Addressing the burden of violence on global mental health : contributions of Narrative Exposure Therapy across different health systems

Abstract

Post-traumatic stress disorder represents a substantial global mental health burden, particularly in the face of cumulative violence, forced migration, and structural inequities. Narrative Exposure Therapy (NET) configures a brief trauma-focused intervention that supports the reconstruction of autobiographical memory by the chronological narration of life events. By integrating fragmented traumatic experiences into a coherent narrative, NET facilitates emotional processing and restores continuity to disrupted life stories. This regional case series examines the integration of NET into the mental health systems in Brazil, the Democratic Republic of Congo, Germany, Switzerland, Japan, Mexico, the United Kingdom, and Scandinavia. Drawing on diverse implementation experiences, the study identifies both enabling conditions and persistent challenges. Results highlight that NET is feasible and adaptable across different sociocultural and resource settings, especially when supported by sustained supervision, task-shifting strategies, and intersectoral collaboration. Embedding NET into existing service structures expanded access to evidence-based trauma care for populations often excluded from specialized treatment. These findings underscore the critical role of trauma-informed public policies in responding to the mental health consequences of violence on a global scale.