Written by Junmin Hu, programmes intern, interviewing Charles Zemp, a PhD Researcher at Trinity College Dublin. Contributions by Esperanza Escorza Lalinde.
In Puntland, Somalia, communities have faced decades of adversity, while access to relevant mental health services remains limited, and there is a massive unmet demand for local mental health support.
To help address this gap, a new mental health intervention has been developed through a collaboration between the Trinity Centre for Global Health (TCGH), World Vision Ireland, World Vision Somalia and local Somali stakeholders. The Healing & Empowering - Achieving Resilience Through Spiritual Nurture (HEARTS) approach offers faith-sensitive support that integrates Islamic principles and practices with evidence-based therapeutic techniques.
Ahead of the 12-week pilot launch in September, Charles Zemp, PhD Researcher at TCGH leading the HEARTS approach design and implementation, shared the details of this project.
What is HEARTS and what is its goal?
HEARTS is a faith-sensitive Mental Health and Psycho-Social Support (MHPSS) approach designed and tailored to the Islamic faith. It integrates Islamic principles and practices with evidence-based psychological mechanisms, like cognitive reframing, emotional regulation, behavioural activation and psychoeducation.
At first, we planned to adapt an existing intervention called ‘Islamic Trauma Healing’ (ITH) for the people in Puntland and reached out to World Vision Ireland because of the research and learning partnership between the organisation and the Trinity Centre for Global Health within the Irish Aid-funded programme EMPOWER! At the end, we decided to co-create a new approach, called HEARTS, with World Vision Ireland within the EMPOWER! programme in Somalia.
Since EMPOWER! focuses on supporting vulnerable women and girls, particularly those who have experienced gender-based violence, HEARTS initially selected Somali survivors of gender-based violence as the research participants. After our community co-design workshops and based on the need for mental health support services mentioned by stakeholders, we adjusted our research plan to the broader local community.
The goal of HEARTS is to provide more accessible mental health support to Muslim communities who are affected by adversity and hopefully that support is effective in improving their mental and psychosocial well-being.
How do you cooperate and what research methods are you using?
We work together and we communicate frequently. I lead the work on the intervention design, research framework development, and delivery manual creation. World Vision Ireland and World Vision Somalia manage all on-site logistics and budgets, provide implementation support and content review. The Ministry of Health in Puntland has been a key co-designer of the HEARTS approach, providing local public health professional guidance and official support. Actually, it’s a very big collaborative effort between a lot of different people and organizations and entities, as we received advice and guidance from the Stakeholder Advisory Group (SAG) as well as a large number of experts in related fields.
We are using both quantitative and qualitative research methodologies for data collection. Quantitatively, we are tracking mental health and well-being related outcomes like psychological distress, subjective wellbeing, functional impairment, and somatic symptoms, and measuring explanatory outcomes like meaning in life and social connectedness. Qualitatively, we are focusing on the lived experience of participants to HEARTS: what they like, what they don’t like, what suggestions they have for improving HEARTS.
How is HEARTS progressing?
Since HEARTS was officially launched in November 2025, we have made some solid progress. We have completed three days of community co-design workshops in Somalia, which helped us confirm that there is real demand for this, and shaped what the intervention should look like and how it should be delivered. There is a clear consensus that faith was a necessary component to include within mental health support for the community.
We have also finalized the version of the HEARTS delivery manual for the upcoming pilot. It went through expert review by mental health and psychosocial support specialists, it has been translated into Somali, and professionally designed. On top of that, we’ve developed the full set of pilot protocols, that everything from how we will randomize participants into the trial, to recruitment procedures, to data collection processes, to how the group facilitation will run session by session.
In the coming weeks, we’re recruiting our pilot participants and community-based facilitators from the local community, and collecting informed consent from everyone for the research data collection. We will also work with World Vision Somalia staff who have been involved in the co-design process to serve as supportive supervisors for the lay leaders, provide emotional support, facilitate skill development, and ensure quality control of HEARTS’ delivery. We will then run two training sessions: one for the on-site data enumerators, covering the data collection tools and protocols and how to conduct post-pilot qualitative interviews, and another in-person facilitator training in Somalia using the HEARTS delivery manual. After that, we will launch 10 pilot groups, each with 10 participants and 2 co-facilitators, and run the 12-week intervention through to December. We expect to see that participants in the HEARTS groups show improvements in psychological distress, wellbeing, functional impairment, and other aspects compared to those in the waitlist control groups.
What challenges have you faced?
Developing HEARTS is an ambitious process. One of the key challenges for me is coordinating a project that brings together research, implementation and community engagement across multiple partners. Managing the many moving parts of an initiative like this requires close collaboration, and I have been fortunate to work alongside highly experienced colleagues from World Vision Ireland and World Vision Somalia. Their expertise in programme implementation and community engagement is incredibly supportive, allowing us to combine strong research foundations with practical delivery experience.
Another challenge is ensuring that the HEARTS reflects the realities and priorities of communities in Puntland. As someone who is not Muslim and does not come from a clinical mental health background, it is essential to draw on the knowledge and perspectives of others throughout the development process. HEARTS has benefited from extensive consultation and review by clinical experts, Islamic scholars, the Ministry of Health in Puntland, and colleagues from World Vision Ireland and World Vision Somalia. This collaborative approach has helped ensure that the intervention is both culturally relevant and grounded in good practice.
What difference can HEARTS make to Somali communities?
I hope that by creating an intervention or an approach that is more Islamically tailored, it will be more acceptable, more familiar, more accessible by the communities in Somalia to get mental wellbeing support. In under-resourced settings like Somalia, the infrastructure just isn’t there for conventional mental health services. HEARTS is designed to fill that gap. As HEARTS is a sustainable approach that can be delivered by trained community members, it can be carried forward without the involvement of World Vision or other organizations in Somalia. People can practice the strategies shown within the HEARTS approach and incorporate it into their daily lives to support their wellbeing.
What is ahead for HEARTS?
While the pilot marks an important milestone, HEARTS is still at the beginning of this long journey. The practical groundwork as well as the preparations and planning by the team give us real hope that HEARTS can bring big changes to affected communities in Somalia. Following the pilot, the research team will analyse quantitative and qualitative findings to understand the effectiveness, acceptability and feasibility of the approach. Lessons learned from participants, facilitators and stakeholders will be used to further refine HEARTS and strengthen future implementation. At the same time, discussions are already underway regarding opportunities for scaling up the approach and exploring its potential application in other contexts.
Ultimately, the vision for HEARTS extends beyond this pilot: to contribute to more accessible, culturally relevant and faith-sensitive mental health and psychosocial support for communities facing adversity.
A special thank you to Chad for taking the time out of his day to introduce this great project.