Developing a mental health support package for women survivors of domestic violence and modern slavery in South Asia: a multiple methods design

Background Women survivors of domestic violence and modern slavery in South Asia face substantial harms to their mental health, but their advocates lack evidence-informed practice guidance on how they might support their well-being and address common mental disorders. In this synopsis, we summarise the development of a support package to help fill the gap. Our aim was to design a package of contextually appropriate interventions with which non-specialist providers could support the mental health of women survivors of domestic violence and human trafficking. Methods Our work involved a transdisciplinary group located in Afghanistan, India and Sri Lanka, with collaborators in the United Kingdom. To identify potential components of the support package, we reviewed existing guidelines, examined and undertook literature reviews and interviewed and held focus group discussions with survivors of domestic violence and human trafficking, service providers and academics. We convened multidisciplinary consultations and examined routine service data on support requirements. We considered our findings alongside published theory, developed a programme theory and articulated it in a package of support. Findings We developed a core support package and four locally adapted versions for caseworkers and field workers who support women survivors of domestic violence and human trafficking. Content areas include background information on domestic violence and modern slavery, trauma, socioecological influences, principles of counselling and ethics and confidentiality. The package includes advice on safety assessment and response to basic needs, mental health assessment, first aid, and suicide prevention, psychoeducation, crisis intervention, supporting mental health, problem-solving and goal-setting. It provides information on mental health assessment and distress reduction techniques, collaborative planning and review. Conclusions and future work We will continue to review the use of the package, networking with providers and survivors to allow iterative adaptation and improvement. We hope it will be useful, with adaptation for specific settings, for advocates and caseworkers in providing comprehensive and appropriate non-specialist support for the mental health of women survivors of violence in South Asia. Funding This synopsis presents independent research funded by the National Institute for Health and Care Research (NIHR) Global Health Research programme as award number 17/63/47.