Karyotaki, Eirini, Sijbrandij, Marit, Purgato, Marianna, Acarturk, Ceren, Lakin, Daniel, Bailey, Della, Peckham, Emily, Uygun, Ersin, Tedeschi, Federico, Wancata, Johannes et al (show 17 more authors)
(2023)
Self-Help Plus for refugees and asylum seekers: an individual participant data meta-analysis.
BMJ MENTAL HEALTH, 26 (1).
e300672-.
Abstract
<h4>Question</h4>Refugees and asylum seekers are at high risk of mental disorders due to various stressors before, during and after forceful displacement. The WHO Self-Help Plus (SH+) intervention was developed to manage psychological distress and a broad range of mental health symptoms in vulnerable populations. This study aimed to examine the effects and moderators of SH+ compared with Enhanced Care as Usual (ECAU) in reducing depressive symptoms among refugees and asylum seekers.<h4>Study selection and analysis</h4>Three randomised trials were identified with 1795 individual participant data (IPD). We performed an IPD meta-analysis to estimate the effects of SH+, primarily on depressive symptoms and second on post-traumatic stress, well-being, self-identified problems and functioning. Effects were also estimated at 5-6 months postrandomisation (midterm).<h4>Findings</h4>There was no evidence of a difference between SH+ and ECAU+ in reducing depressive symptoms at postintervention. However, SH+ had significantly larger effects among participants who were not employed (β=1.60, 95% CI 0.20 to 3.00) and had lower mental well-being levels (β=0.02, 95% CI 0.001 to 0.05). At midterm, SH+ was significantly more effective than ECAU in improving depressive symptoms (β=-1.13, 95% CI -1.99 to -0.26), self-identified problems (β=-1.56, 95% CI -2.54 to -0.59) and well-being (β=6.22, 95% CI 1.60 to 10.90).<h4>Conclusions</h4>Although SH+ did not differ significantly from ECAU in reducing symptoms of depression at postintervention, it did present benefits for particularly vulnerable participants (ie, unemployed and with lower mental well-being levels), and benefits were also evident at midterm follow-up. These results are promising for the use of SH+ in the management of depressive symptoms and improvement of well-being and self-identified problems among refugees and asylum seekers.
| Item Type: | Article |
|---|---|
| Uncontrolled Keywords: | Adult psychiatry, Depression & mood disorders |
| Divisions: | Faculty of Health and Life Sciences Faculty of Health and Life Sciences > Institute of Population Health |
| Depositing User: | Symplectic Admin |
| Date Deposited: | 06 Feb 2024 11:15 |
| Last Modified: | 06 Feb 2024 11:15 |
| DOI: | 10.1136/bmjment-2023-300672 |
| Open Access URL: | https://mentalhealth.bmj.com/content/26/1/e300672 |
| Related URLs: | |
| URI: | https://livrepository.liverpool.ac.uk/id/eprint/3178436 |
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