Dataset Information

Effectiveness of Self-Help Plus in Preventing Mental Disorders in Refugees and Asylum Seekers in Western Europe: A Multinational Randomized Controlled Trial.

ABSTRACT:

Introduction

Self-Help Plus (SH+) is a group-based psychological intervention developed by the World Health Organization for managing stress.

Objective

To assess the effectiveness of SH+ in preventing mental disorders in refugees and asylum seekers in Western Europe.

Methods

We conducted a randomized controlled trial in 5 European countries. Refugees and asylum seekers with psychological distress (General Health Questionnaire score ≥3), but without a Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5) or ICD/10 diagnosis of mental disorder, as assessed with the Mini International Neuropsychiatric Interview (MINI), were randomized to SH+ or enhanced treatment as usual (ETAU). The primary outcome was the frequency of mental disorders with the MINI at 6 months. Secondary outcomes included the frequency of mental disorders at postintervention, self-identified problems, psychological symptoms, and other outcomes.

Results

Four hundred fifty-nine individuals were randomly assigned to SH+ or ETAU. For the primary outcome, we found no difference in the frequency of mental disorders at 6 months (Cramer V = 0.007, p = 0.90, RR = 0.96; 95% CI 0.52-1.78), while the difference significantly favored SH+ at after the intervention (secondary outcome, measured within 2 weeks from the last session; Cramer V = 0.13, p = 0.01, RR = 0.50; 95% CI 0.29-0.87).

Conclusions

This is the first randomized indicated prevention study with the aim of preventing the onset of mental disorders in asylum seekers and refugees in Western Europe. As a prevention effect of SH+ was not observed at 6 months, but rather after the intervention only, modalities to maintain its beneficial effect in the long term need to be identified.

SUBMITTER: Purgato M

PROVIDER: S-EPMC8619740 | biostudies-literature | 2021

REPOSITORIES: biostudies-literature

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Publications

Effectiveness of Self-Help Plus in Preventing Mental Disorders in Refugees and Asylum Seekers in Western Europe: A Multinational Randomized Controlled Trial.

Purgato Marianna M Carswell Kenneth K Tedeschi Federico F Acarturk Ceren C Anttila Minna M Au Teresa T Bajbouj Malek M Baumgartner Josef J Biondi Massimo M Churchill Rachel R Cuijpers Pim P Koesters Markus M Gastaldon Chiara C Ilkkursun Zeynep Z Lantta Tella T Nosè Michela M Ostuzzi Giovanni G Papola Davide D Popa Mariana M Roselli Valentina V Sijbrandij Marit M Tarsitani Lorenzo L Turrini Giulia G Välimäki Maritta M Walker Lauren L Wancata Johannes J Zanini Elisa E White Ross R van Ommeren Mark M Barbui Corrado C

Psychotherapy and psychosomatics 20210720 6

<h4>Introduction</h4>Self-Help Plus (SH+) is a group-based psychological intervention developed by the World Health Organization for managing stress.<h4>Objective</h4>To assess the effectiveness of SH+ in preventing mental disorders in refugees and asylum seekers in Western Europe.<h4>Methods</h4>We conducted a randomized controlled trial in 5 European countries. Refugees and asylum seekers with psychological distress (General Health Questionnaire score ≥3), but without a Diagnostic and Statisti ...[more]

PMID: 34350902

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Project description:AimsAs refugees and asylum seekers are at high risk of developing mental disorders, we assessed the effectiveness of Self-Help Plus (SH + ), a psychological intervention developed by the World Health Organization, in reducing the risk of developing any mental disorders at 12-month follow-up in refugees and asylum seekers resettled in Western Europe.MethodsRefugees and asylum seekers with psychological distress (General Health Questionnaire-12 ⩾ 3) but without a mental disorder according to the Mini International Neuropsychiatric Interview (M.I.N.I.) were randomised to either SH + or enhanced treatment as usual (ETAU). The frequency of mental disorders at 12 months was measured with the M.I.N.I., while secondary outcomes included self-identified problems, psychological symptoms and other outcomes.ResultsOf 459 participants randomly assigned to SH + or ETAU, 246 accepted to be interviewed at 12 months. No difference in the frequency of any mental disorders was found (relative risk [RR] = 0.841; 95% confidence interval [CI] 0.389-1.819; p-value = 0.659). In the per protocol (PP) population, that is in participants attending at least three group-based sessions, SH + almost halved the frequency of mental disorders at 12 months compared to ETAU, however so few participants and events contributed to this analysis that it yielded a non-significant result (RR = 0.528; 95% CI 0.180-1.544; p-value = 0.230). SH + was associated with improvements at 12 months in psychological distress (p-value = 0.004), depressive symptoms (p-value = 0.011) and wellbeing (p-value = 0.001).ConclusionsThe present study failed to show any long-term preventative effect of SH + in refugees and asylum seekers resettled in Western European countries. Analysis of the PP population and of secondary outcomes provided signals of a potential effect of SH + in the long-term, which would suggest the value of exploring the effects of booster sessions and strategies to increase SH + adherence.

Project description:ObjectiveMigrants and refugees/asylum seekers make up a significant proportion of the European workforce. They often suffer from poor working conditions, which might impact mental health. The main objective of this systematic review was to summarize and analyze existing research on working conditions of migrants and refugees/asylum seekers in European host countries and compare them to those of natives. Furthermore, the relationship between working conditions and mental health of migrants/refugees/asylum seekers and natives will be compared.MethodsThree electronic databases (PubMed/MEDLINE, PsycInfo and CINAHL) were systematically searched for eligible articles using quantitative study designs written in English, German, French, Italian, Polish, Spanish or Turkish and published from January 1, 2016 to October 27, 2022. Primary health outcomes were diagnosed psychiatric and psychological disorders, suicide (attempts), psychiatric and psychological symptoms, and perceived distress. Secondary health outcomes were more general concepts of mental health such as well-being, life satisfaction and quality of life. Screening, data extraction and the methodological quality assessment of primary studies by using the Newcastle-Ottawa Scale were done independently by two reviewers. The results of the primary studies were summarized descriptively. Migrants and refugees/asylum seekers were compared with natives in terms of the association between working conditions and mental health.ResultsMigrants and refugees often face disadvantages at work concerning organizational (low-skilled work, overqualification, fixed-term contracts, shift work, lower reward levels) and social conditions (discrimination experiences) in contrast to natives. Most unfavorable working conditions are associated with worse mental health for migrants as well as for natives.ConclusionsEven if the results are to be taken with caution, it is necessary to control and improve the working conditions of migrants and refugees/asylum seekers and adapt them to those of the native population to maintain their mental health and thus their labor force.

Project description:BackgroundAsylum seekers, refugees, and immigrants experience a number of risk factors for mental health problems. However, in comparison to the host population, these populations are less likely to use mental health services. Digital mental health approaches have been shown to be effective in improving well-being for the general population. Thus, they may provide an effective and culturally appropriate strategy to bridge the treatment gap for these populations vulnerable to mental health risks.ObjectiveThis paper aims to provide the background and rationale for conducting a scoping review on digital mental health resources for asylum seekers, refugees, and immigrants. It also provides an outline of the methods and analyses, which will be used to answer the following questions. What are the available digital mental health resources for asylum seekers, refugees, and immigrants? Are they effective, feasible, appropriate, and accepted by the population? What are the knowledge gaps in the field?MethodsThe scoping review methodology will follow 5 phases: identifying the research question; identifying relevant studies; study selection; charting the data; and collating, summarizing, and reporting the results. Searches will be conducted in the following databases: EBSCOhost databases (CINAHL Plus with Full Text, MEDLINE with Full Text, APA PsycArticles, Psychology and Behavioral Sciences Collection, and APA PsycInfo), PubMed, and Scopus. Additionally, OpenGrey, Mednar, and Eldis will be searched for gray literature. All primary studies and gray literature in English concerning the use of information and communication technology to deliver services addressing mental health issues for asylum seekers, refugees, and immigrants will be included.ResultsThis scoping review will provide an overview of the available digital mental health resources for asylum seekers, refugees, and immigrants and describe the implementation outcomes of feasibility, acceptability, and appropriateness of such approaches for those populations. Potential gaps in the field will also be identified.ConclusionsAs of February 2020, there were no scoping reviews, which assessed the effectiveness, feasibility, acceptability, and appropriateness of the available digital mental health resources for asylum seekers, refugees, and immigrants. This review will provide an extensive coverage on a promising and innovative intervention for such populations. It will give insight into the range of approaches, their effectiveness, and progress in their implementation. It will also provide valuable information for health practitioners, policy makers, and researchers working with the population.International registered report identifier (irrid)PRR1-10.2196/19031.

Dataset Information

Effectiveness of Self-Help Plus in Preventing Mental Disorders in Refugees and Asylum Seekers in Western Europe: A Multinational Randomized Controlled Trial.

Introduction

Objective

Methods

Results

Conclusions

Publications

Effectiveness of Self-Help Plus in Preventing Mental Disorders in Refugees and Asylum Seekers in Western Europe: A Multinational Randomized Controlled Trial.

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