Table 2.

Key recommendations for structured mental health assessments of Syrian refugee children and adolescents in informal tented settlements in Lebanon.

Services-level Recommendations - Services need to provide a system in which assessors can schedule assessments quickly and at the timing, and place, that fits with the families’ current needs rather than relying on appointment and office-based weekday service provision - Services should provide opportunities for assessors to meet families more than once in order to have time to build a trusting relationship - Services need to provide opportunities for integration of localized knowledge into clinical judgment (through locally recruited assessors or community advisors) - Assessors need to receive comprehensive training including role play, mutual observation, and double coding - Assessors need access to regular and in-depth clinical supervision that gives time for reflection and conceptualization of presenting difficulties in context

Assessor and Supervisor Recommendations - Assessors need to clearly and repeatedly inform parents and children: o about confidentiality and its limits o that assessments are not linked to any financial or in-kind benefits o that referrals can be made to relevant services, such as medical or financial support, regardless of the outcome of the assessment - During administration of assessments, assessors should use follow-up and exploratory questions when needed, such as asking how the reported difficulties compare to other children in the same context, and other questions that ground an understanding of the difficulties in place and time - Supervisors should support assessors to develop joined-up formulations that consider the whole picture and help to inform treatment and appropriate referral