Responding to mental health needs of Syrian refugees in Turkey: mhGAP training impact assessment

Abstract

Background About 1468 Syrian and Turkish doctors, serving in primary health care, have received the mhGAP training during 2016–2019. As additional training needs were identified, MoH and WHO wanted to understand the usefulness of the training and its impact in responding to the mental health needs of Syrian refugees in Turkey. Methods A five component assessment was done in 2019, consisting of feedback of trainees, assessment of increase in knowledge; utilization of service; compliance to treatment guidelines and service user satisfaction. The purpose was to understand the perception of participants on the training; estimate the knowledge gained—attributable to the training; estimate the increase in mental health cases identified and treated; compliance with treatment guidelines; as well as perception of the services received by end-beneficiaries. Results Results indicate that most of the respondents were happy with the training, but preferred additional mhGAP training as a refresher course in the future. There was knowledge gained due to the training, 9% for the Syrian and 5% for Turkish doctors. The knowledge gained has helped the practicing doctors to be more attentive and increase the numbers of cases diagnosed after the training for almost all groups of diagnoses. Most doctors, observed during practice, comply with the guidelines shared during the training, but improvement is still needed when it comes to prescription and treatment of certain conditions. The average number of mental health cases identified increased by 38 (%27) cases in the year following the training. We observed over 70% compliance with guidelines for 9 out of 12 criteria in question. The results of the patient exit interviews indicate a high level of satisfaction with the MHPSS services provided. About 95% of beneficiaries were happy with the quality of the service, and 92% having their needs met. Conclusions The mhGAP training was found useful. More training should be conducted to fill in the gap in service provision and meet the mental needs of Syrian refugees in Turkey.

Ten years of tracking mental health in refugee primary health care settings: an updated analysis of data from UNHCR’s Health Information System (2009–2018)

“…Over the last decade, various new tools have been developed with the goal of scaling-up delivery of MNS services through task-sharing approaches aimed at improving mental health coverage among refugee populations (e.g., the mhGAP-HIG) [ 21 ] and considerable efforts have been made to train and supervise staff with these methods in some regions [ 22 , 35 – 37 ]. An evaluation of mhGAP-HIG capacity building efforts in refugee camps in seven sub-Saharan African countries showed various effects such as (1) strengthened capacities by facility- and community-based staff to deliver mental health and psychosocial support interventions, (2) positive changes in their attitudes towards people suffering from MNS conditions, and (3) improved collaboration among health and non-health staff regarding people suffering from MNS conditions [ 22 ].…”

Satisfaction in Mental Health Care: Examining Psychometric Properties of Experience of Service Questionnaire in a Turkish Population

“…This result may also point to the importance of clinician-patient relationship and the care received. In another interview-based qualitative study that was conducted by World Health Organization and Ministry of Health on Syrian refugees receiving mental health care and psychosocial support, the results showed that the satisfaction level and 'having needs met' were high among participants (Kahiloğulları et al, 2020).…”

Contemporary Approaches in Refugee Mental Health

“…Klavuz, afet ve acil durumlarında ve sağlık kapasitesinin kısıtlı olduğu durumlarda, birinci basamak sağlık hizmetlerinde çalışan sağlık personelinin ruh sağlığı hizmeti sunabilmesi için, psikiyatrik, nörolojik ve madde kullanımı sorunlarının yönetimi için yönergeler içermektedir (35). Türkiye'de yapılan bir çalışmada (36), RSGÜÇ uygulamasının, hizmet sunan doktorların ruh sağlığına ilişkin bilgi düzeyini arttırdığı, tespit edilen vakaların sayısın arttığı, bu hizmeti alan mültecilerin büyük kısmının (%95) aldıkları hizmetten memnun olduğu ve ihtiyaçlarının karşılandığı tespit edilmiştir. Bu yaklaşıma getirilen eleştiriler ise ruh sağlığı sorunlarının yaygınlığı ve yüklerinin tespitinin kısıtlı veriden gelmesi, batı kültürlerinde geliştirilen tanı sınıflamalarının ve müdahalelerin uygulanması, ruh sağlığı bozukluları epidemiyolojsinin sosyal sorunların önüne geçmesi, hizmet açığını kapatmak için sadece tedavi boşluğuna odaklanıp toplum temelli hizmetleri göz ardı etmesidir.…”