Journal Article

Feasibility and acceptability of Problem Management Plus (PM+) among Syrian refugees and asylum seekers in Switzerland: a mixed-method pilot randomized controlled trial

Fuhr, Daniela C., Bryant, Richard A., Park, A-La, Moergeli, Hanspeter, Sijbrandij, Marit, Morina, Naser, Pfaltz, Monique C., Wenger, Anna, Cuijpers, Pim, Schnyder, Ulrich, Spaaij, Julia, Kiselev, Nikolai, Hemmo, Mahmoud, Schick, Matthis, McDaid, David, Berger, Christine, de Graaff, Anne M.

2022

Overview

The results of this pilot randomized controlled trial suggest that Problem Management Plus (PM+), a low-intensity psychosocial intervention delivered by non-specialized 'helpers' is a feasible, well-accepted and safe treatment option for Syrian refugees in Switzerland. Syrian refugees in Switzerland face several barriers in accessing mental health care. Cost-effective psychological interventions are urgently needed to meet the mental health needs of refugees. Problem Management Plus (PM+) is an evidence-based, psychological intervention delivered by trained non-specialist 'helpers'. To assess the feasibility and acceptability of PM+ among Syrian refugees in Switzerland. We conducted a single-blind pilot randomized controlled trial (RCT) with Syrian refugees impaired by psychological distress (K10 > 15 and WHODAS 2.0 > 16). Participants were randomized to PM+ or Enhanced Treatment As Usual (ETAU). Participants were assessed at baseline, and 1 week and 3 months after the intervention, and completed measures indexing mental health problems and health care usage. Semi-structured interviews were conducted with different stakeholders. N = 59 individuals were randomized into PM+ (n = 31) or ETAU (n = 28). N = 18 stakeholders were interviewed about facilitators and barriers for the implementation of PM+. Retention rates in the trial (67.8%) and mean intervention attendance (M = 3.94 sessions, SD = 1.97) were high. No severe events related to the study were reported. These findings indicate that the trial procedures and PM+ were feasible, acceptable and safe. The findings support the conduct of a definitive RCT and show that PM+ might have the potential to be scaled-up in Switzerland. The importance, as well as the challenges, of implementing and scaling-up PM+ in high-income countries, such as Switzerland, are discussed.

• Publisher: Taylor & Francis,Taylor & Francis Ltd,Taylor & Francis Group
• Subject: Adult / asylums seekers / cambio de tareas / Clinical / Clinical trials / Enfrentar Problemas Plus / Evidence-Based Practice / feasibility / Feasibility Studies / Female / Humans / Intervention / Interviews as Topic / lay-provider / Male / Mental health / Mental Health Services / Mixed methods research / Patient Acceptance of Health Care - psychology / Patient Acceptance of Health Care - statistics & numerical data / Pilot Projects / problem management plus / proveedor no especializado / Psychological Distress / refugees / Refugees - psychology / Refugees - statistics & numerical data / Salud mental / Single-Blind Method / solicitantes de asilos / Switzerland / Syria - ethnology / task-shifting / viabilidadrefugiados / 任务切换 / 可行性 / 寻求庇护者 / 心理健康 / 问题管理 Plus / 难民 / 非专业提供者