A multilevel modeling analysis of community-based mental health and psychosocial support group intervention for refugee newcomers in the United States.

Abstract

A growing number of resettlement agencies adopt and implement interventions and programs to promote community-based mental health and psychosocial support (CB-MHPSS) among refugees and asylum seekers in the United States. However, few studies examine how multilevel factors either facilitate or interfere with mental health and other associated outcomes. Adopting a realist evaluation approach, this study examines the effects of multilevel (i.e., community, group and individual) factors on mental health coping and emotional well-being (EW) among asylum seekers and refugee newcomers in CB-MHPSS group interventions. A total of 235 adult refugees and asylum seekers participated in 31 CB-MHPSS intervention groups implemented by 11 HIAS affiliate agencies in 2021. A series of bi-/multivariate and multilevel modeling analyses were conducted to investigate the impacts of individual, group or agency, and community-level factors on competency for coping and EW among intervention participants. Mental health and psychosocial support (MHPSS) interventions grounded to the local community help facilitate individual-level improvement in competencies for mental health care and EW. Multilevel modeling analyses attested to multilevel effects of individual, group, and community settings on MHPSS outcomes, highlighting the impacts of intervention facilitator types and group composition, as well as community's unemployment rates. This study sheds light on the value of community-based, participatory approaches to psychosocial interventions; focusing on the role of refugee community leaders and bicultural staff who deliver MHPSS activities, which was a key feature that enhanced the well-being and coping of refugee newcomers across various settings. (PsycInfo Database Record (c) 2024 APA, all rights reserved).