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Understanding Supporting and Hindering Factors in Community-Based Psychotherapy for Refugees: A Realist-Informed Systematic Review

Author

Listed:
  • Douglas Gruner

    (Department of Family Medicine, University of Ottawa, 600 Peter Morand Crescent Suite 201, Ottawa, ON K1G 5Z3, Canada)

  • Olivia Magwood

    (C.T. Lamont Primary Health Care Research Centre, Bruyère Research Institute, 85 Primrose Ave, Ottawa, ON K1R 6M1, Canada)

  • Lissa Bair

    (Faculty of Medicine, University of Ottawa, Roger Guindon Hall, 451 Smyth Rd #2044, Ottawa, ON K1H 8M5, Canada)

  • Liezl Duff

    (C.T. Lamont Primary Health Care Research Centre, Bruyère Research Institute, 85 Primrose Ave, Ottawa, ON K1R 6M1, Canada)

  • Shiva Adel

    (Department of Family Medicine, University of Ottawa, 600 Peter Morand Crescent Suite 201, Ottawa, ON K1G 5Z3, Canada)

  • Kevin Pottie

    (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)

Abstract

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.

Suggested Citation

  • Douglas Gruner & Olivia Magwood & Lissa Bair & Liezl Duff & Shiva Adel & Kevin Pottie, 2020. "Understanding Supporting and Hindering Factors in Community-Based Psychotherapy for Refugees: A Realist-Informed Systematic Review," IJERPH, MDPI, vol. 17(13), pages 1-27, June.
    • Handle: RePEc:gam:jijerp:v:17:y:2020:i:13:p:4618-:d:376963
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    References listed on IDEAS

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    1. Glasgow, R.E. & Vogt, T.M. & Boles, S.M., 1999. "Evaluating the public health impact of health promotion interventions: The RE-AIM framework," American Journal of Public Health, American Public Health Association, vol. 89(9), pages 1322-1327.
    2. Michela Nosè & Francesca Ballette & Irene Bighelli & Giulia Turrini & Marianna Purgato & Wietse Tol & Stefan Priebe & Corrado Barbui, 2017. "Psychosocial interventions for post-traumatic stress disorder in refugees and asylum seekers resettled in high-income countries: Systematic review and meta-analysis," PLOS ONE, Public Library of Science, vol. 12(2), pages 1-16, February.
    3. Summerfield, Derek, 1999. "A critique of seven assumptions behind psychological trauma programmes in war-affected areas," Social Science & Medicine, Elsevier, vol. 48(10), pages 1449-1462, May.
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    Cited by:

    1. Jia Lu & Shabana Jamani & Joseph Benjamen & Eric Agbata & Olivia Magwood & Kevin Pottie, 2020. "Global Mental Health and Services for Migrants in Primary Care Settings in High-Income Countries: A Scoping Review," IJERPH, MDPI, vol. 17(22), pages 1-28, November.
    2. Joseph Benjamen & Vincent Girard & Shabana Jamani & Olivia Magwood & Tim Holland & Nazia Sharfuddin & Kevin Pottie, 2021. "Access to Refugee and Migrant Mental Health Care Services during the First Six Months of the COVID-19 Pandemic: A Canadian Refugee Clinician Survey," IJERPH, MDPI, vol. 18(10), pages 1-11, May.
    3. Azaad Kassam & Olivia Magwood & Kevin Pottie, 2020. "Fostering Refugee and Other Migrant Resilience through Empowerment, Pluralism, and Collaboration in Mental Health," IJERPH, MDPI, vol. 17(24), pages 1-3, December.
    4. Elin Lampa & Anna Sarkadi & Georgina Warner, 2020. "Implementation and Maintenance of a Community-Based Intervention for Refugee Youth Reporting Symptoms of Post-Traumatic Stress: Lessons from Successful Sites," IJERPH, MDPI, vol. 18(1), pages 1-13, December.
    5. Olivia Magwood & Azaad Kassam & Dorsa Mavedatnia & Oreen Mendonca & Ammar Saad & Hafsa Hasan & Maria Madana & Dominique Ranger & Yvonne Tan & Kevin Pottie, 2022. "Mental Health Screening Approaches for Resettling Refugees and Asylum Seekers: A Scoping Review," IJERPH, MDPI, vol. 19(6), pages 1-41, March.

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