Table 1 Summary of research challenges and strategies in humanitarian contexts

Ethical

Dismantling power differentials between researchers and vulnerable populations

▪CBPR to ensure community engagement, co-learning, and involvement

▪Community advisory boards to reinforce and enrich investigation

Ensuring appropriateness, sensitivity and relevance in local contexts

▪Employ an ecological approach to investigate individual, family, and community influences

▪Mixed-methods to establish culturally meaningful and valid assessments

▪Focus group discussions to refine items and determine cultural appropriateness

▪Develop locally derived measures in close consultation with local staff and community members

Addressing risk of harm cases

▪Anticipate risk of harm cases and develop rigorous protocols to ensure participant safety, appropriate referrals, and follow-up

Capacity/Sustainability

Developing long-term, stable partnerships

▪Develop a capacity-building core to develop and deliver innovative, locally relevant training and technical assistance programs

Establishing systems of follow-up

Supporting rather than overburdening professionals

Logistical

Adapting to unforeseen, adverse circumstances

▪Anticipate and plan for them. When that fails, accept the challenge presented, make appropriate adaptations to the research process and consider opportunities

Conceptualizations and Assessment of Mental Health in Diverse Cultures and Contexts

Assessing mental health problems, especially in the absence of validated screening tools

▪Involve local teams in qualitative data collection to understand stigma and co- morbidity and to examine protective processes linked to resilient outcomes

Addressing stigma around mental health

▪Use mixed methods models to select, adapt, or create measures of mental health and related constructs

Addressing co-morbidity

▪Use psychometric methods to subject tools to rigorous validation, testing and refinement