Smartphone-delivered mental health care interventions for refugees: A systematic review of the literature

Abstract

According to the United Nations, an estimated 26.6 million people worldwide were refugees in 2021. Experiences before, during, and after flight increase psychological distress and contribute to a high prevalence of mental disorders. The resulting high need for mental health care is generally not reflected in the actual mental health care provision for refugees. A possible strategy to close this gap might be to offer smartphone-delivered mental health care. This systematic review summarizes the current state of research on smartphone-delivered interventions for refugees, answering the following research questions: (1) Which smartphone-delivered interventions are available for refugees? (2) What do we know about their clinical (efficacy) and (3) non-clinical outcomes (e.g., feasibility, appropriateness, acceptance, barriers)? (4) What are their dropout rates and dropout reasons? (5) To what extent do smartphone-delivered interventions consider data security? Relevant databases were systematically searched for published studies, gray literature, and unpublished information. In total, 456 data points were screened. Twelve interventions were included (nine interventions from eleven peer-reviewed articles and three interventions without published study reports), comprising nine interventions for adult refugees and three for adolescent and young refugees. Study participants were mostly satisfied with the interventions, indicating adequate acceptability. Only one RCT (from two RCTs and two pilot RCTs) founda significant reduction in the primary clinical outcome compared to the control group. Dropout rates ranged from 2.9 -80%. In the discussion, the heterogeneous findings are integrated into the current state of literature. Impact StatementRefugees are a large population with special mental health care needs which are nowadays not adequately addressed by most of the host countries. Experiences before, during, and after flight increase psychological distress and contribute to a high prevalence of mental disorders. The resulting high need for mental health care is generally not reflected in the actual mental health care provision for refugees. Potential reasons for low utilization include language difficulties, limited treatment offer, and lack of knowledge

Implementing Arabic-language digital interventions for depression in German routine health care: log data analysis of the iFightDepression (iFD) tool and awareness website

“…The current study further showed that the conversion rate, i.e., the transition from invitation by a guide to user registration and use of the iFD tool, was lower among Arabic-speaking users compared to German-speaking users (of both the guided and unguided version that was offered during the early days of the COVID-19 pandemic). Difficulties in reaching the target populations and managing dropout rates have also been faced by other DID for ASR 34 . The acceptability of the content of the iFD tool was, however, comparable between user groups, even when all subsamples showed higher depressive symptom burden than the study sample of the efficacy study 33 .…”

Arabic-language digital interventions for depression in German routine health care are acceptable, but intervention adoption remains a challenge

“…The current study further showed that the conversion rate, i.e., the transition from invitation by a guide to user registration and use of the iFD tool, was lower among Arabic-speaking users compared to German-speaking users (of both the guided and unguided version that was offered during the early days of the COVID-19 pandemic). Di culties in reaching the target populations and managing dropout rates have also been faced by other DID for ASR 34 . The acceptability of the content of the iFD tool was, however, comparable between user groups, even when all subsamples showed higher depressive symptom burden than the study sample of the e cacy study 33 .…”

A Mobile-Based Preventive Intervention for Young, Arabic-Speaking Asylum Seekers During the COVID-19 Pandemic in Germany: Design and Implementation

“…Arabic- and Russian-speaking participants showed significantly higher click-through rates when COVID-19 vaccine advertisements were displayed in Arabic and Russian compared with the same advertisements presented only in German. Moreover, a review of smartphone-delivered mental health interventions for asylum seekers and refugees included 12 interventions, of which 3 were specially tailored to adolescent and young refugees [ 15 ]. The included interventions varied with regard to the degree of guidance, ranging from unguided (ie, no personal contact or individualized feedback) to guided conditions (ie, different amounts of personal support) [ 16 ].…”