Protocol for a randomized controlled trial: peer-to-peer Group Problem Management Plus (PM+) for adult Syrian refugees in Turkey

Uygun, Ersin; İlkkurşun, Zeynep; Sijbrandij, Marit; Aker, Ahmet; Bryant, Richard A.; Cuijpers, Pim; Fuhr, Daniela C.; Graaff, Anne M. de; Jong, Joop de; McDaid, David; Morina, Naser; Park, A‐La; Roberts, Bayard; Ventevogel, Peter; Yurtbakan, Taylan; Acartürk, Ceren

doi:10.1186/s13063-020-4166-x

Cited by 21 publications

(10 citation statements)

References 32 publications

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“…Scalable psychological interventions to reduce distress and improve functioning that can be delivered through smartphones or face-to-face by lay non-professionals 74 also have the opportunity for usage both within refugee camps and in host countries. Examples developed by the World Health Organization include Problem Management Plus (PM+), 142 , 143 its variants, 74 and Self-Help Plus (SH+), 144 with implementation protocols for RCTs available. 142–144 …”

Section: Addressing Mental Health Concerns In Persons Resettled As Re...mentioning

confidence: 99%

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Addressing Mental Health Concerns in Refugees and Displaced Populations: Is Enough Being Done?

Grasser¹

2022

RMHP

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There are over 82.4 million forcibly displaced people worldwide, about a quarter of whom are resettling as refugees. In the wake of the global refugee crisis spurred by conflict, religious and political persecution, human rights violations, and climate disasters, a mental health has crisis followed. Not only does trauma experienced in home countries and as part of forced migration affect mental health, so too do post-migration traumatic events, discrimination, lack of access to quality and affordable healthcare and housing, and acculturation. To address mental health concerns in refugees and displaced populations, collective action is needed not only from health care providers but also from mental health researchers, funders, journals, resettlement agencies, government entities, and humanitarian organizations. The present review highlights the work of numerous scholars and organizations with the goal of understanding the mental health concerns of forcibly displaced persons within and across ecological systems. The present review seeks to bring attention to the experiences of forcibly displaced persons, summarize the growing body of research understanding the acute and chronic effects of forced displacement and possible interventions, and give a call to action for all members of the global community at every level to engage in joint efforts to improve mental health in refugees and displaced persons. Notably, there is a need for more interventions at the familial and community level that serve not only as treatment but also as prevention. Smartphone-based interventions, mind-body modalities, and interventions delivered by lay and non-clinician community members hold promise. Numerous strides could be made in refugee mental health and treatment when funding agencies include these goals in their research priorities. Despite the challenges they have faced, persons who resettle as refugees are incredibly resilient and deserve to be afforded every right, opportunity, dignity, and respect.

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Section: Addressing Mental Health Concerns In Persons Resettled As Re...mentioning

confidence: 99%

“…Examples developed by the World Health Organization include Problem Management Plus (PM+), 142 , 143 its variants, 74 and Self-Help Plus (SH+), 144 with implementation protocols for RCTs available. 142–144 …”

Section: Addressing Mental Health Concerns In Persons Resettled As Re...mentioning

confidence: 99%

Addressing Mental Health Concerns in Refugees and Displaced Populations: Is Enough Being Done?

Grasser¹

2022

RMHP

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“…Data were collected as part of three studies conducted in Jordan, Turkey and Switzerland which aimed to assess the feasibility of conducting large controlled trials designed to evaluate the effectiveness and implementation of Problem Management Plus (PM+) with SRAs [33][34][35]. PM+ is a scalable low-intensity intervention developed by the WHO for people affected by adversity aiming to reduce symptoms of common mental disorders [36,37].…”

Section: Settingmentioning

confidence: 99%

Problems after flight: understanding and comparing Syrians’ perspectives in the Middle East and Europe

et al. 2021

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Background Syrian refugees and asylum seekers (SRAs) face multiple stressors after flight, which may vary due to different geographic, economic, cultural and socio-political contexts in the host countries. Past research has recognised the importance of participants’ own perspectives. The aims of this multi-country study were to identify and compare self-reported problems of SRAs between various settings. Methods A semi-structured client-generated outcome measurement was used to collect data among adult SRAs in Jordan (N = 61), Turkey (N = 46) and Switzerland (N = 57) between September 2018 and November 2019. Answers were analysed following thematic analysis. Results Over half of the participants reported practical problems with an emphasis on camp-related problems (Jordan), finances (Turkey), employment (Jordan and Switzerland) and government regulations (Switzerland), followed by psychological, and social issues. Conclusion This study highlights the impact of local contextual factors on wellbeing. The findings emphasise that planning preventative procedures and mental health care services for SRAs need to consider local challenges affecting the population in specific countries.

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“…The outcome measures were agreed upon by the STRENGTHS consortium [ 30 ] to establish a common method for all country partners and were further explained in the protocol paper for the current study [ 36 ]. The primary outcome measure was the Hopkins Symptoms Checklist (HSCL-25) at 3-month follow up [ 37 ].…”

Section: Methodsmentioning

confidence: 99%

Group problem management plus (PM+) to decrease psychological distress among Syrian refugees in Turkey: a pilot randomised controlled trial

et al. 2022

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Background Syrian refugees resettled in Turkey show a high prevalence of symptoms of mental disorders. Problem Management Plus (PM+) is an effective psychological intervention delivered by non-specialist health care providers which has shown to decrease psychological distress among people exposed to adversity. In this single-blind pilot randomised controlled trial, we examined the methodological trial procedures of Group PM+ (gPM+) among Syrian refugees with psychological distress in Istanbul, Turkey, and assessed feasibility, acceptability, perceived impact and the potential cost-effectiveness of the intervention. Methods Refugees with psychological distress (Kessler Psychological Distress Scale, K10 > 15) and impaired psychosocial functioning (World Health Organization Disability Assessment Schedule, WHODAS 2.0 > 16) were recruited from the community and randomised to either gPM+ and enhanced care as usual (E-CAU) (n = 24) or E-CAU only (n = 22). gPM+ comprised of five weekly group sessions with eight to ten participants per group. Acceptability and feasibility of the intervention were assessed through semi-structured interviews. The primary outcome at 3-month follow-up was symptoms of depression and anxiety (Hopkins Symptoms Checklist-25). Psychosocial functioning (WHODAS 2.0), symptoms of posttraumatic stress disorder and self-identified problems (Psychological Outcomes Profiles, PSYCHLOPS) were included as secondary outcomes. A modified version of the Client Service Receipt Inventory was used to document changes in the costs of health service utilisation as well as productivity losses. Results There were no barriers experienced in recruiting study participants and in randomising them into the respective study arms. Retention in gPM+ was high (75%). Qualitative analyses of the interviews with the participants showed that Syrian refugees had a positive view on the content, implementation and format of gPM+. No adverse events were reported during the implementation. The study was not powered to detect an effect. No significant difference between gPM+ and E-CAU group on primary and secondary outcome measures, or in economic impacts were found. Conclusions gPM+ delivered by non-specialist peer providers seemed to be an acceptable, feasible and safe intervention for Syrian refugees in Turkey with elevated levels of psychological distress. This pilot RCT sets the stage for a fully powered RCT. Trial registration ClinicalTrials.gov Identifier NCT03567083; date: 25/06/2018.

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Protocol for a randomized controlled trial: peer-to-peer Group Problem Management Plus (PM+) for adult Syrian refugees in Turkey

Cited by 21 publications

References 32 publications

Addressing Mental Health Concerns in Refugees and Displaced Populations: Is Enough Being Done?

Addressing Mental Health Concerns in Refugees and Displaced Populations: Is Enough Being Done?

Problems after flight: understanding and comparing Syrians’ perspectives in the Middle East and Europe

Group problem management plus (PM+) to decrease psychological distress among Syrian refugees in Turkey: a pilot randomised controlled trial

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