The culturally and contextually sensitive assessment of mental health using a structured diagnostic interview (MINI Kid) for Syrian refugee children and adolescents in Lebanon: Challenges and solutions

Abstract

Elevated rates of mental health difficulties are frequently reported in conflict-affected and displaced populations. Even with advances in improving the validity and reliability of measures, our knowledge of the performance of assessment tools is often limited by a lack of contextualization to specific populations and socio-political settings. This reflective article aimed to review challenges and share lessons learned from the process of administering and supervising a structured clinical interview. We administered the MINI International Neuropsychiatric Interview for Children and Adolescents (MINI Kid) and used the Clinical Global Impression (CGI) severity scale with N = 119 Syrian refugee children (aged 8–17) resident in ITSs in Lebanon. Qualitative data were derived from supervision process notes on challenges that arose during assessments, analyzed for thematic content. Five themes were identified: (1) practical and logistical challenges (changeable nature of daily life, competing demands, access to phones, temporary locations, limited referral options); (2) validity (lack of privacy, trust, perceptions of mental health, stigma, false positive answers); (3) cultural norms and meaning (impact of different meanings on answers); (4) contextual norms (reactive and adaptive emotional and behavioral responses to contextual stress); and (5) co-morbidity and formulation (interconnected and complex presentations). The findings suggest that while structured assessments have major advantages, cultural and contextual sensitivity during assessments, addressing practical barriers to improving accessibility, and consideration for inter-connected formulations are essential to help inform prevalence rates, treatment plans, and public health strategies.

Self-concept in Adolescents with Physical-Mental Comorbidity

“…It has been shown to be valid and reliable in clinical and population-based samples of adolescents. [23][24][25][26] Responses are binary (no/yes), and screening questions are used for each illness module on the MINI-KID. If the screening questions are not endorsed, the module is skipped.…”

Global migration: Moral, political and mental health challenges

“…Intercultural work challenges this assumption by raising questions about the cross-cultural applicability of standard instruments. Kyrillos et al (2023) drew data from a larger study of Syrian refugee children and adolescents in Lebanon to consider how the MINI International Neuropsychiatric Interview for Children and Adolescents (MINI Kid; Sheehan et al, 2010) functioned in clinical assessments. They found that attention paid to cultural norms and meanings during the assessments was critical to accurately interpreting results.…”