Rebecca Horn

Self employed

Background Individual, social and environmental factors play a dynamic role in determining mental health outcomes. The linkage between mental health and non-communicable disease is widely noted, but the mechanisms are poorly understood. The current systematic review aims to identify common contributing factors linking mental health to non-communica...

We describe an effort to develop a consensus-based research agenda for mental health and psychosocial support (MHPSS) interventions in humanitarian settings for 2021-30. By engaging a broad group of stakeholders, we generated research questions through a qualitative study (in Indonesia, Lebanon, and Uganda; n=101), consultations led by humanitarian...

Purpose Growing evidence demonstrates that daily stressors such as family violence, unemployment, and living conditions play an important part in causing psychological distress. This paper investigates the impact of distressing events and day-to-day living conditions on psychological distress in the fragile context of Sierra Leone. Methods A cross...

Background Studies of psychological distress in Sierra Leone have typically used measures which were developed for use in other contexts, and which often have not been adapted or validated for use in Sierra Leone. This has resulted in a lack of reliable information about the patterns of psychological distress within the population, which is a barri...

Qualitative comparative analysis (QCA) is a relatively new method that examines causal complexity. Its use in mental health research is nascent. In low-income and fragile settings, with weak mental health service provision, identifying pathways of recovery from psychological distress can inform the appropriate deployment of scarce community and pub...

Background There is increasing global evidence that mental health is strongly determined by social, economic and environmental factors, and that strategic action in these areas has considerable potential for improving mental health and preventing and alleviating mental disorders. Prevention and promotion activities in mental health must address the...

Armed conflict and forced migration are associated with an increase in intimate partner violence (IPV) against women. Yet as risks of IPV intensify, familiar options for seeking help dissipate as families and communities disperse and seek refuge in a foreign country. The reconfiguration of family and community systems, coupled with the presence of...

Background: Conflict and displacement impact the social fabric of communities through the disruption of social connections and the erosion of trust. Effective humanitarian assistance requires understanding the social capital that shapes patterns of help-seeking in these circumstances - especially with stigmatised issues such as violence against wo...

Background Over recent decades there has been considerable mental health research in Sierra Leone but little on local conceptualisations of mental health conditions. Understanding these is crucial both for identifying the experienced needs of the population and utilising relevant community-based resources to address them. This study took a grounded...

Background Conflict and displacement impact the social fabric of communities through both the disruption of social connections and the erosion of trust. Targeted humanitarian assistance requires understanding the continuing forms of social capital that shape patterns of help seeking in these circumstances. This is especially pertinent with issues s...

Background: Conflict and displacement impact the social fabric of communities through the disruption of social connections and the erosion of trust. Effective humanitarian assistance requires understanding the social capital that shapes patterns of help seeking in these circumstances - especially with stigmatised issues such as violence against wom...

Psychological first aid (PFA) is a world-wide implemented approach to helping people affected by an emergency, disaster, or other adverse event. Controlled evaluations of PFA’s training effects are lacking. We evaluated the effectiveness of a one-day PFA training on the acquisition and retention of knowledge of appropriate responses and skills in t...

The myth of the 1-day training: the effectiveness of psychosocial support capacity-building during the Ebola outbreak in West Africa – ADDENDUM - Volume 6 - Rebecca Horn, Fiona O'May, Rebecca Esliker, Wilfred Gwaikolo, Lise Woensdregt, Leontien Ruttenberg, Alastair Ager

Introduction: Whilst there is some preliminary evidence for the benefits of sports-related interventions for survivors of torture, how sport and exercise can contribute to the rehabilitation of torture survivors needs to be better understood. Specifically, this paper aims to: 1) explore the ways in which a football group contributed to the wellbei...

Background In emergencies and resource-poor settings, non-specialists are increasingly being trained to provide psychosocial support to people in distress, with Psychological First Aid (PFA) one of the most widely-used approaches. This paper considers the effectiveness of short training programmes to equip volunteers to provide psychosocial support...

The Scoping review covered information available on the burden of mental health in Sierra Leone. It also identify existing official policies and strategies, and interventions designed and implemented, with respect to MHPSS with particular focus on (a) their evaluation, assessment, and current challenges in delivery and (b) their integration into th...

This qualitative study examined the “drivers” of intimate partner violence (IPV) against women in displacement to identify protective factors and patterns of risk. Qualitative data were collected in three refugee camps in South Sudan, Kenya, and Iraq (N = 284). Findings revealed interrelated factors that triggered and perpetuated IPV: gendered soci...

Freedom from Torture is a UK-based human rights organisation dedicated to the treatment and rehabilitation of torture survivors. The organisation has been working towards the development of a clinical outcome tool for a number of years, and the purpose of this paper is to (a) describe the process of developing the tool and the final tool itself, an...

The creation of ‘friendly spaces’ for women and girls has been a key strategy in the protection and empowerment of women and girls in South Sudan since conflict re-erupted in the country in December 2013. This document, developed by HealthNetTPO on behalf of UNICEF South Sudan, provides guidance on the aims of these spaces, and how they can best be...

Armed conflict causes massive displacement, erodes the social fabric of communities, and threatens the healthy development of a nation's future - its youth. Although more than half of the world's registered refugees under the age of eighteen currently reside in urban areas, research on the unique needs of and realities experienced by this populatio...

Introduction Intimate partner violence is one of the most commonly reported forms of violence against women and girls in humanitarian settings. Yet, it has received much less inquiry and lower prioritization from research and humanitarian communities than more public forms of violence, such as sexual violence perpetrated by armed actors. Objectives...

This paper explores the possibilities for agency in intimate partner violence (IPV) situations from the perspective of women in Sierra Leone and Liberia using focus group discussions (N groups = 14, N participants = 110) and individual interviews (N = 20). Findings identify multiple interrelated factors influencing the decision-making of women expe...

Background: The aim of this paper is to explore women's perceptions of the causes of intimate partner violence (IPV) in West Africa, and the ways in which they understand these causes to interact with the experiences of war. Methods: The study was conducted in two locations in Sierra Leone and two in Liberia, using focus group discussions (N gro...

Objectives. This study looked at police and non-police beliefs about offenders. It was hypothesized that police officers would have a more negative attitude than non-police officers towards offenders, and that female offenders would be viewed in a more positive way than male offenders. Police officers were expected to perceive greater differences b...

This paper describes the experience of those who have testified in the Special Court for Sierra Leone (SCSL), particularly in terms of the impact on witness security and emotional welfare. The SCSL is an international war crimes tribunal located in Freetown, Sierra Leone. Testifying in such a court has the potential to negatively impact on witnesse...

This paper explores how conditions of life in a refugee camp contribute to domestic violence. It draws on the 'nested ecological model' of domestic violence (Dutton 2001), which integrates individual and family factors, socio-economic context, and culture. Displacement depletes the resources available to refugees at each of these levels. Eighteen f...

This study explores the emotional problems affecting refugees in Kakuma refugee camp (northern Kenya). The freelisting technique was used to interview 52 community members and 32 ‘key informants’. Freelisting was found to be useful in this setting, and provided information which could assist with advocacy, programme planning and programme evaluatio...

The success of interventions to address psychosocial issues depends on e¡ectively identifying areas in which assistance is needed, and measuring whether the intervention is providing that assistance. This study evaluates one attempt to develop a locally meaningful assessment of emotional wellbeing (the Kakuma Emotional Wellbeing Interview or KEWI)...

Intimate partner violence (IPV) has been recognised as a significant problem amongst forcibly displaced communities, and great progress has been made by the United Nations High Commission for Refugees (UNHCR) in responding to IPV and other forms of sexual and gender based violence. However, they have not always effectively engaged refugee communiti...

Displaced communities respond to the challenges and losses of their changed circumstances by drawing on their remaining resources.The challenge for those working in such contexts is how to e¡ectively combine these community initiatives with their own organis-ational resources.This paper reports a study of 112 residents of four camps for internally...

This study is concerned with the relationship between witnesses testifying in the Special Court for Sierra Leone and their legal teams. Other research conducted with witnesses in international war crimes tribunals suggests that this relationship has a significant impact on the experience of such witnesses. A structured interview was administered to...

The research described in this article investigates the extent to which witnesses who testified in the Special Court for Sierra Leone (SCSL) report the experience as positive or negative. It also seeks to identify the factors that contribute to these evaluations. It reports the results of structured interviews conducted with 171 witnesses who testi...

This paper reports the findings of an interview study of 144 victim-witnesses who testified in the Special Court for Sierra Leone (SCSL). Witnesses expressed satisfaction with the preparation they received for testifying from their lawyers, particularly appreciating emotional support, as well as practical preparations. Victim-witnesses generally ev...

This case study describes the use of the IASC Guidelines on Mental Health and Psychosocial Support in Emergency Settings in Jordan. The fieldwork was carried out 17-27 August 2008 in Jordan and involved discussions with representatives of humanitarian organisations and UN agencies in Amman and Zarqa. This paper describes the ways in which the guide...

With the goal of better understanding some of the psychological factors related to refugees’ desire to return home, surveys were administered to 235 South Sudanese refugees living in the Kakuma Refugee Camp in Kenya. Respondents were asked about how much they wanted to return to Sudan, their emotional reactions about returning, their views on the p...

This chapter discusses the impact-moral, emotional, psychological, and behavioral-of long-term stays in refugee camps. It also attempts to identify those factors that lead refugees to stay for years at a time in camps and suggests some solutions, such as protecting their freedom of movement and enabling their speedier integration into host country...

This study analysed the information contained in 6,972 pre-sentence reports. The allocation of cases was found to be influenced by gender: male probation officers were allocated more male clients, and female officers more female clients. Male and female officers also seem to be allocated cases with different types of current offences, but with simi...

The aim of this study was to report on the evaluation of an attitude scale for General Dental Practitioners (GDPs) and Dental Auxiliaries/Professionals Complementary to Dentistry (PCDs), to determine the reliability of the scale with these two groups and to note any inter-group differences. Seventy-four GDPs and 89 PCDs completed the self-administe...

This paper is concerned with the position of women researching male dominated environments; in particular, the police. Although the ideal response to such situations is to spend time negotiating an effective role for oneself, this is not always possible. The researcher often has to work with the perceptions of her held by the researched, and it has...