Deconstructing Counselling: The Complexity of Psychosocial Support Services in Nakivale Refugee Settlement

This research analyzes the psychosocial social support component of Mental Health and Psychosocial Support (MHPSS) services in Nakivale Refugee Settlement. The objectives are (1) to define psychosocial support (2) to contextualize what services are being provided in Nakivale (3) to analyze what challenges exist for providing adequate support and (4) to discuss some strategies being employed by refugees and service-providers to combat these difficult circumstances. 56 semi-structured individual and group interviews and 2 focus group discussions were conducted to reach 96 respondents. This total includes Congolese, Rwandan, Burundian, Somali, and Ethiopian male and female refugees and organization representatives from the United Nations High Commissioner for Refugees (UNHCR), Office of the Prime Minister (OPM), American Refugee Committee (ARC), Medical Teams International (MTI), Tutapona, the Refugee Law Project (RLP) and Mental Health Uganda. The research highlights the interconnectedness of one\u27s surroundings and one\u27s mental-well being and importance of recognizing the overlap in service-provision. Psychosocial support services in Nakivale go beyond individual counselling, group therapy and psychiatric care to include livelihood assistance, material support (including food, non-food items and shelter) and protection. Hence, deconstructing a Westernized outlook on psychotherapy solely as counselling and medication is necessary for an analysis of psychosocial support in a refugee settlement. The research notes challenges to adequate service-provision to include logistical barriers, material barriers and cultural barriers.The analysis also recognizes strategies for combatting these challenging surroundings: employing a holistic approach, adopting community-based mechanisms for awareness, capitalizing on refugee leadership and using other culturally-based and contextuallyappropriate techniques during sessions and programs. Overall, psychosocial support services in Nakivale are operating in a a culturally-based framework, but one that is severely limited by lack of personnel and funding in a high-need area. The overlying recommendation is that if this material gap were to be addressed, the effective ethno-central counselling and de-centralized programs which exist could expand to reach and follow-up with more individuals