TY - JOUR
KW - Adolescent
KW - Adult
KW - Anxiety
KW - Child
KW - Female
KW - Humans
KW - Male
KW - Mental Health
KW - Primary Health Care
KW - Psychotherapy
KW - Refugees/psychology
KW - Stress Disorders, Post-Traumatic/therapy
KW - CBT
KW - CETA
KW - NET
KW - global mental health
KW - refugees and asylum seekers
AU - D. Gruner
AU - O. Magwood
AU - L. Bair
AU - L. Duff
AU - S. Adel
AU - K. Pottie
A1 - 
AB - Culture, tradition, structural violence, and mental health-related stigma play a major role in global mental health for refugees. Our aim was to understand what factors determine the success or failure of community-based psychotherapy for trauma-affected refugees and discuss implications for primary health care programs. Using a systematic realist-informed approach, we searched five databases from 2000 to 2018. Two reviewers independently selected RCTs for inclusion, and we contacted authors to obtain therapy training manuals. Fifteen articles and 11 training manuals met our inclusion criteria. Factors that improved symptoms of depression, anxiety, and PTSD included providing culturally adapted care in a migrant-sensitive setting, giving a role to other clinical staff (task-shifting), and intervention intensity. Precarious asylum status, constraining program monitoring requirements, and diverse socio-cultural and gender needs within a setting may reduce the effectiveness of the program. Primary care programs may enable community based mental health care and may reduce mental health-related stigma for refugees and other migrants. More research is needed on the cultural constructs of distress, programs delivered in primary care, and the role of cultural and language interpretation services in mental health care.
AD - Department of Family Medicine, University of Ottawa, 600 Peter Morand Crescent Suite 201, Ottawa, ON K1G 5Z3, Canada.; C.T. Lamont Primary Health Care Research Centre, Bruyère Research Institute, 85 Primrose Ave, Ottawa, ON K1R 6M1, Canada.; Faculty of Medicine, University of Ottawa, Roger Guindon Hall, 451 Smyth Rd #2044, Ottawa, ON K1H 8M5, Canada.; C.T. Lamont Primary Health Care Research Centre, Bruyère Research Institute, 85 Primrose Ave, Ottawa, ON K1R 6M1, Canada.; Department of Family Medicine, University of Ottawa, 600 Peter Morand Crescent Suite 201, Ottawa, ON K1G 5Z3, Canada.; Department of Family Medicine, University of Ottawa, 600 Peter Morand Crescent Suite 201, Ottawa, ON K1G 5Z3, Canada.; C.T. Lamont Primary Health Care Research Centre, Bruyère Research Institute, 85 Primrose Ave, Ottawa, ON K1R 6M1, Canada.; School of Epidemiology and Public Health, University of Ottawa. 600 Peter Morand Crescent Suite 101, Ottawa, ON K1G 5Z3, Canada.
BT - International journal of environmental research and public health
C5 - Education & Workforce; Healthcare Disparities
CP - 13
DO - 10.3390/ijerph17134618
IS - 13
JF - International journal of environmental research and public health
LA - eng
M1 - Journal Article
N2 - Culture, tradition, structural violence, and mental health-related stigma play a major role in global mental health for refugees. Our aim was to understand what factors determine the success or failure of community-based psychotherapy for trauma-affected refugees and discuss implications for primary health care programs. Using a systematic realist-informed approach, we searched five databases from 2000 to 2018. Two reviewers independently selected RCTs for inclusion, and we contacted authors to obtain therapy training manuals. Fifteen articles and 11 training manuals met our inclusion criteria. Factors that improved symptoms of depression, anxiety, and PTSD included providing culturally adapted care in a migrant-sensitive setting, giving a role to other clinical staff (task-shifting), and intervention intensity. Precarious asylum status, constraining program monitoring requirements, and diverse socio-cultural and gender needs within a setting may reduce the effectiveness of the program. Primary care programs may enable community based mental health care and may reduce mental health-related stigma for refugees and other migrants. More research is needed on the cultural constructs of distress, programs delivered in primary care, and the role of cultural and language interpretation services in mental health care.
PY - 2020
SN - 1660-4601; 1661-7827; 1660-4601
SP - 4618
T1 - Understanding Supporting and Hindering Factors in Community-Based Psychotherapy for Refugees: A Realist-Informed Systematic Review
T2 - International journal of environmental research and public health
TI - Understanding Supporting and Hindering Factors in Community-Based Psychotherapy for Refugees: A Realist-Informed Systematic Review
U1 - Education & Workforce; Healthcare Disparities
U2 - 32604990
U3 - 10.3390/ijerph17134618
VL - 17
VO - 1660-4601; 1661-7827; 1660-4601
Y1 - 2020
Y2 - Jun 27
ER -