scholarly journals A brief transdiagnostic psychological intervention for Afghan asylum seekers and refugees in Austria: a randomized controlled trial

Trials ◽  
2020 ◽  
Vol 21 (1) ◽  
Author(s):  
Matthias Knefel ◽  
Viktoria Kantor ◽  
Andrew A. Nicholson ◽  
Jennifer Schiess-Jokanovic ◽  
Dina Weindl ◽  
...  
Keyword(s):  
Mental Health ◽  
Asylum Seekers ◽  
Mental Health Problems ◽  
Psychological Intervention ◽  
Health Problems ◽  
Immigrant Integration ◽  
World Health ◽  
Afghan Refugees ◽  
Link Type ◽  
Asylum Seekers And Refugees

Abstract Background Asylum seekers and refugees are at great risk for developing mental disorders. Afghan refugees are a particularly vulnerable group with a low average education and mental health literacy level. Traumatic experiences and hardship before and during migration are predictive of mental health problems. However, post-migration living difficulties (PMLDs) also account for a large proportion of mental distress in such populations, which, critically, are not sufficiently considered in treatment protocols and research investigations. Indeed, the evidence base for the treatment of refugees and asylum seekers is sparse and limited mainly to trauma-specific treatments, where refugees may likely suffer from other mental health problems such as depression or anxiety. Methods/design This trial is the first evaluation of a short-term, transdiagnostic treatment protocol for treatment-seeking Afghan refugees which addresses mental health problems and PMLDs while using an adapted version of the Problem Management Plus (PM+) protocol. Here, we will investigate the efficacy of an intervention manual with a prospective, single-center, randomized, assessor-blind, two-group trial among refugees who are on a waiting list for professional mental health treatment. Furthermore, we will investigate participants’ subjective experiences with the intervention manual via in-depth interviews. One hundred twenty people will be assessed and randomly allocated to either the intervention arm or a treatment-as-usual arm. Clinical psychologists will conduct the treatment, and the sessions will take place with a Dari interpreter. The protocol consists of six 90-min sessions. The primary endpoint is the general symptom distress measure, assessed with the General Health Questionnaire 28 (GHQ-28). Secondary endpoints are the Post-Migration Living Difficulties Checklist (PMLDC), the International Trauma Questionnaire (ITQ), the World Health Organization Quality of Life Questionnaire (WHOQOL-BREF), the Psychological Outcome Profile (PSYCHLOPS), service and health care use (assessed with several items), and the Immigrant Integration Index (IPL-12). Discussion This trial may provide substantial evidence for a brief transdiagnostic psychological intervention. Here, we intend to contribute to the treatment of mental health problems among Afghan refugees. The assessment of subjective experience with this treatment manual, as well as the evaluation of its clinical applicability, may optimize treatment acceptance and outcomes across a wide range of mental health problems among refugees. Trial registration German Clinical Trials Register (DRKS) registration number: DRKS00016538. Universal Trial Number: U1111-1226-3285. Registered on January 7, 2019. https://www.drks.de/drks_web/setLocale_EN.do

scholarly journals A brief transdiagnostic psychological intervention for Afghan asylum seekers and refugees in Austria: A Randomized Controlled Trial

2019 ◽  
Author(s):  
Matthias Knefel ◽  
Viktoria Kantor ◽  
Andrew A. Nicholson ◽  
Jennifer Schieß-Jokanovic ◽  
Dina Weindl ◽  
...  
Keyword(s):  
Mental Health ◽  
Asylum Seekers ◽  
Mental Health Problems ◽  
Psychological Intervention ◽  
Health Problems ◽  
Immigrant Integration ◽  
Life Questionnaire ◽  
Afghan Refugees ◽  
Wide Range ◽  
Asylum Seekers And Refugees

Abstract Background Asylum seekers and refugees are at great risk for developing mental disorders. Afghan refugees are a particularly vulnerable group with a low average educational and mental health literacy level. Traumatic experiences and hardship pre- and during migration are predictive of mental health problems. However, post-migration living difficulties (PMLDs) also account for a large proportion of mental distress in such populations, which critically are not sufficiently considered in treatment protocols and research investigations. Indeed, the evidence base for the treatment of refugees and asylum seekers is sparse and mainly limited to trauma-specific treatments, where refugees may likely suffer from other mental health problems such as depression or anxiety as well. Methods/design This trial is the first evaluation of the efficacy of a short-term, transdiagnostic treatment protocol adapted to address mental health problems and PMLDs for treatment seeking Afghan refugees using an adapted version of the Problem Management Plus (PM+) protocol. We investigate the efficacy of an intervention manual with a prospective, single-center, randomized, assessor blind, two-group trial. Furthermore we investigate participants’ subjective experiences with the intervention manual with in-depth interviews. One-hundred-twenty people will be assessed and randomly allocated to either the intervention arm or a TAU arm. Clinical psychologists will conduct the treatment and the sessions will take place with a Dari interpreter. The protocol includes six 90-minute sessions. The primary endpoint is the general symptom distress measure, assessed with the General Health Questionnaire 28 (GHQ-28). Secondary endpoints include the Post-Migration Living Difficulties Checklist (PMLDC), the International Trauma Questionnaire (ITQ), the WHO Quality of Life Questionnaire (WHOQOL-BREF), the Psychological Outcome Profile (PSYCHLOPS), service and health care use (assessed with several items), and the Immigrant Integration Index (IPL-12). Discussion This trial may provide substantial evidence for a brief transdiagnostic psychological intervention. Here, we intend to contribute to the treatment of mental health problems among Afghan refugees. The assessment of subjective experience with this treatment manual, as well as the evaluation of its clinical applicability, may optimize treatment acceptance and outcomes across a wide range of mental health problems among refugees.

scholarly journals A brief transdiagnostic psychological intervention for Afghan asylum seekers and refugees in Austria: A Randomized Controlled Trial

2019 ◽  
Author(s):  
Matthias Knefel ◽  
Viktoria Kantor ◽  
Andrew A. Nicholson ◽  
Jennifer Schieß-Jokanovic ◽  
Dina Weindl ◽  
...  
Keyword(s):  
Mental Health ◽  
Asylum Seekers ◽  
Mental Health Problems ◽  
Psychological Intervention ◽  
Health Problems ◽  
Immigrant Integration ◽  
Life Questionnaire ◽  
Afghan Refugees ◽  
Wide Range ◽  
Asylum Seekers And Refugees

Abstract Background: Asylum seekers and refugees are at great risk for developing mental disorders. Afghan refugees are a particularly vulnerable group with a low average education and mental health literacy level. Traumatic experiences and hardship before and during migration are predictive of mental health problems. However, post-migration living difficulties (PMLDs) also account for a large proportion of mental distress in such populations, which critically, are not sufficiently considered in treatment protocols and research investigations. Indeed, the evidence base for the treatment of refugees and asylum seekers is sparse and mainly limited to trauma-specific treatments, where refugees may likely suffer from other mental health problems such as depression or anxiety. Methods/design: This trial is the first evaluation of a short-term, transdiagnostic treatment protocol to address mental health problems and PMLDs for treatment seeking Afghan refugees using an adapted version of the Problem Management Plus (PM+) protocol. Here, we will investigate the efficacy of an intervention manual with a prospective, single-center, randomized, assessor blind, two-group trial among refugees who are on a waiting list for professional mental health treatment. Further, we will investigate participants’ subjective experiences with the intervention manual via in-depth interviews. One-hundred-twenty people will be assessed and randomly allocated to either the intervention arm or a TAU arm. Clinical psychologists will conduct the treatment and the sessions will take place with a Dari interpreter. The protocol includes six 90-minute sessions. The primary endpoint is the general symptom distress measure, assessed with the General Health Questionnaire 28 (GHQ-28). Secondary endpoints include the Post-Migration Living Difficulties Checklist (PMLDC), the International Trauma Questionnaire (ITQ), the WHO Quality of Life Questionnaire (WHOQOL-BREF), the Psychological Outcome Profile (PSYCHLOPS), service and health care use (assessed with several items), and the Immigrant Integration Index (IPL-12). Discussion: This trial may provide substantial evidence for a brief transdiagnostic psychological intervention. Here, we intend to contribute to the treatment of mental health problems among Afghan refugees. The assessment of subjective experience with this treatment manual, as well as the evaluation of its clinical applicability, may optimize treatment acceptance and outcomes across a wide range of mental health problems among refugees.

scholarly journals Investigating differential effects of socio-emotional and mindfulness-based online interventions on mental health, resilience and social capacities during the COVID-19 pandemic: The study protocol

PLoS ONE ◽  
2021 ◽  
Vol 16 (11) ◽  
pp. e0256323
Author(s):  
Malvika Godara ◽  
Sarita Silveira ◽  
Hannah Matthäus ◽  
Christine Heim ◽  
Manuel Voelkle ◽  
...  
Keyword(s):  
Mental Health ◽  
Mental Health Problems ◽  
Health Problems ◽  
Future Application ◽  
Second Phase ◽  
Depression And Anxiety ◽  
Online Interventions ◽  
Epigenetic Markers ◽  
Differential Effects ◽  
Link Type

Background The SARS-CoV-2 pandemic has led to a mental health crisis on a global scale. Epidemiological studies have reported a drastic increase in mental health problems, such as depression and anxiety, increased loneliness and feelings of disconnectedness from others, while resilience levels have been negatively affected, indicating an urgent need for intervention. The current study is embedded within the larger CovSocial project which sought to evaluate longitudinal changes in vulnerability, resilience and social cohesion during the pandemic. The current second phase will investigate the efficacy of brief online mental training interventions in reducing mental health problems, and enhancing psychological resilience and social capacities. It further provides a unique opportunity for the prediction of intervention effects by individual biopsychosocial characteristics and preceding longitudinal change patterns during the pandemic in 2020/21. Methods We will examine the differential effects of a socio-emotional (including ‘Affect Dyad’) and a mindfulness-based (including ‘Breathing Meditation’) intervention, delivered through a web- and cellphone application. Participants will undergo 10 weeks of intervention, and will be compared to a retest control group. The effectiveness of the interventions will be evaluated in a community sample (N = 300), which is recruited from the original longitudinal CovSocial sample. The pre- to post-intervention changes, potential underlying mechanisms, and prediction thereof, will be assessed on a wide range of outcomes: levels of stress, loneliness, depression and anxiety, resilience, prosocial behavior, empathy, compassion, and the impact on neuroendocrine, immunological and epigenetic markers. The multi-method nature of the study will incorporate self-report questionnaires, behavioral tasks, ecological momentary assessment (EMA) approaches, and biological, hormonal and epigenetic markers assessed in saliva. Discussion Results will reveal the differential effectiveness of two brief online interventions in improving mental health outcomes, as well as enhancing social capacities and resilience. The present study will serve as a first step for future application of scalable, low-cost interventions at a broader level to reduce stress and loneliness, improve mental health and build resilience and social capacities in the face of global stressors. Trial registration This trial has been registered on May 17, 2020 with the ClinicalTrials.gov NCT04889508 registration number (clinicaltrials.gov/ct2/show/NCT04889508).

scholarly journals The vulnerability paradox in global mental health and its applicability to suicide

2019 ◽  
Vol 215 (04) ◽  
pp. 588-593 ◽  
Author(s):  
Michel L. A. Dückers ◽  
Lennart Reifels ◽  
Derek P. De Beurs ◽  
Chris R. Brewin
Keyword(s):  
Mental Health ◽  
Data Quality ◽  
Goodness Of Fit ◽  
Survey Methodology ◽  
Mental Health Problems ◽  
Global Mental Health ◽  
Vulnerability Index ◽  
Health Problems ◽  
World Health ◽  
Country Level

BackgroundPrevious research has identified a vulnerability paradox in global mental health: contrary to positive associations at the individual level, lower vulnerability at the country level is accompanied by a higher prevalence in a variety of mental health problems in national populations. However, the validity of the paradox has been challenged, specifically for bias from modest sample sizes and reliance on a survey methodology not designed for cross-national comparisons.AimsTo verify whether the paradox applies to suicide, using data from a sizable country sample and an entirely different data source.MethodWe combined data from the World Health Organization 2014 suicide report and the country vulnerability index from the 2016 World Risk Report. Suicide was predicted in different steps based on gender, vulnerability and their interaction, World Bank income categories, and suicide data quality.ResultsA negative association between country vulnerability and suicide prevalence in both women and men was found. Suicide rates were higher for men, regardless of country vulnerability. The model predicting suicide in 96 countries based on gender, vulnerability, income and data quality had the best goodness-of-fit compared with other models. The vulnerability paradox is not accounted for by income or data quality, and exists across and within income categories.ConclusionsThe study underscores the relevance of country-level factors in the study of mental health problems. The lower mental disorder prevalence in more vulnerable countries implies that living in such countries fosters protective factors that more than compensate for the limitations in professional healthcare capacity.Declaration of interestNone.

scholarly journals Study on the correlation between mental health and socio-demographics of patients in five designated treatment hospitals in China during the COVID-19 outbreak :  a cross-sectional survey

2021 ◽  
Author(s):  
Zhonghuan Liang ◽  
Xiuli Ou ◽  
Jieming Li ◽  
Gang He ◽  
Qingdong Xu ◽  
...  
Keyword(s):  
Mental Health ◽  
Health Care Professionals ◽  
Mental Health Problems ◽  
Psychological Intervention ◽  
Health Problems ◽  
Occurrence Rate ◽  
Cross Sectional Survey ◽  
Online Questionnaire ◽  
Peak Period ◽  
Cross Sectional

Abstract Purpose The global epidemic of 2019 Novel Coronavirus Diseases (COVID-19) has caused many psychological problems. At present, there are few studies on the mental health status and correlation of COVID-19 patients. Methods During the peak period of COVID-19 outbreak in China, COVID-19 patients from 5 designated hospitals with new coronary pneumonia were selected by convenient sampling method. Symptom Checklist 90 (SCL-90) were investigated by either a convenient online questionnaire at: WJX.cn as a data collecting platform or an equivalent paper questionnaire. Results It showed that the positive detection rate of SCL-90 in the COVID-19 patients was 29.83%. The most common mental health problem was anxiety (28.3%), and the top three prominent mental health problems are depression (9.4%), interpersonal sensitivity (9.4%), paranoia ideation (7.7%). Compared with the Chinese adult norm, there were significant differences in the SCL-90 total score and somatization, depression, anxiety, and phobic anxiety dimension (P < 0.05). The main influencing factors of mental health of COVID-19 patients are the number of confirmed cases nationwide, sex, marital status and psychological intervention. Conclusion The mental state of some groups is relatively low, which leads to depression and anxiety more easily. In particular, the most vulnerable group was found to be unmarried women who have a high occurrence rate of mental health problems. We need to pay particular attention to high risk groups, and support patients with increased susceptibility, which will require timely assessment by mental health care professionals.

The WHO-EC partnership project on empowerment in mental health

2011 ◽  
Vol 26 (S2) ◽  
pp. 2101-2101
Author(s):  
A. Baumann
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Health Services ◽  
Mental Health Problems ◽  
National Level ◽  
Health Problems ◽  
World Health ◽  
Full Potential ◽  
Regional Office ◽  
Country Level

People with mental health problems and their families have not been involved as equal partners in decision-making processes on mental health services, and they continue to be at risk of social exclusion and discrimination in all facets of life. In a mental health context, empowerment refers to the level of choice, influence and control that users of mental health services can exercise over events in their lives, and the key to empowerment is the removal of formal or informal barriers and the transformation of power relations between individuals, communities, services and governments. Despite all achievements that have been made over the past decade, there is still a strong need for empowerment of people with mental health problems and their families. The World Health Organization Regional Office for Europe and the European Commission started a three years lasting "Partnership Project on Empowerment in Mental Health" in 2008 which aims to support Member States in the European Region in creating societies in which people with mental health problems are enabled to develop and express their full potential as equal citizens. The WHO Statement on Empowerment in Mental Health has been published, about 100 examples of empowerment practice across Europe have been collected, and indicators for empowerment applicable at national level have been identified. The project outcomes and possibilities for their implementation at country level will be presented.

scholarly journals Head injury in asylum seekers and refugees referred with psychological trauma

2016 ◽  
Vol 3 ◽  
Author(s):  
S. M. Doherty ◽  
R. Craig ◽  
M. Gardani ◽  
T. M. McMillan
Keyword(s):  
Mental Health ◽  
Head Injury ◽  
Asylum Seekers ◽  
Mental Health Problems ◽  
Psychological Trauma ◽  
Mental Health Clinicians ◽  
Trauma Service ◽  
History Of ◽  
Preliminary Study ◽  
Asylum Seekers And Refugees

Objective.Individuals who seek asylum are frequently fleeing violent persecution and may experience head injury (HI). However, little is known about the prevalence of HI in asylum seekers and refugees (ASR) despite the potential for HI to significantly affect cognitive and emotional functioning and to compromise asylum outcomes. This preliminary study investigates the prevalence of HI in ASR referred to a complex psychological trauma service.Method.Participants were 115 adult ASR referred to a community psychological trauma service with moderate to severe mental health problems associated with psychological trauma. They were screened for a history of HI using a questionnaire developed for the study. Interpreters were used when required.Results.The overall prevalence of HI was 51%. At least 38% of those with HI had a moderate–severe HI that could cause persisting disability. In 53% of those with HI, the cause was torture, human trafficking or domestic violence. Repeat HI can have cumulative effects on function; it was common, and was reported in 68% of those with HI. An injury to the head was not known to mental health clinicians prior to screening in 64% of cases.Conclusion.The emotional and cognitive consequences of HI in ASR may increase the vulnerability of this disadvantaged group, and can be associated with neurobehavioural problems affecting daily life and may compromise asylum outcomes. Routine screening for HI in ASR is needed, as are links to neuropsychology and brain injury services for advice, assessment and intervention.

scholarly journals Level of Stigma among Spanish Nursing Students toward Mental Illness and Associated Factors: A Mixed-Methods Study

2019 ◽  
Vol 16 (23) ◽  
pp. 4870 ◽  
Author(s):  
Rodríguez-Almagro ◽  
Hernández-Martínez ◽  
Rodríguez-Almagro ◽  
Quiros-García ◽  
Solano-Ruiz ◽  
...  
Keyword(s):  
Mental Health ◽  
Mixed Methods ◽  
Nursing Students ◽  
Associated Factors ◽  
Mental Health Problems ◽  
Family Members ◽  
Health Problems ◽  
World Health ◽  
Mental Health Stigma ◽  
Cross Sectional

Mental health problems have been identified by the World Health Organization as a global development priority. Negative attitudes toward mental health patients have been documented in multiple health professionals. The aim of this study was to determine the level of stigma and associated factors toward people with mental health problems among students doing their degree in nursing. An explanatory sequential mixed-methods approach. A cross-sectional descriptive observational study was carried out on a sample of 359 students doing their degree in nursing. Students had to be enrolled in any of the four years of study of the degree at the time the questionnaire was done. We explored the perception and experience of students doing their degree in nursing regarding the level of stigma, through in-depth interviews (n = 30). The mean overall Mental Health Stigma Scale (MHSS) score was 30.7 points (SD = 4.52); 29.5% (n = 106) scored low for stigma, 49.9% (n = 179) showed moderate stigma, and 20.6% (n = 74) scored high. The multivariate analysis showed that 4th-year students had an OR of 0.41 (CI95%: 0.20–0.84) for high/moderate stigma and that 3rd-year students had an OR of 0.49 for high/moderate stigma compared with 1st-year students. We also observed that students with family members with mental health problems had an OR of 2.05 (CI95%: 1.19–3.56) for high/moderate stigma compared with students who did not have family members with mental health problems. The following categories emerged: fear and lack of knowledge, breaking the silence, and integration into society. The levels of mental health stigma in our sample of nursing students were moderate. Stigma levels were lower in 3rd- and 4th-year students (i.e., after having received training in mental health), and in students with family members with mental health problems.

The mental health needs of asylum seekers and refugees in Ireland

2011 ◽  
Vol 26 (S2) ◽  
pp. 452-452
Author(s):  
A. Datta ◽  
J. Frewen
Keyword(s):  
Mental Health ◽  
Health Risks ◽  
Asylum Seekers ◽  
English Language ◽  
Mental Health Problems ◽  
Outcome Expectations ◽  
Cultural Integration ◽  
Economic Sectors ◽  
Psychiatric Problems ◽  
Asylum Seekers And Refugees

IntroductionAsylum seekers and refugees (ASR) are commonly portrayed as opportunists who came to Ireland to fraudulently scrounge off the Irish public. Such views and the consequent exclusion and discrimination they experience can aggravate their mental health risks and reduce their willingness to seek professional help.ObjectivesTo identify the mental health risks faced by ASR and outline specific measures to improve their situation.AimsThrough available hardcopy and online literature1/Assess and evaluate impact of asylum seeking and refugee integration process on ASR psychiatric problems in Ireland.2/Assess and evaluate knowledge and understanding of ASR mental health status; effects of segregation from local communities due to living in isolated ‘centres’ and no employment entitlement; communication and cultural integration difficulties; impact of exclusion and/or (racial) discrimination; apprehension of alien mental health system and treatment process; differing outcome expectations held by ASR and mental health specialists; and fear of being stigmatised by peers.MethodsRigorous review of relevant and applicable hardcopy and internet literature in English language since 2000.ResultsASR mental health problems associated are generally multi-dimensional. In addition to ‘normal’ stresses, many ASR are haunted by past hardships, experience exclusion and integration difficulties and endure a highly stressful asylum process.ConclusionASR require additional, specifically targeted mental health assistance and services that respect and understand their particular needs. Mental health services should work with the asylum process and other relevant socio-economic sectors to develop programmes to tackle potential ASR mental health concerns.

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