SH+), a brief, group-based intervention meant to be delivered by briefly trained lay facilitators
PROGRAMME DESIGN
• Structure: Five weekly, two-hour group sessions (20–30 women per group), delivered via pre-recorded audio and supported by an illustrated self-help book (to accommodate low literacy), all conducted in Juba Arabic
• Content: Mindfulness-based ACT principles, including present-moment awareness, mindfulness grounding, acceptance of difficult thoughts, identifying personal values and self-compassion
• Facilitators: Selected locally (post‑secondary education), trained for roughly 8 days, supervised lightly to ensure consistency but requiring minimal resources
OUTCOMES & IMPACT
• Participants: 694 refugee women
• Psychological Distress: Significant reduction at 3‑month follow‑up
• Benefits: Improvements in depression, PTSD, explosive anger, functioning, subjective well‑being; consistent gains across different trauma histories and distress levels
• Acceptability: High participation rate (~83% attendance across sessions)
• Scalability: Demonstrated delivery feasibility via non-specialists using low-cost materials, ideal for crisis regions
FOOD FOR THOUGHT
1.In what ways did SH+ make sure the women felt safe and comfortable during the sessions?
2.What made SH+ possible to deliver to many people, even without a lot of money or resources?
3.Which ideas from SH+ could you also use when supporting migrants or refugees in your work?
MORE INFORMATION
• WHO Self-Help Plus (SH+) Manual – A step-by-step guide for facilitators delivering SH+ to help manage stress and support mental health in humanitarian settings. https://www.who.int/publications/i/item/9789240035119
• Research on SH+ with South Sudanese Refugee Women in Uganda – Study protocol describing how SH+ is used in real-life refugee camp settings.https://pubmed.ncbi.nlm.nih.gov/30128161/WHO
• News Story on SH+ – A short article explaining how SH+ reduced psychological distress and improved well-being for refugees in humanitarian crises.https://www.who.int/news/item/23-01-2020-guided-self-help-intervention-reduces-refugees-psychological-distress-and-improves-wellbeing-in-humanitarian-crises