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An online tiered screening procedure to identify mental health problems among refugees
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.
Mid Sweden University, Faculty of Human Sciences, Department of Psychology and Social Work.
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2023 (English)In: BMC Psychiatry, E-ISSN 1471-244X, Vol. 23, no 1, article id 7Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: Many refugees suffer from mental health problems due to stressful and traumatic events before, during, and after migration. However, refugees are facing a wide variety of barriers, limiting their access to mental health care. Internet-based tools, available in several languages, could be one way to increase the availability of mental health services for refugees. The present study aimed to develop and test a screening tool to screen for clinically relevant symptoms of psychiatric disorders common among refugees (i.e. Depression, Anxiety, Post-traumatic stress disorder, and Insomnia). We, designed, translated, and adapted an internet-based tiered screening procedure suitable for use with the largest refugee populations residing in Sweden. The tool aims to accurately identify symptoms of mental distress (Tier 1), differentiate between symptoms of specific psychiatric disorders (Tier 2), and assess symptom severity (Tier 3). We tested the overall efficiency of using a tiered screening procedure. METHODS: Seven hundred fifty-seven refugees residing in Sweden, speaking any of the languages Arabic, Dari, Farsi, English, or Swedish, completed an online questionnaire following a three-tiered procedure with screening instruments for each tier. In this study, the Tier 3 scales were used as reference standards for clinically relevant symptoms, to evaluate screening efficiency in terms of accuracy and reduction of item burden in previous tiers. RESULTS: The results show that the tiered procedure could reduce the item burden while maintaining high accuracy, with up to 86% correctly assessed symptoms and few false negatives with moderate symptoms and above (at most 9%), and very few with severe symptoms (at most 1.3%). DISCUSSION: This study generated an accurate screening tool that efficiently identifies clinically relevant symptoms of common psychiatric disorders among refugees. Using an adapted online tiered procedure to screen for multiple mental health issues among refugees has the potential to facilitate screening and increase access to mental health services for refugees. We discuss the utility of the screening tool and the necessity of further evaluation. 

Place, publisher, year, edition, pages
2023. Vol. 23, no 1, article id 7
Keywords [en]
Digital mental health, Online assessment, Refugees, Tiered screening
National Category
Applied Psychology
Identifiers
URN: urn:nbn:se:miun:diva-46792DOI: 10.1186/s12888-022-04481-2ISI: 000907109400001PubMedID: 36597066Scopus ID: 2-s2.0-85145428681OAI: oai:DiVA.org:miun-46792DiVA, id: diva2:1725156
Available from: 2023-01-10 Created: 2023-01-10 Last updated: 2024-01-17Bibliographically approved

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Meurling, JenniferRondung, ElisabetLeiler, AnnaWasteson, ElisabetBjärtå, Anna

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