Mental health in refugees and asylum seekers (MEHIRA): study design and methodology of a prospective multicentre randomized controlled trail investigating the effects of a stepped and collaborative care model.

Publisher: Springer International Country of Publication: Germany NLM ID: 9103030 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1433-8491 (Electronic) Linking ISSN: 09401334 NLM ISO Abbreviation: Eur Arch Psychiatry Clin Neurosci Subsets: MEDLINE

Original Publication: Berlin ; New York : Springer International, c1990-

Culturally Competent Care* ; Depression*/diagnosis ; Depression*/therapy ; Mental Health Services*/organization & administration ; Psychotherapy* ; Refugees*/psychology ; Stress Disorders, Post-Traumatic*/diagnosis ; Stress Disorders, Post-Traumatic*/therapy; Adolescent ; Adult ; Aged ; Female ; Humans ; Male ; Middle Aged ; Young Adult ; Germany ; Multicenter Studies as Topic/methods ; Prospective Studies ; Randomized Controlled Trials as Topic/methods ; Research Design

The sudden arrival of culturally diverse asylum seekers and refugees into Germany has created a strong demand for recognizing and appropriately treating those suffering from mental health issues. Due to many systemic, organizational, cultural and socio-linguistic barriers, psychiatric treatment of refugees is posing a major challenge to Germany's mental health care system. Thus, there is a need for alternative models that allow for increased access to adequate, effective and efficient culturally sensitive mental health care services. Here, we describe the Mental Health in Refugees and Asylum Seekers (MEHIRA) project, a multicentre randomized controlled trial investigating a stepped collaborative care model (SCCM) for providing mental health treatment in this vulnerable population. The proposed SCCM aims to decrease the aforementioned barriers. Adult and adolescent participants will be screened for depressive symptoms and matched to appropriate psychological interventions, including group-level interventions (START intervention, Empowerment/Gender-sensitive/Peer to peer), and other innovative, digital treatment approaches (Smartphone application). The therapeutic effect of the SCCM will be compared to TAU (treatment-as-usual). All interventions have been designed to be culturally sensitive, and offered in two different languages: Arabic and Farsi. The outcome of this study may contribute significantly to future clinical and legal guidelines in developing parallel and efficient new structures of treatment. Collected data will inform primary and secondary mental health care providers with recommendations concerning the design and implementation of effective treatment models and programmes. Guidelines and recommendations may also potentially be adopted by other host countries, developing countries and also in humanitarian aid programmes.

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01VSF16061 Innovationsfond

Keywords: Asylum seekers; Depression; Mental health; Refugees; Stepped collaborative care model

Date Created: 20190224 Date Completed: 20201106 Latest Revision: 20240321

20240321

10.1007/s00406-019-00991-5

30796528