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Globalization and Health
Published in: Globalization and Health 1/2017

Open Access 01-12-2017 | Debate

Ethical standards for mental health and psychosocial support research in emergencies: review of literature and current debates

Authors: Anna Chiumento, Atif Rahman, Lucy Frith, Leslie Snider, Wietse A. Tol

Published in: Globalization and Health | Issue 1/2017

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Abstract

Background

Research in emergencies is needed to understand the prevalence of mental health and psychosocial problems and strengthen the evidence base for interventions. All research - including operational needs assessments, programme monitoring and evaluation, and formal academic research - must be conducted ethically. While there is broad consensus on fundamental principles codified in research ethics guidelines, these do not address the ethical specificities of conducting mental health and psychosocial support (MHPSS) research with adults in emergencies. To address this gap, this paper presents a review of multidisciplinary literature to identify specific ethical principles applicable to MHPSS research in emergencies.

Discussion

Fifty-nine sources meeting the literature review inclusion criteria were analysed following a thematic synthesis approach. There was consensus on the relevance of universal ethical research principles to MHPSS research in emergencies, including norms of participant informed consent and protection; ensuring benefit arises from research participation; researcher neutrality, accountability, and safety; and the duty to ensure research is well designed and accounts for contextual factors in emergency settings.
We go onto discuss unresolved issues by highlighting six current debates relating to the application of ethics in emergency settings: (1) what constitutes fair benefits?; (2) how should informed consent be operationalised?; (3) is there a role for decision making capacity assessments?; (4) how do risk management approaches impact upon the construction of ethical research?; (5) how can ethical reflection best be achieved?, and (6) are ethical review boards sufficiently representative and equipped to judge the ethical and scientific merit of emergency MHPSS research? Underlying these debates is a systemic tension between procedural ethics and ethics in practice.

Summary and recommendations

In summary, underpinning the literature is a desire to ensure the protection of participants exposed to emergencies and in need of evidence-based MHPSS. However, there is a lack of agreement on how to contextualise guidelines and procedures to effectively maximise the perspectives of researchers, participants and ethical review boards. This is a tension that the field must address to strengthen ethical MHPSS research in emergencies.
Footnotes
1
New IASC-RG membership is restricted to those organisations working in a minimum of 2 countries. For the development of the ethical guidelines that arose out of this review we were able to include the perspectives of national NGO’s.
 
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Metadata
Title
Ethical standards for mental health and psychosocial support research in emergencies: review of literature and current debates
Authors
Anna Chiumento
Atif Rahman
Lucy Frith
Leslie Snider
Wietse A. Tol
Publication date
01-12-2017
Publisher
BioMed Central
Published in
Globalization and Health / Issue 1/2017
Electronic ISSN: 1744-8603
DOI
https://doi.org/10.1186/s12992-017-0231-y

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