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

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posted on 31.01.2022, 08:40 by Julia Spaaij, Nikolai Kiselev, Christine Berger, Richard A. Bryant, Pim Cuijpers, Anne M. de Graaff, Daniela C. Fuhr, Mahmoud Hemmo, David McDaid, Hanspeter Moergeli, A-La Park, Monique C. Pfaltz, Matthis Schick, Ulrich Schnyder, Anna Wenger, Marit Sijbrandij, Naser Morina

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.

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.

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.

Funding

This study was supported by the STRENGTHS project. This project has received funding from the European Union’s Horizon 2020 Research and Innovation programme Societal Challenges under Grant Agreement No 733337 and the Swiss State Secretariat for Education, Research and Innovation under contract number 16.0205. The content of this article reflects only the authors’ views and the European Community is not liable for any use that may be made of the information contained therein.

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