# Can an Evidence-Based Mental Health Intervention Indirectly Benefit Caregivers and Peers of Intervention Participants in Rural Sierra Leone?

## TL;DR

This study examined if a mental health program for youth in Sierra Leone indirectly improved the mental health of their peers and caregivers.

## Contribution

The study introduces a network psychometrics approach to assess indirect mental health benefits of interventions in low-resource settings.

## Key findings

- Higher social support was strongly linked to better coping skills among peers and caregivers.
- Peers of non-participants showed stronger links between depression and poor emotion regulation.
- Caregivers of non-participants experienced higher care burden linked to worse emotion regulation and increased depression and anxiety.

## Abstract

This study explored potential indirect mental health benefits of the Youth Readiness Intervention (YRI) among peers and caregivers of YRI participants and control participants via a networks psychometrics approach. We recruited and enrolled index participants who participated in an implementation trial in Sierra Leone (N = 165 control index participants; N = 165 YRI index participants). Index participants nominated three of their closest peers (N = 879) and one cohabitating caregiver (N = 284) to complete quantitative assessments on mental health and functioning. We used network psychometrics to explore patterns of association between mental health outcomes and risk/protective factors among YRI participants’ peers and caregivers and those of non-participants. Models of network structures showed several strong associations between mental health symptoms and risk/protective factors. There was a strong association between higher social support and positive coping skills. Additionally, models reflected stronger associations between higher depression symptoms and worse emotion regulation for peers of non-participants only. For caregivers of non-participants, a higher burden of care was strongly associated with worse emotion regulation, which was associated with higher levels of depression and anxiety. On a broader scale, the findings may provide support for wider societal benefits that evidence-based mental health interventions can offer in resource-constrained settings.