Guidelines for Remote MHPSS Programming in Humanitarian Settings: Step 2

2.1 Prepare for Administration and Management

2.1.1 Staff Sensitization

• Organize discussions with program staff to present the findings of the assessment and to advocate for the importance of remote programming.
• Run interdepartmental workshops to review and adapt contingency plans as necessary in transitioning to remote programming and service provision and incorporate all relevant and up-to-date contextual factors (e.g., changes to the security situation, government policy).

2.1.2 HR and Staff Care

• Sufficient staffing levels should be planned, budgeted and recruited for remote programming.
• Work with HR to conduct orientation sessions on any changes or updates to HR processes and policies for staff.
• Conduct a training or orientation session for staff with practical tips and advice on how to effectively set up and manage remote programming, working from home or in isolation, e.g., time management, the importance of taking planned breaks, exercise and diet, stretching routines for those not used to sedentary working practices, planning the schedule for a work day from home, and setting personal/professional boundaries.
• Work with HR to update staff-care policies and practices to ensure sufficient support for staff, adapted to remote programming and the situational context.

2.1.3 Funding and Other Resources

• Advocate for the need to reallocate funds or secure new funds to provide effective remote services, which may necessitate communication with the donor about staffing levels; procuring means of remote communication to be supplied for staff, including service providers, and clients (laptops, phones, internet data, solar chargers, loudspeakers, etc.); and funding activities to support remote service delivery such as setting up mobile units, hotlines or conducting radio and TV broadcasts.
• Staff, including service providers, should be provided with the most appropriate means of communication and technology—e.g., access to platforms, using separate devices such as phones and laptops for work and not personal items, and internet/phone connection—and know how to use these technologies.
• Confirm service providers have confidential spaces to work from and can protect client privacy when connecting with them remotely. If working from home is not conducive to service provider and client privacy and confidentiality, an alternative space should be made available to the service providers.

2.1.4 Recordkeeping and Data Storage

• If existing client files are not digitized and stored electronically, establish procedures and protocols for accessing hard-copy files by service providers working remotely, ensuring the files are not kept in unsecured places, where the client confidentiality can be compromised.
• Establish procedures and protocols for keeping client notes and other documentation once transitioned to remote modality. If possible, a secure online database should be established for service providers to store and access all client files digitally while providing remote services.
• If digital documentation and data storage is not feasible, clear protocols and procedures for keeping paper files while working remotely should be established (e.g., providing cabinet files with locks to the providers, clarifying when and how to transport hard-copy files to a central location, keeping a client file log and periodically performing audits, etc.).
• Similar procedures should be established for documenting and storing supervision-related files.
• Refer to recordkeeping and data storage for additional guidance.

2.1.5 Cybersafety

• Data privacy is paramount and should be continuously prioritized.
• Without appropriate safeguards for client data, client safety can be at risk. Safeguards should be in place to keep client data both private and secure. Data privacy and information security work hand in hand. One cannot exist without the other.
• Tips to increase security:
  • Strong authentication: The platforms used should have strong authentication methods, such as unique and personal usernames and password protected logins. Strong passwords that cannot be easily guessed should be created. Service providers and/or users should log out at the end of the calls.
  • End to end encryption: where possible, choose modalities with end to end encryption to ensure privacy and security of the information communicated.
  • Regular software updates: The laptops/phones/tablets should receive regular software updates and operate with the most up-to-date operating systems.
  • Avoiding scams: Educate the staff and service users on phishing messages. If staff or service users receive any messages from senders they do not know or requesting them to share personal or sensitive information, they should delete the message or the email. If in doubt throw it out.
  • Online safety guidance: During training and supervision, service providers should be provided guidance on how to support the client and beneficiaries stay safe online. Service providers should be up to date with any possible scams happening and how to protect themselves and the clients.

2.2 Prepare for Service Provision

• Service providers and their supervisors should be engaged in all stages and steps of preparation for remote services, and provide their input on the necessary resources, capacity building needs, and the needs of clients.
• Update service mapping with information on the context and situation, websites and measures by the authorities and available services. This should include information on how to contact health authorities, as well as contact details of health and mental health services. Continually review and update this information and make it available to all staff.
• Based on the updated mapping, put in place procedures for when and how to refer persons with significant psychological distress or mental, neurological, and substance use (MNS) conditions. Where referral options are not available a plan for providing support for this group as well as handling suicidality and other emergency cases should be developed. These plans/procedures should be written down and shared with all staff (Refer to Section 3.7. Understand risk and manage emergency).
• Plan for client and community sensitization on availability of remote services, including when and how to access them and prepare to address access-related and other concerns (Refer to Section 2.5. Prepare Clients and Communities).

2.3 Prepare for Training

• All service providers and their supervisors should receive specialized training on adapting their skills to remote delivery. Reference Section Cross-Cutting Component: Capacity Building for additional guidance on remote training.

2.3.1 Adapt Training Materials and Tools

• Based on the assessment conducted in Step 1.2, make further adaptations to the identified training materials and tools, as needed, including for cultural and contextual factors as well as revisions of technical content, such as how to adapt clinical skills and competencies to fit remote service provision.
• Consult with MHPSS trainers, experts, supervisors, potential participants and other stakeholders for technical review before finalizing training materials.
• Adapt training feedback form, examination and monitoring and evaluation tools for remote use, incorporating sections for feedback on the remote training modality and how it could be improved.

2.3.2 Choose and Set up Appropriate Means of Information and Communication Technology

• Choose platforms that are secure and accessible to participants and free to use (e.g., Skype, WhatsApp, Signal, Telegram, Viber, Zoom, Microsoft Teams, phone call), which also facilitate participatory activities and smaller group discussions (breakout rooms, whiteboards, etc.).
• Spend time familiarizing yourself with the advanced features of the platform so you can provide technical support to the participants if needed.
• Ensure reliable and stable internet connection, with a back-up option available, if possible.
• If possible, use additional hardware to enhance the quality of communication, e.g., external camera or microphone with higher quality definition.

2.3.3 Identify Trainers and Secure Additional Support

• Identify trainers, preferably with experience in remote modalities – to undertake a training of trainers (ToT) in remote MHPSS service delivery.
• Facilitating remote training, especially for large groups of participants, can be difficult to manage alone. If possible, consider asking for additional support in facilitation for managing technological difficulties, screening questions and/or conducting some parts of the training.

2.4 Prepare for Supervision

• Reference Section Cross-Cutting Component: Capacity Building for additional guidance on remote supervision.

2.4.1 Set Up the Supervision Relationship

• Decide if you are going to offer 1-on-1 supervision or in a group.
• If possible, match supervisors and supervisees who have complimentary personality traits, or who have established rapport so that you can build a positive and supportive relationship within the remote supervision framework.
• If possible, at least one face-to-face meeting between supervisors and supervisees should be arranged, to enable them to get to know each other and discuss the goals of supervision, which remote technologies to use and when to use them.

2.4.2 Define the Type of Supervision

• Administrative Supervision focuses on reviewing the supervisee documentation, recordkeeping and addressing logistic and administrative problems happening in the program including starting systems, advocacy and creating referral networks.
• Clinical Supervision focuses on the development of a supervisee’s clinical role, skills, competence and confidence in caring for someone with an MHPSS problem.
• Note: Both can occur remotely but be clear which one you are doing and design sessions according to the goal. If these roles are combined in one person, mitigation measures should be put in place to prevent any potential conflict of interest and ensure clinical supervision remains a supportive space.

2.4.3 Set Boundaries, Clarify Expectations and Identify Means of Communication

• Prepare to set boundaries for supervisors and supervisees, encouraging all parties to think and plan when they will be available (only during business hours vs. as-needed) and how they will deal with emergency calls and situations.
• Identify remote technologies to which both supervisors and supervisees have regular access, ensuring supervisees feel confident about using them. Offer the supervisee some training on the chosen technology, if necessary.
• Plan for supervision sessions that focus on promoting positive well-being among the supervisees. For example, working remotely can be isolating so organize social events and support the supervisees to engage in activities that promote mental health and well-being.
• Set a timeframe for evaluation of the selected supervision strategy and be prepared to redefine supervision approach if necessary.

2.5 Prepare Clients and Communities

• Organize workshops/conversations with communities/community leaders/peer support groups/healthcare providers/families and individuals about the need to move to remote service delivery.
• Explain what is meant by remote service delivery and how it will be organized, clarifying the necessary conditions for remote delivery (e.g., availability of private and confidential spaces for both the provider and client; connectivity; access to phones and other technology).
  • Be prepared to answer questions about the lack of resources to engage in remote services and what alternatives, if any, will be provided.
• Emphasize that engaging in remote services is voluntary, and that confidentiality will be prioritized as before. To allay potential concerns, specify what safeguarding measures are in place to protect confidentiality (Be very explicit as to pre-emptively address potential resistance, as distrust around technology is common).
• Explain how they can access remote services, why it is important that they access remote services.
• Identify if any clients or their families need orientation on how to use or access technology to connect to remote services.