Applying the Interpersonal Framework to the Mental Health Experiences of Urban Internally Displaced Persons in Mozambique

OBJECTIVE: Internally displaced persons (IDPs) are at high risk for mental disorders, yet few have access to treatment. In northern Mozambique, a violent insurgency has displaced more than 1 million people to neighboring provinces. In this qualitative study, the authors explored how interpersonal counseling (IPC), an evidence-based intervention for common mental disorders currently being scaled in Mozambique, could be tailored to the psychosocial needs of IDPs. METHODS: Six focus groups and five in-depth interviews were conducted with stakeholders (N=53), including IDPs, community leaders, program implementers, and humanitarian organization representatives. A thematic codebook was developed, refined, and applied to all data. The four problem areas of the interpersonal framework-grief, life transitions, interpersonal disagreements, and loneliness-guided the analysis to inform IPC adaptation. RESULTS: Three of the four problem areas (grief, life transitions, and interpersonal disagreements) were relevant to this population, although they often co-occurred and intersected, complicating identification of a single focal problem area-a core element of IPC. Grief was pervasive but often ambiguous when loved ones were missing, creating tension between mourning and hope. Role transitions were also salient: many mothers faced sudden single parenthood, and adolescents left school to assume adult responsibilities. Disagreements between IDPs and local residents were also common. CONCLUSIONS: The interpersonal framework was highly relevant for IDPs, although adaptation may be required to address overlapping and context-specific challenges of displacement.