The Employability Integration Approach: Integrating Mental Health and Psycho-Social Support with Employability

Learning from the 2019 Learning Review about integrating livelihoods and psychosocial assistance improves socio-economic inclusion.


From 2017 onwards, Action Against Hunger’s food security and livelihoods sector in Iraq, has been transitioning from the delivery of large-scale food assistance programming to refugees and internally displaced persons in camps and out of camps, towards the provision of sustainable livelihoods solutions to remainees and returnees. More particularly, the sector has been addressing unemployment of youth and women in urban areas.
In the past three years, Action Against Hunger has implemented a range of projects focused on the employability approach. Beneficiaries can benefit from employability assistance ranging from technical capacity building, financial assistance for micro and small businesses, to apprenticeship schemes co-funded by local enterprises, and direct employment. The intervention often includes a cash for work component, which supports the rehabilitation of communal facilities and infrastructure while ensuring short-term employment schemes.

In the post-conflict context of a massive population displacement and economic crisis, the targeted audience for this approach needs to strengthen their resilience to socio-economic shocks. Motivation is central for the placements’ success, as well addressing psychosocial barriers to employability.
In response to these needs and in order to ensure sustainability of the project, a psychosocial follow-up was integrated into livelihoods’ intervention. It consisted in providing beneficiaries with indispensable life, social and emotional skills in addition to material support. The integration of livelihoods and mental health was formally recognised as essential in this intervention’s final evaluation. As a result, Action Against Hunger Iraq staff have been working together to better frame the integration approach.

Good practisces have been put in place for impactful action. At programme design stage, protection aspects have also been integrated into business grants and apprenticeship activities, through internal and external referrals. Business grants and apprenticeship beneficiaries are now selected on the basis of online registration, which allows better inclusion of persons with disabilities and specific risks of vulnerabilities. Assessments are then carried-out by staff who are livelihoods and psychosocial workers. They visit families to discuss and address their issues, as well as detect sensitive cases. Apprentices’ working conditions are monitored on a weekly basis.


The integration approach increased the livelihoods and psychosocial resilience of its beneficiaries, as evidenced by recent learning exercises in employability projects such as a final evaluation and learning workshops.

Beneficiaries acquired life and communication skills through mental health and psychosocial support sessions, improving their well-being, self-esteem, communication, confidence and decision-making skills in addition to increasing the sustainability and profitability of their economic activity. They were able to make informed and adapted livelihoods choices and to integrate the market, thus increasing their socio-economic inclusion in the community.

Performance evaluations conducted five months after activities recorded a satisfactory 66% of apprentices still at work and 70% of grants beneficiaries of still running their businesses.

Persons with disabilities in particular reported how the livelihood and psychosocial support sessions enabled them to overcome their psychological difficulties due to their personal financial and disability situation, and feel empowered in the market and local economy. One said “I attended all the mental health and psychosocial support sessions as they provided me with a lot of positive energy.”

Life, Social and Emotional trainings coupled with psychosocial follow-up have proved to be beneficial for both livelihoods and protection components, especially for women who had not entered the labour market before. Involving women in the employability schemes proved to be a challenge. It required adaptation of trainings’ time, support for transportation solutions and, not the least, support by psychosocial workers aimed at overcoming cultural gender barriers and coping with harassment in the workplace.

The short duration of interventions is also a challenge. The employability approach requires more time than emergency interventions to meet long term sustainability achievements linked with job inclusion and retention.

Overall, the integration approach enhanced the project’s relevance, effectiveness, efficiency, sustainability, and impact, emerging as one of the best practices across the apprenticeship and business components of the livelihoods intervention.


Through systematic learning workshops, Action Against Hunger Iraq identified ways to further foster inter-sectorial integration in their employability programmes.

Action Against Hunger will allocate more resources to the integration approach. More human resources are needed on the protection side to ensure greater coverage and increased inclusion in the provision of the mental health and psychosocial support services.

Outcome indicators which consider both livelihood and psychosocial support will be designed, and will consider the inclusion of mental health, wellbeing and resilience aspects.

The provision of cross training at the inception of a new program will also support the collaborative approach between the two sectors.

Livelihoods and protection staff will better jointly engage on carrying-out joint initial assessments of beneficiaries’ enabling and limitation factors to enter the job market. A good understanding of the barriers individuals might be facing would facilitate targeting.

With regard to selection processes, the current scoring system will be revised accordingly and the selection committee will be integrated to ease discussions between livelihoods and protection staff. Employability programMEs are at the crossroads of several types of vulnerabilities. They need to provide specific psychosocial services for individuals that could eventually not qualify for a job but are in situation of psychological distress. The employability programs are a good entry point for detection of psychosocial needs and internal referral.

Joint monitoring visits need to be encouraged as well so that the situation of each beneficiary can be understood holistically.

Innovative solutions will be considered in order to involve and maintain women in the job market, such as services oriented to women with children and different working time.

The overall future interventions will need to be more linked to local partners, to ensure a complementarity of action and long term sustainability. In this end, availability of locally managed microfinance solutions will also be assessed in order to replace the direct provision of grants, with a consequent improvement of cost-efficiency.


About this document

Section: Learning

Thematic Area: Implementation and Monitoring Mental Health and Care Practices

Type: Article

Language: English

Key Information


Author: Lara Colace, FSL Technical Advisor, Middle East Pool, France; Alexandre Letzelter, MHCP-GP Technical Advisor, Middle East Pool, France; Eugénie Parjadis, MEAL Advisor, UK

Year Published: 2019
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