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Supported self-help intervention prevents mental disorders among refugees

A psychological intervention can prevent mental disorders among refugees facing hard times, new research has found.

An international team of top researchers has been examining the impact of a psychological intervention called Self-Help Plus (SH+) on 642 refugees in Turkey who were experiencing psychological distress but did not have a mental disorder when they signed up as participants.

The RE-DEFINE study is the first-ever randomised controlled trial to demonstrate that a psychological intervention can prevent mental disorders from developing in refugee populations.

Professor Ross White from the School of Psychology at Queen’s University Belfast was co-investigator on the study. He explains: “Our study looked at the impact of self-help psychological intervention – a form of cognitive behavioural therapy.

“We found that six months after receiving Self-Help Plus, refugees were less likely to have a mental disorder than those who did not receive the intervention. With many refugees having to contend with ongoing uncertainty and difficult life circumstances, these findings show that this type of low-intensity psychological intervention has enormous potential in supporting the millions of people who have been forcibly displaced from their homes across the world.

“This approach could be scaled up as a public health strategy and represents an important piece in a larger jigsaw that also needs to tackle the sources of adversity that refugees face at root cause.”

The research has been published in World Psychiatry and the SH+ intervention, which was developed by the World Health Organization, has now been released as a free manual that can be used by organisations and agencies working in humanitarian contexts.

An illustrated guide called ‘Doing What Matters in Times of Stress’ contains key information from the SH+ course. It can be used along with the course or as a self-help guide for stress and is available in multiple languages.

Professor White comments: “There are more than 80 million people worldwide who have been forcibly removed from their homes. This research and the WHO’s efforts to make the intervention available in humanitarian settings will have a positive impact on the health and well-being of refugee populations across the globe.

“Researchers working at Queen’s are committed to playing a key role in supporting those experiencing adversity across the globe and will continue to work in collaboration with partners to tackle real world issues.”

Professor Corrado Barbui from the University of Verona, Italy, was Principal Investigator on the study. He comments: “Although this study has shown that Self-Help Plus can help reduce psychological distress and prevent the development of mental health conditions, there is much still to learn. Research is needed to investigate which delivery modalities may optimise full-scale implementation, aiming to provide Self-Help Plus and other key interventions on a routine and regular basis to those in need in a variety of settings and contexts.”

Dr Ceren Acarturk, who is based at Koc University, Turkey, comments: “For better mental health we not only need effective interventions, but we are encouraged to develop and deliver programs that would prevent mental health disorders.

“This study has found out that SH+ is effective in preventing the onset of mental disorders in a vulnerable group, such as Syrian refugees. Considering the difficulties mental health systems are facing during the COVID-19 pandemic, SH+, which requires less resources to implement compared to many other psychological interventions, could be offered in different modalities in the first steps of a stepped care model.”


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