Department of Psychiatry and Psychotherapy, Charité - Universitätsmedizin, Campus Benjamin Franklin, Berlin, Germany.
Department of Psychiatry and Psychotherapy, RWTH Aachen University and JARA-Institute Brain Structure Function Relationship (INM 10), Research Center Jülich and RWTH, Aachen, Germany.
Eur Arch Psychiatry Clin Neurosci. 2020 Feb;270(1):95-106. doi: 10.1007/s00406-019-00991-5. Epub 2019 Feb 22.
The sudden arrival of culturally diverse asylum seekers and refugees into Germany has created a strong demand for recognizing and appropriately treating those suffering from mental health issues. Due to many systemic, organizational, cultural and socio-linguistic barriers, psychiatric treatment of refugees is posing a major challenge to Germany's mental health care system. Thus, there is a need for alternative models that allow for increased access to adequate, effective and efficient culturally sensitive mental health care services. Here, we describe the Mental Health in Refugees and Asylum Seekers (MEHIRA) project, a multicentre randomized controlled trial investigating a stepped collaborative care model (SCCM) for providing mental health treatment in this vulnerable population. The proposed SCCM aims to decrease the aforementioned barriers. Adult and adolescent participants will be screened for depressive symptoms and matched to appropriate psychological interventions, including group-level interventions (START intervention, Empowerment/Gender-sensitive/Peer to peer), and other innovative, digital treatment approaches (Smartphone application). The therapeutic effect of the SCCM will be compared to TAU (treatment-as-usual). All interventions have been designed to be culturally sensitive, and offered in two different languages: Arabic and Farsi. The outcome of this study may contribute significantly to future clinical and legal guidelines in developing parallel and efficient new structures of treatment. Collected data will inform primary and secondary mental health care providers with recommendations concerning the design and implementation of effective treatment models and programmes. Guidelines and recommendations may also potentially be adopted by other host countries, developing countries and also in humanitarian aid programmes.
文化背景多样的寻求庇护者和难民的突然涌入，对识别和妥善治疗那些患有精神健康问题的人提出了强烈的需求。由于存在许多系统、组织、文化和社会语言方面的障碍，难民的精神治疗对德国的精神卫生保健系统构成了重大挑战。因此，需要替代模式来增加获得适当、有效和高效的文化敏感的精神保健服务的机会。在这里，我们描述了难民和寻求庇护者精神健康（MEHIRA）项目，这是一项多中心随机对照试验，研究了一种阶梯式协作护理模式（SCCM），以向这一弱势群体提供精神卫生治疗。所提议的 SCCM 旨在减少上述障碍。将对成年和青少年参与者进行抑郁症状筛查，并与适当的心理干预措施相匹配，包括群体干预措施（START 干预措施、赋权/性别敏感/同伴对同伴）和其他创新的数字治疗方法（智能手机应用程序）。SCCM 的治疗效果将与 TAU（常规治疗）进行比较。所有干预措施都经过精心设计，具有文化敏感性，并以两种不同的语言提供：阿拉伯语和波斯语。这项研究的结果可能会对未来制定平行且高效的新治疗结构的临床和法律指南产生重大影响。收集的数据将为初级和二级精神卫生保健提供者提供建议，内容涉及有效治疗模式和方案的设计和实施。这些准则和建议也可能被其他收容国、发展中国家以及人道主义援助方案所采纳。
