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A Pilot Study of a Psychoeducational Group Intervention Delivered at Asylum Accommodation Centers-A Mixed Methods Approach
Mid Sweden University, Faculty of Human Sciences, Department of Psychology and Social Work.
Mid Sweden University, Faculty of Human Sciences, Department of Psychology and Social Work.
Mid Sweden University, Faculty of Human Sciences, Department of Psychology and Social Work. Region Örebro County.
Mid Sweden University, Faculty of Human Sciences, Department of Psychology and Social Work.ORCID iD: 0000-0003-0011-7770
2020 (English)In: International Journal of Environmental Research and Public Health, ISSN 1661-7827, E-ISSN 1660-4601, Vol. 17, no 23, article id 8953Article in journal (Refereed) Published
Abstract [en]

Asylum seekers suffer high levels of distress but have restricted access to mental health care. This paper constitutes an evaluation of a psycho-educational group intervention, called AMIN, which was provided at two asylum accommodation centers in Sweden. A mixed-methods approach was used. To assess potential effectiveness, acceptability, and feasibility, quantitative outcome measures were combined with qualitative information from interviews with both intervention participants and staff providing the intervention. Potential effectiveness in reducing symptoms of distress and insomnia and in increasing physical quality of life was found, even though the intervention participants suffered from more severe distress than expected. In general, the intervention seemed to be acceptable to both participants and staff, with concrete strategies seeming more meaningful than abstract psychological techniques. Finally, regardless of the asylum process itself being a complicating factor, the intervention seemed feasible to deliver to individuals with different backgrounds and conditions. Taken together, these results indicate that some sessions may need further elaboration, but also that the transition to a randomized control trial is reasonable.

Place, publisher, year, edition, pages
2020. Vol. 17, no 23, article id 8953
Keywords [en]
asylum seekers, mental health, pilot study, psychoeducation, psychosocial intervention
National Category
Psychology
Identifiers
URN: urn:nbn:se:miun:diva-40759DOI: 10.3390/ijerph17238953ISI: 000597481500001Scopus ID: 2-s2.0-85097123056OAI: oai:DiVA.org:miun-40759DiVA, id: diva2:1510162
Available from: 2020-12-15 Created: 2020-12-15 Last updated: 2021-04-12
In thesis
1. Mental Health and Quality of Life Among Individuals in Asylum Accommodations: Screening and Intervention
Open this publication in new window or tab >>Mental Health and Quality of Life Among Individuals in Asylum Accommodations: Screening and Intervention
2021 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Refugees have often experienced traumatic events that could be classified as disasters before leaving their home countries. They are further distressed by difficult experiences while in flight and after reaching the new country. Since the experience of traumatic events is associated with an increased risk of subsequent mental health problems, recommendations regarding psychosocial support after disasters have been established. Two examples are the screen and treat approach, and active monitoring. According to these recommendations, individuals who have experienced a disaster ought to be screened for mental health problems one month after the disaster, and those with persisting symptoms of distress should be offered treatment. 

The general aim of this thesis is to assess the possibility and appropriateness of applying a screen and treat approach to the mental health of refugees.

Four studies are included in the thesis. The first study assessed the mental health and quality of life among individuals living in refugee housing facilities in Sweden. The results showed that the prevalence of symptoms of anxiety, depression and PTSD was high, and that the included participants rated their quality of life as low. Individuals without residence permits generally had worse outcomes than those who had received a residence permit. In the second study, the ability of the Refugee Health Screener (RHS, an instrument developed for assessment of emotional distress among newly arrived refugees) to distinguish between different levels of symptom severity was assessed. By comparing the scores on the RHS with scores on other established scales with cutoffs indicating symptom severity, we identified cutoff values for mild, moderate, and severe distress. In the third study, these cutoffs were further assessed by an investigation of the association between suicidal ideation and symptom severity. The odds of an individual having suicidal ideation increased notably at each severity level. More than half of the individuals with severe distress had suicidal ideation, indicating that they needed support. The fourth study is a pilot study assessing potential effectiveness, acceptability and feasibility of a group psychoeducational intervention delivered at asylum accommodations. The results showed that the intervention was promising in alleviating symptoms of distress and insomnia. It also seemed to be acceptable to both participants and staff, even though some sessions require further elaboration. To deliver the intervention in the midst of the asylum process was demanding, but feasible. This was an early evaluation but shows that the transition to an RCT is reasonable. 

Taken together, the results of the four studies indicate that the mental health needs among newly arrived refugees are considerable, that the RHS can be used to identify individuals with differing needs of mental health care, and that high levels of distress are associated with suicidal ideation. The results also indicate that it is possible and meaningful to provide psychosocial interventions to individuals at asylum accommodations. This indicates that it could be possible to implement a screen and treat approach to the mental health of refugees. However, if access to treatment cannot be assured, only implementing the screening would neither be ethical nor appropriate.  

Place, publisher, year, edition, pages
Östersund: Mittuniversitetet, 2021. p. 92
Series
Mid Sweden University doctoral thesis, ISSN 1652-893X ; 344
Keywords
mental health, quality of life, refugees, asylum seekers, screening, intervention
National Category
Psychology
Identifiers
urn:nbn:se:miun:diva-41830 (URN)978-91-89341-05-0 (ISBN)
Public defence
2021-05-21, Digitalt, Östersund, 10:00 (English)
Opponent
Supervisors
Note

Delfinansierad av Asyl, migration och integrationsfonden (AMIF)

Available from: 2021-04-12 Created: 2021-04-12 Last updated: 2021-04-21Bibliographically approved

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Leiler, AnnaWasteson, ElisabetHolmberg, JoannaBjärtå, Anna

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