Humanitarian crises increase the burden of mental disorders due to exposure to traumatic events and ongoing daily stressors. Effective mental health and psychosocial support (MHPSS) interventions exist, but barriers and facilitators for scaling up those interventions are less understood. The study aim was to identify barriers and facilitators for scaling up MHPSS interventions for populations affected by humanitarian crises in low- and middle-income countries. A systematic review following PRISMA guidelines was conducted. Types of scale up were summarised, and barriers and facilitators analysed using the World Health Organization’s Expandnet framework of scaling up. Evidence quality was appraised using the Mixed Methods Appraisal Tool. Fourteen eligible studies were identified. Most described horizontal types of scale up, integrating services into primary and community care through staff training, task-sharing, and establishing referral and supervision mechanisms. Barriers were reported in a range of framework elements, but primarily related to those in the health system. The overall quality of studies were limited. Few MHPSS interventions in humanitarian crises appear to have been scaled up, and scaling up efforts were largely horizontal which challenges long-term sustainability. Greater focus should be on both horizontal and vertical scaling up, which should be accompanied by higher quality research.

中文翻译：

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在低收入和中等收入国家为受人道主义危机影响的人群扩大心理健康和社会心理支持干预措施的障碍和促进者：系统回顾

由于暴露于创伤事件和持续的日常压力下，人道主义危机增加了精神障碍的负担。存在有效的心理健康和社会心理支持（MHPSS）干预措施，但人们对扩大这些干预措施的障碍和促进者了解较少。该研究的目的是确定在中低收入国家扩大针对受人道主义危机影响的人口的MHPSS干预措施的障碍和促进因素。根据PRISMA指南进行了系统的审查。总结了按比例放大的类型，并使用了世界卫生组织的按比例放大的Expandnet框架分析了障碍和促进因素。使用混合方法评估工具评估证据质量。确定了十四项符合条件的研究。最多描述的水平放大类型，通过人员培训，任务共享以及建立推荐和监督机制，将服务整合到初级和社区护理中。在一系列框架要素中都报告了障碍，但主要与卫生系统中的障碍有关。研究的整体质量是有限的。似乎很少扩大针对人道主义危机的MHPSS干预措施，而扩大努力在很大程度上是横向的，这对长期可持续性提出了挑战。应将重点更多地放在水平和垂直扩展上，同时应进行高质量的研究。研究的整体质量是有限的。似乎很少扩大针对人道主义危机的MHPSS干预措施，而扩大努力在很大程度上是横向的，这对长期可持续性提出了挑战。应将重点更多地放在水平和垂直扩展上，同时应进行高质量的研究。研究的整体质量是有限的。似乎很少扩大针对人道主义危机的MHPSS干预措施，而扩大努力在很大程度上是横向的，这对长期可持续性提出了挑战。应将重点更多地放在水平和垂直扩展上，同时应进行高质量的研究。