Effectiveness of a peer-refugee delivered psychological intervention to reduce psychological distress among adult Syrian refugees in the Netherlands: study protocol

• Published in: European journal of psychotraumatology 2020-12, Vol.11 (1), p.1694347-1694347
• Main Authors: de Graaff, Anne M., Cuijpers, Pim, Acarturk, Ceren, Bryant, Richard, Burchert, Sebastian, Fuhr, Daniela C., Huizink, Anja C., de Jong, Joop, Kieft, Barbara, Knaevelsrud, Christine, McDaid, David, Morina, Naser, Park, A-La, Uppendahl, Jana, Ventevogel, Peter, Whitney, Claire, Wiedemann, Nana, Woodward, Aniek, Sijbrandij, Marit
• Format: Article
• Language: English
• Subjects: ansiedad; anxiety; cambio de tarea; common mental disorders; consejero no especialista; cortisol en cabello; depresión; depression; Despite availability of adequate mental health services in high-income countries such as the Netherlands, refugees face various barriers in accessing these services. Brief, non-specialist helper delivered psychological interventions can be effective in reducing psychological distress, i.e. depression and anxiety. This paper describes a protocol to evaluate Problem Management Plus (PM+) delivered by peer-refugee helpers to Syrian refugees in the Netherlands in a definite randomized controlled trial, comparing PM+ and usual care with usual care alone; ensayo clínico aleatorizado; hair cortisol; intervención psicológica; Intervention; Mental disorders; Mental health; non-specialist counsellors; posttraumatic stress disorder; psychological intervention; randomized controlled trial; Refugee mental health; Refugees; Salud mental del refugiado; Study Protocol; task-shifting; trastorno de estrés postraumático; trastorno mental frecuente; 任务转移; 创伤后应激障碍; 头发皮质醇; 常见精神障碍; 心理干预; 抑郁; 焦虑; 随机对照试验; 难民心理健康; 非专业咨询师
• ISSN: 2000-8066; 2000-8198; 2000-8066
• DOI: 10.1080/20008198.2019.1694347

Background: Syrian refugees face multiple hardships and adversities which put them at risk for the development of mental health problems. However, access to adequate mental health care in host countries is limited. The WHO has developed Problem Management Plus (PM+), a brief, scalable psychological intervention, delivered by non-specialist helpers, that addresses common mental disorders in people affected by adversity. This study is part of the STRENGTHS project, that aims to evaluate peer-refugee delivered psychological interventions for Syrian refugees in Europe and the Middle East. Objective: To evaluate the effectiveness and cost-effectiveness of the peer-refugee delivered PM+ intervention among Syrian refugees with elevated levels of psychological distress in the Netherlands. Methods: PM+ will be tested in a randomized controlled trial (RCT) among Arabic-speaking Syrian refugees in the Netherlands aged 18 years and above with self-reported psychological distress (Kessler Psychological Distress Scale; K10 >15) and impaired daily functioning (WHO Disability Assessment Schedule; WHODAS 2.0 >16). Participants (N = 380) will be randomized into care as usual with PM+ (CAU/PM+, n = 190) or CAU only (CAU, n = 190). Baseline, 1-week post-intervention, and 3-month and 12-month follow-up assessments will be conducted. Primary outcomes are symptoms of depression and anxiety. Secondary outcomes are functional impairment, posttraumatic stress disorder symptoms, self-identified problems, anger, health and productivity costs, and hair cortisol concentrations. A process evaluation will be carried out to evaluate treatment dose, protocol fidelity and stakeholder views on barriers and facilitators to implementing PM+. Results and Conclusions: PM+ has proved effectiveness in other populations and settings. After positive evaluation, the adapted manual and training materials for individual PM+ will be made available through the WHO to encourage further replication and scaling up. Trial registration: Trial registration Dutch Trial Registry, NL7552, registered prospectively on March 1, 2019. Medical Ethics Review Committee VU Medical Center Protocol ID 2017.320, 7 September 2017.