“My home is (now) at peace”: Evaluating the relevance, acceptability and potential scalability of a guided self-help intervention for male refugees in Uganda

In humanitarian crises, male refugees face significant mental health challenges, including high rates of depression and alcohol misuse. However, access to adequate mental health services is limited. In this study, we evaluate a combined intervention that addresses both mental health and alcohol misuse among male refugees in Uganda, focusing on its relevance, acceptability, and potential for scalability. We conducted a qualitative study, using process evaluation data, to evaluate a combined guided self-help intervention for mental health and alcohol use among male refugees in Uganda's Rhino and Imvepi camp refugee settlements. We used thematic network analysis to identify themes related to relevance, acceptability, and potential scalability. 28 in-depth process evaluation interviews were conducted in total. Participants included male South Sudanese refugees who had received enhance usual care, or SH+ only or SH+ and ASSIST-BI combined. Family members of the participants and intervention facilitators were also interviewed. Results highlighted the intervention's relevance, emphasising the need for participants to be providers and productive citizens. Acceptability was underscored by a sense of community and social acceptance, particularly evident in SH+ group sessions. Facilitators noted that the intervention format was key to scalability, despite barriers such as competing priorities and resource limitations. These results highlight the importance of addressing mental health and alcohol misuse simultaneously, demonstrating the combined intervention's relevance, acceptability and scalability. We emphasise the need for a comprehensive approach that integrates additional support mechanisms, such as livelihoods, to enhance overall impact while preserving the interventions core components. This broader understanding is important for developing effective and sustainable solutions in similar humanitarian contexts.