How does context influence the delivery of mental health interventions for asylum seekers and refugees in low- and middle-income countries? A qualitative systematic review
Abstract Background Low- and middle-income countries (LMICs) host the majority of the world’s refugees. Evidence suggests that refugees and asylum seekers have high mental health needs compared to the host country population. However, they face many social, economic and culture barriers to receiving...
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| Format: | Article |
| Language: | English |
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BMC
2021-10-01
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| Series: | International Journal of Mental Health Systems |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s13033-021-00501-y |
| _version_ | 1819011196496379904 |
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| author | Sohail Jannesari Claudia Lotito Giulia Turrini Siân Oram Corrado Barbui |
| author_facet | Sohail Jannesari Claudia Lotito Giulia Turrini Siân Oram Corrado Barbui |
| author_sort | Sohail Jannesari |
| collection | DOAJ |
| description | Abstract Background Low- and middle-income countries (LMICs) host the majority of the world’s refugees. Evidence suggests that refugees and asylum seekers have high mental health needs compared to the host country population. However, they face many social, economic and culture barriers to receiving mental health care and benefitting from mental health interventions. This paper examines how these contextual factors affect the implementation of mental health interventions for refugees and asylum seekers in LMICs. Methods We conducted a qualitative systematic review searching 11 databases and 24 relevant government and non-governmental organisation (NGO) websites. We spoke with academic experts and NGO professionals for recommendations, and conducted forwards and backwards citation tracking. Results From 2055 records in abstract and title screening, and then 99 in full-text screening, 18 eligible studies were identified. Qualitative thematic synthesis was conducted on eligible papers. Three main thematic clusters were identified around: (1) support during a time of pressure and insecurity, and the need for intervention flexibility through facilitator and participant autonomy; (2) different cultural conceptions of mental health, and how interventions negotiated these differences; and (3) the importance of facilitator skills, knowledge, characteristics and relationships to intervention implementation. Conclusion Evidence suggests that intervention coordinators and developers should continue to: (1) think broadly about the range of social influences on mental health, addressing structural issues where possible; (2) offer flexibility with intervention style, content and timings; and (3) encourage building research capacity in LMICs while acknowledging pre-existing mental health knowledge and practice. |
| first_indexed | 2024-12-21T01:24:19Z |
| format | Article |
| id | doaj.art-b1a391a8eb9a4c528079c848c89a2e20 |
| institution | Directory Open Access Journal |
| issn | 1752-4458 |
| language | English |
| last_indexed | 2024-12-21T01:24:19Z |
| publishDate | 2021-10-01 |
| publisher | BMC |
| record_format | Article |
| series | International Journal of Mental Health Systems |
| spelling | doaj.art-b1a391a8eb9a4c528079c848c89a2e202022-12-21T19:20:33ZengBMCInternational Journal of Mental Health Systems1752-44582021-10-0115112010.1186/s13033-021-00501-yHow does context influence the delivery of mental health interventions for asylum seekers and refugees in low- and middle-income countries? A qualitative systematic reviewSohail Jannesari0Claudia Lotito1Giulia Turrini2Siân Oram3Corrado Barbui4Institute of Psychiatry, Psychology and Neuroscience, Department of Health Services and Population Research, King’s College LondonWHO Collaborating Centre for Research and Training in Mental Health and Service Evaluation, Department of Neuroscience, Biomedicine and Movement Sciences, Section of Psychiatry, University of VeronaWHO Collaborating Centre for Research and Training in Mental Health and Service Evaluation, Department of Neuroscience, Biomedicine and Movement Sciences, Section of Psychiatry, University of VeronaInstitute of Psychiatry, Psychology and Neuroscience, Department of Health Services and Population Research, King’s College LondonWHO Collaborating Centre for Research and Training in Mental Health and Service Evaluation, Department of Neuroscience, Biomedicine and Movement Sciences, Section of Psychiatry, University of VeronaAbstract Background Low- and middle-income countries (LMICs) host the majority of the world’s refugees. Evidence suggests that refugees and asylum seekers have high mental health needs compared to the host country population. However, they face many social, economic and culture barriers to receiving mental health care and benefitting from mental health interventions. This paper examines how these contextual factors affect the implementation of mental health interventions for refugees and asylum seekers in LMICs. Methods We conducted a qualitative systematic review searching 11 databases and 24 relevant government and non-governmental organisation (NGO) websites. We spoke with academic experts and NGO professionals for recommendations, and conducted forwards and backwards citation tracking. Results From 2055 records in abstract and title screening, and then 99 in full-text screening, 18 eligible studies were identified. Qualitative thematic synthesis was conducted on eligible papers. Three main thematic clusters were identified around: (1) support during a time of pressure and insecurity, and the need for intervention flexibility through facilitator and participant autonomy; (2) different cultural conceptions of mental health, and how interventions negotiated these differences; and (3) the importance of facilitator skills, knowledge, characteristics and relationships to intervention implementation. Conclusion Evidence suggests that intervention coordinators and developers should continue to: (1) think broadly about the range of social influences on mental health, addressing structural issues where possible; (2) offer flexibility with intervention style, content and timings; and (3) encourage building research capacity in LMICs while acknowledging pre-existing mental health knowledge and practice.https://doi.org/10.1186/s13033-021-00501-yInterventionsMental healthSystematic reviewLow- and middle-income countriesContext |
| spellingShingle | Sohail Jannesari Claudia Lotito Giulia Turrini Siân Oram Corrado Barbui How does context influence the delivery of mental health interventions for asylum seekers and refugees in low- and middle-income countries? A qualitative systematic review International Journal of Mental Health Systems Interventions Mental health Systematic review Low- and middle-income countries Context |
| title | How does context influence the delivery of mental health interventions for asylum seekers and refugees in low- and middle-income countries? A qualitative systematic review |
| title_full | How does context influence the delivery of mental health interventions for asylum seekers and refugees in low- and middle-income countries? A qualitative systematic review |
| title_fullStr | How does context influence the delivery of mental health interventions for asylum seekers and refugees in low- and middle-income countries? A qualitative systematic review |
| title_full_unstemmed | How does context influence the delivery of mental health interventions for asylum seekers and refugees in low- and middle-income countries? A qualitative systematic review |
| title_short | How does context influence the delivery of mental health interventions for asylum seekers and refugees in low- and middle-income countries? A qualitative systematic review |
| title_sort | how does context influence the delivery of mental health interventions for asylum seekers and refugees in low and middle income countries a qualitative systematic review |
| topic | Interventions Mental health Systematic review Low- and middle-income countries Context |
| url | https://doi.org/10.1186/s13033-021-00501-y |
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