Most Significant Change in conflict settings: staff development through monitoring and evaluation

Capoeira4Refugees is an NGO that uses the Afro-Brazilian art-form of Capoeira to promote psychosocial well-being in children affected by conflict and occupation. Capoeira4Refugees introduced the Most Significant Change (MSC) methodology to monitor and evaluate project implementation and impact across two locations in the Middle East. Analysis of interviews conducted with five field staff revealed that in line with, and building on previous research, MSC became an empowering tool that led to staff development. The potential for MSC to build staff reflexivity, independence and leadership has implications for other organisations working in conflict areas, particularly in situations of remote management.

Are mental health staff getting better at asking about abuse and neglect?

This study ascertained the extent to which abuse and neglect are identified and recorded by mental health services. A comprehensive audit of 250 randomly selected files from four community mental health centres in Auckland, New Zealand was conducted, using similar methodology to that of a 1997 audit in the same city so as to permit comparisons. Significant increases, compared to the 1997 audit, were found in the rates of child sexual and physical abuse, and adulthood sexual assault (but not adulthood physical assault) identified in the files. Identification of physical and emotional neglect, however, was poor. Male service users were asked less often than females; and male staff enquired less often than female staff. People with a diagnosis indicative of psychosis, such as ‘schizophrenia’, tended to be asked less often and had significantly lower rates of abuse/neglect identified. Despite the overall improvement, mental health services are still missing significant amounts of childhood and adulthood adversities, especially neglect. All services need clear policies that all service users be asked about both abuse and neglect, whatever their gender or diagnosis, and that staff receive training that address the barriers to asking and to responding therapeutically to disclosures.