A lay provider delivered behavioral intervention for Syrian refugees and their children in Jordan

Abstract

Abstract Background Refugees and their children are exposed to many distressing events, including detention in refugee camps. Not surprisingly, refugees are at high risk for common mental disorders. A major barrier to addressing mental health problems in refugees is that most host countries lack sufficient mental health specialists to provide high-intensity treatments. A recent trend has focused on training non-specialists to deliver simple psychosocial programs to those with distress. One such program is Problem Management Plus (PM+) which was developed by the World Health Organization; it comprises 5 small-group sessions that teach behavioural skills to reduce distress. This study reports the first evaluation of group PM+ in a refugee camp. We investigated the extent to which PM+ provided to adult Syrian refugees can benefit their children. Methods 480 Adult Syrian refugees in the Azraq Refugee Camp were randomized to either PM+ or Treatment as Usual (TAU). Participants were independently assessed prior to the program, immediately following the program, and 3 months later. Outcome variables included anxiety, depression, functioning, posttraumatic stress, and grief and parenting behaviours. Children's psychological wellbeing was assessed in one child of each participant. Results Of the 650 adult refugees were screened in the camp, 96% met the cut-off for psychological distress and 76% met criteria for functional impairment. 480 participants were randomized to PM+ or TAU. The baseline assessment indicated 85% of refugees met criteria for depression, 84% met criteria for anxiety, and 84% met criteria for posttraumatic stress disorder. The 3-month assessment will be presented following linear mixed modelling to determine the relative gains made by refugees and their children in PM+ and TAU. Conclusions These findings will be discussed in terms of implementation of scalable programs in refugee settings, and specifically how these can benefit participants and their children.