Scaling-up problem management plus for refugees in Switzerland - a qualitative study
Abstract Background Refugees are at an increased risk of developing symptoms of mental disorders but face various structural and socio-cultural barriers to accessing mental health care. The SPIRIT project (Scaling-up Psychological Interventions in Refugees In SwiTzerland) seeks to promote the resili...
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| Format: | Article |
| Language: | English |
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BMC
2023-05-01
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| Series: | BMC Health Services Research |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12913-023-09491-8 |
| _version_ | 1797822936900435968 |
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| author | Julia Spaaij Daniela C. Fuhr Aemal Akhtar Luisa Casanova Tobias Klein Matthis Schick Sonja Weilenmann Bayard Roberts Naser Morina |
| author_facet | Julia Spaaij Daniela C. Fuhr Aemal Akhtar Luisa Casanova Tobias Klein Matthis Schick Sonja Weilenmann Bayard Roberts Naser Morina |
| author_sort | Julia Spaaij |
| collection | DOAJ |
| description | Abstract Background Refugees are at an increased risk of developing symptoms of mental disorders but face various structural and socio-cultural barriers to accessing mental health care. The SPIRIT project (Scaling-up Psychological Interventions in Refugees In SwiTzerland) seeks to promote the resilience of refugees and improve their access to mental health care. For this purpose, Problem Management Plus (PM+), an evidence-based low-intensity psychological intervention delivered by trained non-specialist “helpers”, is being scaled-up in Switzerland. Objective To identify factors influencing the process of the large-scale implementation of PM + for refugees in Switzerland and to develop recommendations to guide the implementation process. Methods 22 semi-structured interviews were conducted with key informants (Syrian refugees who previously participated in PM+, PM + helpers, health professionals working with refugees and decision-makers from the migration, integration, social, and health sectors). The data were analyzed using thematic analysis, combining an inductive and deductive approach. Results The data revealed three major themes, which might have an impact for the longer-term implementation of PM + in Switzerland. First, preconditions for successful integration in the health system prior to scaling-up such as sustainable funding or the introduction of a stepped care approach. Second, the requirements for the PM + intervention supporting scale-up such as quality control during PM + delivery, PM + modality, time and setting when PM + is offered or the views on task sharing. Third, the perceived benefits of scaling-up PM + in Switzerland. Conclusions Our results have shown that PM + must be scaled-up within a stepped care approach, including a functioning triage system and sustainable funding. Rather than selecting one modality or setting, it seemed preferable to offer a variety of formats and settings to achieve maximum reach and benefits. A successful scale-up of PM + in Switzerland might have various benefits. Communicating them to policy-makers and health providers, might enhance their acceptability of the intervention and their willingness to adopt PM + in regulatory structure and promote it. |
| first_indexed | 2024-03-13T10:16:36Z |
| format | Article |
| id | doaj.art-3eae646014b04e5c810c4193c506446f |
| institution | Directory Open Access Journal |
| issn | 1472-6963 |
| language | English |
| last_indexed | 2024-03-13T10:16:36Z |
| publishDate | 2023-05-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Health Services Research |
| spelling | doaj.art-3eae646014b04e5c810c4193c506446f2023-05-21T11:11:59ZengBMCBMC Health Services Research1472-69632023-05-0123111510.1186/s12913-023-09491-8Scaling-up problem management plus for refugees in Switzerland - a qualitative studyJulia Spaaij0Daniela C. Fuhr1Aemal Akhtar2Luisa Casanova3Tobias Klein4Matthis Schick5Sonja Weilenmann6Bayard Roberts7Naser Morina8Department of Consultation-Liaison Psychiatry and Psychosomatic Medicine, University Hospital Zurich, University of ZurichDepartment of Health Services Research and Policy, London School of Hygiene and Tropical MedicineSchool of Psychology, University of New South WalesDepartment of Consultation-Liaison Psychiatry and Psychosomatic Medicine, University Hospital Zurich, University of ZurichDepartment of Consultation-Liaison Psychiatry and Psychosomatic Medicine, University Hospital Zurich, University of ZurichDepartment of Consultation-Liaison Psychiatry and Psychosomatic Medicine, University Hospital Zurich, University of ZurichDepartment of Consultation-Liaison Psychiatry and Psychosomatic Medicine, University Hospital Zurich, University of ZurichDepartment of Health Services Research and Policy, London School of Hygiene and Tropical MedicineDepartment of Consultation-Liaison Psychiatry and Psychosomatic Medicine, University Hospital Zurich, University of ZurichAbstract Background Refugees are at an increased risk of developing symptoms of mental disorders but face various structural and socio-cultural barriers to accessing mental health care. The SPIRIT project (Scaling-up Psychological Interventions in Refugees In SwiTzerland) seeks to promote the resilience of refugees and improve their access to mental health care. For this purpose, Problem Management Plus (PM+), an evidence-based low-intensity psychological intervention delivered by trained non-specialist “helpers”, is being scaled-up in Switzerland. Objective To identify factors influencing the process of the large-scale implementation of PM + for refugees in Switzerland and to develop recommendations to guide the implementation process. Methods 22 semi-structured interviews were conducted with key informants (Syrian refugees who previously participated in PM+, PM + helpers, health professionals working with refugees and decision-makers from the migration, integration, social, and health sectors). The data were analyzed using thematic analysis, combining an inductive and deductive approach. Results The data revealed three major themes, which might have an impact for the longer-term implementation of PM + in Switzerland. First, preconditions for successful integration in the health system prior to scaling-up such as sustainable funding or the introduction of a stepped care approach. Second, the requirements for the PM + intervention supporting scale-up such as quality control during PM + delivery, PM + modality, time and setting when PM + is offered or the views on task sharing. Third, the perceived benefits of scaling-up PM + in Switzerland. Conclusions Our results have shown that PM + must be scaled-up within a stepped care approach, including a functioning triage system and sustainable funding. Rather than selecting one modality or setting, it seemed preferable to offer a variety of formats and settings to achieve maximum reach and benefits. A successful scale-up of PM + in Switzerland might have various benefits. Communicating them to policy-makers and health providers, might enhance their acceptability of the intervention and their willingness to adopt PM + in regulatory structure and promote it.https://doi.org/10.1186/s12913-023-09491-8Mental healthScale-upRefugeesAsylum seekersProblem management plusLay-provider |
| spellingShingle | Julia Spaaij Daniela C. Fuhr Aemal Akhtar Luisa Casanova Tobias Klein Matthis Schick Sonja Weilenmann Bayard Roberts Naser Morina Scaling-up problem management plus for refugees in Switzerland - a qualitative study BMC Health Services Research Mental health Scale-up Refugees Asylum seekers Problem management plus Lay-provider |
| title | Scaling-up problem management plus for refugees in Switzerland - a qualitative study |
| title_full | Scaling-up problem management plus for refugees in Switzerland - a qualitative study |
| title_fullStr | Scaling-up problem management plus for refugees in Switzerland - a qualitative study |
| title_full_unstemmed | Scaling-up problem management plus for refugees in Switzerland - a qualitative study |
| title_short | Scaling-up problem management plus for refugees in Switzerland - a qualitative study |
| title_sort | scaling up problem management plus for refugees in switzerland a qualitative study |
| topic | Mental health Scale-up Refugees Asylum seekers Problem management plus Lay-provider |
| url | https://doi.org/10.1186/s12913-023-09491-8 |
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