Violence and Mental Health in South Asia (VAMHSA)

Project Summary

Women survivors of violence in South Asia face substantial harms to their mental health, but advocates and care providers lack guidance on how best to support women’s wellbeing and address common mental disorders. This multidisciplinary group developed four context-specific, but adaptable support packages to guide improvements in the mental health of survivors of Violence Against Women (VAW), modern slavery, and civil conflict in resource-constrained settings in India, Sri Lanka, and Afghanistan.

Our Global Health Research, funded by the UK National Institute for Health and Care Research (NIHR), aimed to:

Identify candidate component interventions
Understand survivors’ mental health needs
Develop mental health and psychosocial support packages to fill existing service gaps
Determine the feasibility, acceptability, and transferability of care package components

Important commonalities exist between the mental health needs of survivors of VAW, modern slavery and conflict, with known implications for mental distress, particularly in the forms of depression, anxiety, post-traumatic stress, and risk of self-directed violence.

VAW describes physical, sexual, emotional, or economic intimate partner, domestic, and non-partner violence. Modern slavery describes forced marriage, forced labour and commercial sexual exploitation. It affects 40 million people worldwide with the greatest burden in Asia. Lastly, conflict - amidst discriminatory gender norms - has exposed a majority of women to abuse, trauma and poor mental health in countries worldwide, including Afghanistan and Sri Lanka. These forms of violence are gendered, culturally and generationally reproduced.

To develop our support packages, we:

reviewed existing guidelines
examined and undertook literature reviews
engaged with survivors of violence and modern slavery, service providers, and academics
convened multidisciplinary consultations
examined routine service data on perceived support requirements
reviewed findings against published theory, and
developed a programme theory for support

This programme theory was then articulated as a support package tailored to the needs of each context. Each version of the package can be found in Resources, alongside publications related to the primary and review-based evidence generated by our group.

Key Project Information

Dates: April 2018 – September 2022

Status: Completed

Principal Investigator: Prof Delan Devakumar

Partners: Sangath, Goa; Society for Nutrition, Education & Health Action (SNEHA), Mumbai; University of Colombo, Colombo; London School of Hygiene and Tropical Medicine; King’s College London; University of Nottingham; St George’s, University of London; Sri Lanka; Institute for Health Policy (IHP)’, Afghanistan; Humanitarian Assistance for the Women and Children of Afghanistan (HAWCA)

Location: India, Sri Lanka and Afghanistan

Funding: The National Institute for Health Research (NIHR)

Contact: d.devakumar@ucl.ac.uk