Abstract

The recent refugee crisis presented a huge challenge for the Swedish mental health workforce. Hence, innovative mental health workforce solutions were needed. Unaccompanied refugee minors (URM) are a particularly vulnerable refugee group. Teaching Recovery Techniques (TRT) was introduced as a community-based intervention utilising trained lay counsellors in a stepped model of care for refugee youth experiencing trauma symptoms. Professionals (e.g., teachers, social workers) can deliver the Cognitive Behavioural Therapy-based intervention after a brief training. A point of debate in this workforce solution is the readiness of trained lay counsellors to deal with potentially demanding situations like disclosure of suicidal ideation. This study aimed to explore the TRT trained lay counsellors’ experiences of procedures upon URM’s disclosure of suicidal ideation. Individual semi-structured interviews with TRT trained lay counsellors were conducted, then analysed using systemic text condensation. The analysis revealed four themes: “Importance of safety structures”, “Collaboration is key”, “Let sleeping dogs lie” and “Going the extra mile”. Dealing with suicidal ideation is challenging and feelings of helplessness occur. Adding adequate supervision and specific training on suicidal ideation using role play is recommended. Collaboration between agencies and key stakeholders is essential when targeting refugee mental health in a stepped care model.

Highlights

  • In 2016, Europe faced the largest single influx of refugees since World War II

  • A pilot study (N = 55) showed that in addition to posttraumatic stress symptoms, 83% of unaccompanied refugee minors (URM) receiving Teaching Recovery Techniques (TRT) suffered from moderate to severe depression and 48% displayed suicidal ideation or plans [9]

  • This study explored how TRT trained lay counsellors, without formal training in mental health or counselling, experienced dealing with URM disclosing suicidal ideation

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Summary

Introduction

In 2016, Europe faced the largest single influx of refugees since World War II. This put a high demand on European countries to re-examine and find new sustainable solutions in various aspects of society, including the health care system. A substantial group of refugees were unaccompanied refugee minors (URM) [2], who still remain in Sweden. They have been described as the most vulnerable refugee group [3]. It has been formally acknowledged by the Swedish Social Services that existing psychiatric services do not meet the needs of this population, and an innovative mental health workforce solution is required to bridge the service gap [4]

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