Problem Management Plus Entrepreneurs

Programmes to Treat Common Mental Disorders in Post-conflicted Areas of Pakistan

Project Title

Problem Management Plus (PM+) for Small and Medium Enterprise (SME) Entrepreneurs

Year

2018 to 2019

Collaborators

World Bank Group, Washington, USA, University of Liverpool, Liverpool, UK, Human Development Research Foundation, Islamabad, Pakistan, & Khyber Medical University, Peshawar, Pakistan

Project Information

Epidemiological studies from conflict effected areas of Pakistan found high rates of clinically significant psychological distress ranging from 38% to 65%. Globally psychological distress especially depression has a huge impact upon economic productivity estimated to the tune of 1 trillion dollars per year. This burden would be even greater in conflict effected areas, but there is very little research on interventions that could address this, especially in the productive workforce engaged in rebuilding business and enterprises in the post-conflict period. The aims of this project were threefold; 1) to enable rapid and safe collection of data from conflict effected settings that can inform intervention development, 2) development of a feasible and culturally appropriate intervention targeting small and medium enterprises, 3) to evaluate the effectiveness of the intervention in this population.

We used the WHO Problem Management Plus (PM+) programmes, a non-specialist delivered, low intensity psychological intervention and contextualized its training within the “Adaptive Leadership Framework” for SME entrepreneurs, a non-clinical population, living and working in war and conflict affected areas of province of Khyber Pakhtunkhwa, Pakistan. Furthermore, we adapted the intervention content for relevance to the lives and context of SME entrepreneurs. The adapted intervention (i.e. PM+ for Entrepreneurs) focuses on preventing the psychological distress in entrepreneurs by giving them skillset to apply to stressful situations in their everyday life and work, and to negotiate such challenges in an adaptive fashion.

The project demonstrates that high quality research including Randomized Controlled Trials (RCTs) can be conducted in such challenging settings through appropriate rapid training of local researchers. The results of a pilot RCT show promising trends indicating that low intensity psychological intervention, embedded within the adaptive leadership framework can not only improve the clinical outcomes; but, can also potentially improve the level of productivity in SME entrepreneurs, working in war and conflict affected areas of Pakistan.

Publications

Relevant Links

Investing in Better Mental Health of Entrepreneurs in Pakistan