Behind the Paper: Complementing humanitarian staff care with arts-based initiatives? Viewpoints from in-house mental health professionals

In this post, we speak to Hannah Strohmeier, lead author of a recent PLOS Global Public Health article “Complementing humanitarian staff care with arts-based initiatives? Viewpoints from in-house mental health professionals”, co-authored with Christiane Ganter-Argast, about the story behind the research.

What led you to decide on this research question?

Humanitarian staff care is a topic I’ve been researching for more than a decade, and I care about deeply. When I started, little systematically collected data was available and the field was still in its infancy. Much progress has been made over the last 10–15 years in both research and practice, with growing interest from researchers, and organisations investing more in workplace mental health and wellbeing. And yet significant challenges remain: mental health problems are widespread among staff while support services are often underfunded, insufficient, and underutilised, which suggests they don’t speak to the needs of all staff. There are also persistent differences in access between nationally and internationally recruited staff, and much of what is offered — one-on-one counselling or talk therapy, for instance — is rooted in Euro-American traditions of helping and healing, even though the humanitarian workforce is highly diverse.

Based on this body of knowledge, I felt it was important to explore alternative, complementary approaches that could complement existing service portfolios. Arts-based interventions (ABIs), which are increasingly gaining attention from stakeholders such as the WHO and, closer to home, Charité’s Network Arts and Medicine, emerged as a potentially transformative avenue. For example, they can help articulate experiences that are otherwise hard to put into words — particularly valuable in situations involving trauma or language barriers. In group settings, ABIs are also considered useful for fostering mutual social support, and they can be adapted to local forms of expression, religion, and cultural context, making them well suited to diverse or underserved populations. While ABIs have been used successfully by humanitarian organisations to support crisis-affected communities, they remain largely overlooked in the formal practice and academic literature on humanitarian staff care — which is the gap this study set out to address.

Could you talk us through how you designed your study? What was important for your team as you created the study team?

This study was part of a larger research project on humanitarian staff health – my GLOHRA postdoctoral fellowship at the Charité Center for Global Health – which examined the relationship between racism and mental health within organisations; its findings were captured in the documentary film Colour. To my knowledge, no prior study has focused specifically on the perspectives of in-house mental health professionals (MHPs) on this topic. I chose a qualitative design using in-depth, semi-structured interviews because it allows for rich insight and a degree of flexibility that suited both the broader project and the exploratory nature of this particular component, which looked at ABIs as a complement to existing staff care services. Specifically, I embedded a set of questions on ABIs within the larger project’s interview guide, and analysed the answers to these separately at a later stage. The fellowship gave me the space to pursue this exploratory work; it was largely a solo project, with me as Principal Investigator throughout, though I consulted with art therapists and artists before conducting the interviews. My co-author, Christiane Ganter-Argast, kindly agreed to join later to help discuss the results and bring in her expertise as a professor of art therapy at Nürtingen-Geislingen University with a background in both research and clinical practice — a good and necessary complement to my own knowledge of current staff care approaches. I’m grateful for the depth and care she brought to the study, and for how enriching our interdisciplinary exchanges were.

 Hannah Strohmeier presenting the larger research project ‘Racism and Mental Health: A Qualitative Study with Humanitarian Workers’ at GLOHRA Day 2025

What challenges did you encounter during your study?

The main challenge was participant recruitment. It took about a year to interview ten MHPs, eight of whom were asked specifically about ABIs — their perspectives form the basis of this article. Levels of organisational engagement with recruitment varied considerably, and it’s often difficult to find people in key positions within organisations willing to support this kind of research, for example through circulating the call through official channels. The reasons are varied: sometimes workloads are already high, sometimes internal approval processes are complex and time-intensive, and sometimes it simply takes time to build trust in a new kind of research.

Beyond that, MHPs as a group are inherently hard to reach. Accessing humanitarian staff communities in general isn’t easy, but this occupational group presents particular challenges: their numbers across the sector are limited, they often carry responsibility for large staff populations, they work under high workloads that frequently involve extensive travel, and they operate under strict confidentiality requirements that understandably make them rather cautious research participants. I’m genuinely grateful to the organisations and staff who helped setting up this research and to the MHPs who agreed to be interviewed and took the time, out of already demanding schedules, to share their perspectives with me. Every interview was a privilege.

What did you find most striking about your results? How will this research be used?

What stood out to my co-author and me most was the openness participants showed toward new and complementary initiatives. Change isn’t always welcomed in organisational settings, so it was genuinely encouraging to find that most MHPs responded positively to the idea of systematically introducing ABIs into staff care portfolios. Some even showed enthusiasm, which was a joy to observe. We were also glad that participants were candid about the challenges and barriers they anticipated, since this is essential groundwork for anyone looking to take this further, whether in research or in practice.

I plan to share this study with my contacts within organisations and through wider humanitarian practice networks, including, of course, the MHPs who participated. Our hope is that these findings – while based on a small,  exploratory study – will spark further research and generate interest among people in decision-making roles, so that collaborations between research and practice can take shape and ABI pilots can get off the ground — this potential impact on practice matters a great deal to us. I’m also planning further research of my own on ABIs in humanitarian and other workplaces, exploring how dance, music, and visual art can be effectively integrated into workplace wellbeing — a field I engage with directly through my own practice as a workplace wellbeing consultant. As Christiane points out, art therapists are a distinct profession whose expertise in supporting people through challenging and emotionally demanding situations makes collaboration with them an important part of this work.

Examples of art therapy outputs from Christiane Ganter-Argast’s practice, shown here for illustrative purposes and not connected to the study’s participants or data

What further research questions need to be addressed in this area?

A great deal of further research is needed. To our knowledge, ABIs have not yet been systematically integrated into organisational staff care portfolios, and more groundwork is needed to determine if and how they could best be used. First, the grey literature on art therapy and ABIs should be reviewed to establish whether it addresses work with humanitarian staff specifically; at the same time, ABIs already in informal use — for example at staff retreats — should be systematically documented, drawing on MHPs’ prior experience to identify best practices and lessons learned for future programming.

Second, focused pilot studies are needed to generate data on how to design and integrate ABIs into staff care programs effectively. Large-scale surveys with humanitarian workers, for instance, could address questions such as preferred media and initiative types, motivations for participation, and optimal frequency — work that would require close collaboration between researchers and organisations. This evidence base could then inform tailored guidance for organisations on integrating ABIs as a complement to existing staff care approaches.

Third, and at a later stage, rigorous evaluation studies are needed to assess the effectiveness and limitations of ABIs as implemented in organisational contexts, ensuring that such initiatives are genuinely beneficial, ethically sound, and free of unintended harm. This matters especially to me — rigorously examining what works, what doesn’t, and why is something that tends to fall by the wayside in staff care more broadly. As a result, I think we’re missing real opportunities to strengthen service delivery.

Christiane Ganter-Argast practicing art therapy, Photo credit: Katrin Spannblöchl, Impossiblefoto

Why did you choose PLOS Global Public Health as a venue for your article?

This research sits within the field of global health, and I’ve had good experiences publishing with PLOS before. We appreciate the journal’s interdisciplinary approach, its focus on addressing inequities, and its commitment to publishing findings relevant to a broad range of stakeholders — researchers, health practitioners, policymakers, and communities alike.

On a personal note, we also value the absence of a strict word count. Some journals can be quite restrictive, and especially with qualitative research, we like having the space to present as much data as we think is useful for readers, and to properly discuss and situate findings in relation to other relevant work. We’re happy that the article has been published, and are excited to see where this research goes next.

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