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Summary PDF: What works to improve mental health of refugee children and adults?

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   Health, Mental Health and Wellness
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   Behavioral Health Care
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What works to improve mental health of refugee children and adults?

There is very strong evidence that numerous interventions are effective in improving the mental health of child and adult refugees. Specifically, cognitive behavioral therapy (CBT), trauma-focused interventions (TF), and psycho-education (PE) have been shown to improve symptoms related to anxiety, depression, post-traumatic stress disorder, and/or general distress in refugee populations. Furthermore, cultural adaptations of these interventions yield additional effectiveness over and above their non-adapted counterparts. School-based and group programs for refugee children and high-support living environments for unaccompanied minors have been shown to improve children’s mental health. A number of additional interventions for refugee adults and children have inconclusive effects or moderate support. Finally, digital technologies including telehealth, online interventions, and video games show promising results for increasing access to care as well as improving outcomes.

Post TitleStrength of EvidenceType of StudyDirection of Evidence
Efficacy of Psychological Interventions on Depression Anxiety and Somatization in Migrants: A Meta-analysisStrongMeta-analysisInconclusive or mixed impact
Imagery rehearsal therapy and/or mianserin in treatment of refugees diagnosed with PTSD: Results from a randomized controlled trialModerateImpact evaluationNo impact
Mental health services designed for Black, Asian and Minority Ethnics (BAME) in the UK: a scoping review of case studiesStrongSystematic reviewPositive impact
Narrative exposure therapy for posttraumatic stress disorder: A meta-analysis of randomized controlled trialsStrongMeta-analysisInconclusive or mixed impact
The effectiveness of adapted psychological interventions for people from ethnic minority groups: A systematic review and conceptual typologyStrongSystematic reviewPositive impact
A meta-analysis of school-based interventions for student refugees, migrants, and immigrantsStrongMeta-analysisPositive impact
Cultural Adaptations of Evidence-Based Mental Health Interventions for Refugees: Implications for Clinical Social WorkSuggestiveLiterature reviewPositive impact
Trauma-focused psychotherapies for post-traumatic stress disorder: a systematic review and network meta-analysisStrongMeta-analysisPositive impact
Psychological and pharmacological interventions for posttraumatic stress disorder and comorbid mental health problems following complex traumatic events: Systematic review and component network meta-analysis.StrongMeta-analysisPositive impact
Psychological interventions for posttraumatic stress disorder and depression in refugees: A meta-analysis of randomized controlled trialsStrongMeta-analysisPositive impact
A Full Systematic Review on the Effects of Cognitive Behavioural Therapy for Mental Health Symptoms in Child RefugeesStrongSystematic reviewPositive impact
Exposure therapy for PTSD: A meta-analysisStrongMeta-analysisPositive impact
Evidence-based individual psychotherapy for complex posttraumatic stress disorder and at-risk groups for complex traumatization: A meta-reviewStrongMeta-analysisPositive impact
Improving Mental Health in Refugee Populations: A Review of Intervention Studies Conducted in the United StatesStrongN/APositive impact
Effectiveness of self-help plus in preventing mental disorders in refugees and asylum seekers in Western Europe: A multinational randomized controlled trialModerateN/AInconclusive or mixed impact
A Meta-Analysis of Group Interventions for Trauma and Depression Among Immigrant and Refugee ChildrenStrongMeta-analysisPositive impact
Evaluating narrative exposure therapy for post-traumatic stress disorder and depression symptoms: A meta-analysis of the evidence baseStrongMeta-analysisInconclusive or mixed impact
A Systematic Review of Psychosocial Interventions for Adult Refugees and Asylum SeekersStrongSystematic reviewInconclusive or mixed impact, Positive impact
Efficacy and Acceptability of Psychosocial Interventions in Asylum Seekers and Refugees: Systematic Review and Meta-AnalysisStrongMeta-analysisInconclusive or mixed impact, No impact, Positive impact
Common Mental Disorders in Asylum Seekers and Refugees: Umbrella Review of Prevalence and Intervention StudiesStrongSystematic reviewInconclusive or mixed impact, No impact, Positive impact
Enhancing Need Satisfaction to Reduce Psychological Distress in Syrian RefugeesModerateImpact evaluationNo impact, Positive impact
The Effectiveness of Narrative Exposure Therapy: a Review, Meta-Analysis and Meta-Regression AnalysisStrongMeta-analysisPositive impact
Complementary and Alternative Medicine in the Treatment of Refugees and Survivors of Torture: A Review and Proposal for ActionStrongSystematic reviewInconclusive or mixed impact
Mental Health Interventions in Canada for Migrants Affected by State-Sanctioned Violence: An Effectiveness StudyStrongSystematic reviewInconclusive or mixed impact, Positive impact
Evidence-Based Psychological Interventions for Adult Survivors Of Torture And Trauma: A 30-Year ReviewStrongSystematic reviewInconclusive or mixed impact, Positive impact
Meeting the Needs of Older Adult Refugee Populations with Home Health ServicesSuggestiveSuggestive evidencePositive impact
Prevention of Psychological Distress and Promotion of Resilience Amongst Unaccompanied Refugee Minors in Resettlement CountriesStrongSystematic reviewInconclusive or mixed impact, Positive impact
Transcultural Telepsychiatry and Its Impact on Patient SatisfactionSuggestiveSuggestive evidencePositive impact
Review of Refugee Mental Health Interventions Following Resettlement: Best Practices And RecommendationsStrongSystematic reviewInconclusive or mixed impact
Evidence-Based Care for Iraqi, Kurdish, and Syrian Asylum Seekers and Refugees of the Syrian Civil War: A Systematic ReviewStrongSystematic reviewPositive impact
Cultural Adaptations in Psychosocial Interventions for Post-Traumatic Stress Disorder Among Refugees: A Systematic ReviewStrongSystematic reviewInconclusive or mixed impact, Positive impact
Tell Your Story: A Randomized Controlled Trial of an Online intervention to Reduce Mental Health Stigma and Increase Help-Seeking in Refugee Men with Posttraumatic StressModerateImpact evaluationPositive impact
The Effectiveness of Psychosocial Interventions in War-Traumatized Refugee and Internally Displaced Minors: Systematic Review and Meta-AnalysisStrongMeta-analysisInconclusive or mixed impact, Positive impact
Treating Posttraumatic Stress Disorder in Female Victims of Trafficking Using Narrative Exposure Therapy: A Retrospective AuditSuggestiveSuggestive evidencePositive impact
Chronic Pain in Refugees with Posttraumatic Stress Disorder (PTSD): A Systematic Review on Patients’ Characteristics and Specific interventionsStrongSystematic reviewInconclusive or mixed impact, Positive impact
Treatment of Sleep Disturbances in Refugees Suffering from Post-Traumatic Stress DisorderStrongSystematic reviewInconclusive or mixed impact
Digital Game-Based Education for Syrian Refugee Children: Project HopeModerateImpact evaluationPositive impact
An Integrative Adapt Therapy for Common Mental Health Symptoms and Adaptive Stress Amongst Rohingya, Chin, and Kachin Refugees Living in Malaysia: A Randomized Controlled TrialModerateImpact evaluationPositive impact
Complex PTSD and Phased Treatment in Refugees: A Debate PieceStrongSystematic reviewInconclusive or mixed impact, Positive impact
EMDR with Traumatized Refugees: From Experience-Based to Evidence-Based PracticeStrongSystematic reviewInconclusive or mixed impact
Psychological Interventions for Post-Traumatic Stress Disorder in Refugees and Asylum Seekers: A Systematic Review and Meta-AnalysisStrongMeta-analysisInconclusive or mixed impact, No impact, Positive impact
Imagery Rescripting as Treatment for Complicated PTSD in Refugees: A Multiple Baseline Case Series StudySuggestiveSuggestive evidencePositive impact
Psychosocial Interventions for Children and Adolescents After Man-Made and Natural Disasters: A Meta-Analysis and Systematic ReviewStrongMeta-analysisPositive impact
Intermediated Communication by Interpreters in Psychotherapy with Traumatized RefugeesSuggestiveSuggestive evidencePositive impact
Dealing with Difference: A Scoping Review of Psychotherapeutic Interventions with Unaccompanied Refugee MinorsStrongSystematic reviewInconclusive or mixed impact
Preventive Mental Health Interventions for Refugee Children and Adolescents in High Income SettingsStrongSystematic reviewInconclusive or mixed impact, Positive impact
Guidelines for Psychiatric Care of Torture SurvivorsStrongSystematic reviewInconclusive or mixed impact, Positive impact
Trauma-Focused Therapy for Refugees: Meta-Analytic FindingsStrongMeta-analysisPositive impact

Studies included in the database focused on high-income or upper middle-income countries, including but not limited to the United States. Studies included must have been published since 2000. To identify evidence, we searched the following websites and databases using the following population, methodology, and target problem terms:

Websites and Databases Population Terms Methodology Terms Target Problem Terms

Campbell Collaboration Cochrane Collaboration Mathematica Policy Research Evidence Aid
Urban Institute
Migration Policy Institute HHS OPRE
ASSIA
Social Services Abstracts Social Work Abstracts PsycInfo
CINAHL
PILOTS

refugee
OR
immigrant
OR “unaccompanied minor”
OR
asylee
OR
“temporary protected status”
OR
“victims of traffick*” OR
“traffick* victims” OR
T-Visa
OR
U-Visa
OR
Cuban
OR
Haitian
OR
Amerasian

evaluation OR
impact
OR program
OR intervention OR policy
OR project
OR train*
OR therapy OR treatment OR counseling OR workshop ORreview
OR meta-analysis OR
synthesis

“mental health” OR
depression
OR
anxiety
OR
“post-traumatic stress disorder”
OR
PTSD

 

For databases or websites that permitted only basic searches, free-text terms and limited term combinations were selected out of the lists above, and all resultant studies were reviewed for relevance. Conversely, for databases or websites with advanced search capability, we made use of relevant filters available. All search terms were searched in the title and abstract fields only in order to exclude studies that made only passing mention of the topic under consideration.  

After initial screening, Switchboard evidence mapping is prioritized as follows: First priority is given to meta-analyses and systematic reviews, followed by individual impact evaluations when no meta-analyses or systematic reviews are available. Evaluations that are rated as impact evidence are considered before those rated as suggestive, with the latter only being included for outcomes where no evidence is available from the former.