In dialogue with mental health and psychosocial support (MHPSS) workers in northwest Syria: Navigating challenges, opportunities and resources in complex humanitarian settings

In resource-stressed settings, mental health workers bear a heavy service burden. Different studies indicate that multiple factors, including organizational demands and aids, contribute significantly towards burnout in such challenging conditions. The present study examines the contextual and organizational factors affecting the well-being and service quality of mental health and psychosocial support workers (MHPSS) in Northwest Syria. Ten semi-structured interviews were conducted to discuss the intricate challenges and dynamics that influence their daily work experiences. Participants are half women and half men, aged 29 to 45 years (M = 35, SD = 5.6). They worked in ten different organizations across eight locations in Northwest Syria, with work experience ranging from 8 months to 10 years (M = 4, SD = 2.95). Participants serve various client groups including children, teenagers, and adults. Most participants hold bachelor's degrees in education or related fields and three are pursuing or have completed graduate studies. A community-based participatory research approach wase utilized, and reflexive thematic analysis was conducted to engage with the data. The analysis identified three main themes: (1) The Sociopolitical and Economic Climate Exacerbating Workers' Demands, which highlighted how economic instability and sociopolitical struggles impact workers' ability to provide support; (2) Work-related Demands and Resources, revealing high workloads, harmful policies, and limited career growth opportunities contributing to burnout, and coping through peer support resources; (3) Balancing and Integrating Psychosocial Resources, Demands, and Cultural Norms, describing how workers manage sociocultural and personal demands and resources. Organizational policies contribute to cognitive, emotional, and physical stress, while short-term project-based employment creates job insecurity and affects workers' well-being. Key findings stress the need for long-term projects, better organizational support, and ethical evaluation practices to better support frontline workers. Future research should focus on supportive policies and the causal impacts of contextual and organization factors on daily stressors and burnout in humanitarian settings. Keywords: humanitarian workers, occupational stress, psychological distress, thematic analysis, reflexive thematic analysis, stressors, MHPSS workers