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Martinez W, Jimenez-Salazar MC, Suárez-Orozco C. School-Based Behavioral Health Programming for Newcomer Youth: A Scoping Review. Acad Pediatr 2024; 24:83-92. [PMID: 38991814 DOI: 10.1016/j.acap.2024.01.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Revised: 01/07/2024] [Accepted: 01/26/2024] [Indexed: 07/13/2024]
Abstract
OBJECTIVE Newcomer youth experience health disparities in accessing behavioral health services. School-based mental health programming is proposed a potential solution to address these disparities. The present study uses a scoping review methodology to examine the state-of-the-art of the evidence base for school-based mental health programming for newcomer youth. Studies were categorized into a tiered typology using the framework established by the National Center for School Mental Health. METHODS Several databases were examined as well as the results of one scoping and two systemic recent reviews. RESULTS A total of 37 studies were included in the present analysis, over half from the last decade. Most studies were conducted in the United States and Europe, and most programs were focused on mental health promotion and wellness (Tier 1) or were multi-tiered. Programming for younger children, especially those in early childhood settings, were underrepresented. CONCLUSIONS While the literature is promising regarding programming for newcomer youth, particularly the advent of complex multi-tiered programming, many gaps still remain. For example, most programs do not provide information on how programming was adapted for different groups of newcomers with different cultural and contextual needs. Tier 1 programs lack theoretical foundations or theories of change in the design of programming. Further, more research is needed for a group with rising numbers across high- and middle-income countries, particularly for programming targeting early and middle childhood.
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Affiliation(s)
- William Martinez
- Department of Psychiatry and Behavioral Sciences (W Martinez and MC Jimenez-Salazar), University of California, San Francisco, Calif.
| | - Maria C Jimenez-Salazar
- Department of Psychiatry and Behavioral Sciences (W Martinez and MC Jimenez-Salazar), University of California, San Francisco, Calif
| | - Carola Suárez-Orozco
- Culture, Institutions, and Society, Harvard Graduate School of Education (C Suárez-Orozco), Cambridge, Mass
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2
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Stevens AJ, Boukari Y, English S, Kadir A, Kumar BN, Devakumar D. Discriminatory, racist and xenophobic policies and practice against child refugees, asylum seekers and undocumented migrants in European health systems. THE LANCET REGIONAL HEALTH. EUROPE 2024; 41:100834. [PMID: 39119094 PMCID: PMC11306214 DOI: 10.1016/j.lanepe.2023.100834] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/14/2023] [Revised: 12/20/2023] [Accepted: 12/29/2023] [Indexed: 08/10/2024]
Abstract
Child refugees, asylum seekers and undocumented migrants who have been forcibly displaced from their countries of origin have heightened health needs as a consequence of their migration experiences. Host countries have a duty to respond to these needs, yet across Europe we are seeing a rise in potentially harmful discriminative, hostile and restrictive migration policies and practices. Research exploring the role racism, xenophobia and discrimination in European health systems may play in child migrant health inequities is lacking. This Personal View seeks to highlight this knowledge gap and stimulate discourse on how discrimination in health information systems, data sharing practices, national health policy, healthcare entitlements, service access, quality of care, and healthcare workers attitudes and behaviours may infringe upon the rights of, and impact the health of child refugees, asylum-seekers and undocumented migrants. It calls for action to prevent and mitigate against potentially harmful policies and practices.
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Affiliation(s)
| | - Yamina Boukari
- Institute of Health Informatics, University College London, UK
| | - Sonora English
- Institute for Global Health, University College London, London, UK
| | - Ayesha Kadir
- Save the Children International, St Vincent House, London, UK
| | | | - Delan Devakumar
- Institute for Global Health, University College London, London, UK
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3
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Seff I, Bennouna C, Gillespie A, Ali A, Allaf C, Wessells M, Stark L. Meaning-focused coping as a cultural process: A mixed quantitative and PhotoVoice study of adolescents with Arab backgrounds overcoming stigma and harassment. Soc Sci Med 2024; 350:116921. [PMID: 38723586 DOI: 10.1016/j.socscimed.2024.116921] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2023] [Revised: 04/15/2024] [Accepted: 04/25/2024] [Indexed: 05/21/2024]
Abstract
Poor mental health among U.S. adolescents has reach epidemic proportions, with those from the Middle East and North African region exhibiting increased risk for distress and suicide ideation. This mixed-methods study analyzes quantitative data from first- and second-generation Arab adolescents (n = 171) and qualitative data from a participatory study conducted with 11 adolescents of the same population to understand the role of cultural resources in coping. Drawing on the Intersectional Theory of Cultural Repertoires in Health, we show that: 1) cultural resources underlie meaning-making throughout coping; 2) coping strategies are inseparable from the influence of peer and familial relationships, as dictated through the social norms and other cultural resources; 3) collectively held repertoires of coping can promote belonging, affirm identity, and protect against discrimination; and 4) the outcomes of coping strategies, and the culturally informed meaning individuals make of these outcomes, influence their future coping behaviors.
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Affiliation(s)
- Ilana Seff
- Brown School at Washington University in St. Louis, St. Louis/Washington DC/Chicago, USA.
| | - Cyril Bennouna
- Brown University, Department of Political Science, Providence/Denver, USA.
| | - Alli Gillespie
- Brown School at Washington University in St. Louis, St. Louis/Washington DC/Chicago, USA.
| | - Ali Ali
- School of Social Work, The University of Michigan, Ann Arbor, MI, USA.
| | | | - Michael Wessells
- Columbia University, Program on Forced Migration and Health, New York City, USA.
| | - Lindsay Stark
- Brown School at Washington University in St. Louis, St. Louis/Washington DC/Chicago, USA.
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4
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Rosenberg J, McDonough Ryan P, Brown C, Schaffer R, O’Brien C, Ganjavi F, Sharifi M. Exploring the determinants of successful implementation of a preventive mental health and wellness intervention for Afghan refugee families: a qualitative analysis. HEALTH EDUCATION RESEARCH 2024; 39:119-130. [PMID: 37534755 PMCID: PMC10952411 DOI: 10.1093/her/cyad034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Revised: 06/04/2023] [Indexed: 08/04/2023]
Abstract
Many refugee children experience trauma in early childhood. Effective, tailored interventions are needed to improve refugee children's access to preventive mental health. We interviewed refugee-serving stakeholders and parents participating in an evidence-based preventive mental health and wellness intervention adapted for Afghan refugee children and families who may have experienced trauma. Interview guide development was informed by two implementation science frameworks: the Consolidated Framework for Implementation Research and the Model for Adaptation Design and Impact. A three-person team coded transcripts via rapid qualitative analysis, and the study team reached consensus on themes. Six refugee-serving facilitators and five refugee parents discussed key determinants of successful implementation. Themes included: (i) modeling cultural humility to promote communication about emotions; (ii) needed linguistic support and referral networks to avoid miscommunications and missed communications; (iii) bridging connections between children, families and schools; (iv) different takeaways, or differing goals and expectations between facilitators and participants; and (v) timely, specific cultural considerations to overcome participation barriers. Overall, we found key determinants of successful implementation of a preventive mental health and wellness intervention for refugee children and families included adaptations to enhance cultural humility and sensitivity to cultural context while strengthening communication among facilitators, children and families.
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Affiliation(s)
- Julia Rosenberg
- Department of Pediatrics, Yale University School of Medicine, 333 Cedar Street, New Haven, CT 06510, USA
| | - Patricia McDonough Ryan
- Department of Psychological Sciences, University of Connecticut, 1 University Pl, Stamford, CT 06901, USA
| | - Camille Brown
- Department of Pediatrics, Yale University School of Medicine, 333 Cedar Street, New Haven, CT 06510, USA
| | - Rachel Schaffer
- Health Coordination, Elena’s Light, 58 Foundain St Apt J2, New Haven, CT 06515, USA
| | - Caroline O’Brien
- Department of Neuroscience, Georgetown University Medical Center, Building EP-04 3970 Reservoir Rd, NW Washington, DC 20057, USA
| | - Fereshteh Ganjavi
- Founder and Director, Elena’s Light, 58 Foundain St Apt J2, New Haven, CT 06515, USA
| | - Mona Sharifi
- Department of Pediatrics, Yale School of Medicine, Department of Biostatistics, Yale School of Public Health, 333 Cedar Street, New Haven, CT 06510, USA
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5
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Seff I, Stark L, Ali A, Sarraf D, Hassan W, Allaf C. Supporting social emotional learning and wellbeing of displaced adolescents from the middle east: a pilot evaluation of the 'forward with peers' intervention. BMC Psychiatry 2024; 24:176. [PMID: 38438860 PMCID: PMC10910802 DOI: 10.1186/s12888-024-05544-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/15/2023] [Accepted: 01/20/2024] [Indexed: 03/06/2024] Open
Abstract
BACKGROUND A growing literature points to the critical role schools can play in promoting improved psychosocial wellbeing and resilience among first- and second-generation Arab immigrant and refugee adolescents, but few evaluations have examined the effectiveness of culturally adapted, school-based interventions. METHODS We conducted a pilot evaluation of a culturally adapted social and emotional learning and life skills program, Forward with Peers (FwP), and examined its potential effectiveness for this population. FwP was evaluated across three high schools in the Detroit Metropolitan Area. Within each school, one Arabic class was randomly assigned to receive FwP programming and another served as a control. The pilot evaluation sought to examine changes in several mental health and psychosocial outcomes of interest. FINDINGS Improvements in overall perceived social support (P = 0.045) and perceived social support from someone special in one's life (0.042) were statistically significant in the treatment as compared to the control group. Comparative improvements were also marginally significant for resilience (P = 0.095) and perceived social support from family (P = 0.074). CONCLUSIONS Findings highlight the potential of FwP and support the growing interest in establishing efficacy of school-based, culturally appropriate SEL programming to improve psychosocial wellbeing among Arab refugee and immigrant adolescents. FwP's demonstrated improvements in resilience and social support have the potential to prevent mental health disorders and bolster coping mechanisms to minimize adverse consequences in this vulnerable population. Employing a strengths-based approach, FwP offers an alternative intervention to traditional treatment-oriented supports for the proliferation of mental health disorders within this vulnerable population.
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Affiliation(s)
- Ilana Seff
- Brown School, Washington University in St. Louis, One Brookings Drive, 63130, St. Louis, MO, Box 1196, USA.
| | - Lindsay Stark
- Brown School, Washington University in St. Louis, One Brookings Drive, 63130, St. Louis, MO, Box 1196, USA.
| | - Ali Ali
- School of Social Work, University of Michigan, Ann Arbor, MI, USA
| | - Danielle Sarraf
- Brown School, Washington University in St. Louis, One Brookings Drive, 63130, St. Louis, MO, Box 1196, USA
| | - Wafa Hassan
- Global Educational Excellence Schools, Ann Arbor, MI, USA
| | - Carine Allaf
- Qatar Foundation International, Washington, DC, USA
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6
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de Smet S, Spaas C, Derluyn I, Kevers R, Colpin H, De Haene L. The role of school-based creative expression interventions in the aftermath of migration: A qualitative exploration of parents' and teachers' perspectives. J Sch Psychol 2024; 102:101260. [PMID: 38143093 DOI: 10.1016/j.jsp.2023.101260] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2022] [Revised: 12/01/2022] [Accepted: 10/27/2023] [Indexed: 12/26/2023]
Abstract
This study explored supportive relational processes for immigrant children's well-being between peers, teachers, and parents in the development of school-based creative interventions in European multi-ethnic societies. Within the present study, we integrated the perspectives of teachers and parents to broaden the dominant focus on the assessment of individual symptomatology within the existing body of studies of school-based interventions studies. As a part of a larger multi-method study on the implementation of a creative expression program for immigrant children ages 8-12 years in three schools in Belgium, we conducted focus group discussions to learn parents' and teachers' perspectives on the role of school-based creative interventions in children's coping with histories of migration and life in exile. Parents and teachers identified the need for the intervention to foster emotional expression impacting children's self-esteem and social connectedness with peers and to foster emotional connections between parents, teachers, and children. Parents also stressed the importance of the intervention within society as a forum to engage with social conditions, promote cultural belonging, and social integration. Results identified the importance of school-based interventions in terms of individual benefits as well as connectedness and coherence in entire communities, thereby strengthening the development of transcultural research evidence for school-based interventions in multi-ethnic societies.
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Affiliation(s)
- Sofie de Smet
- KU Leuven, University of Leuven, Belgium; Ghent University, Belgium.
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Bunn M, Khanna D, Farmer E, Esbrook E, Ellis H, Richard A, Weine S. Rethinking mental healthcare for refugees. SSM - MENTAL HEALTH 2023; 3:100196. [PMID: 37501680 PMCID: PMC10370474 DOI: 10.1016/j.ssmmh.2023.100196] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/15/2023] Open
Abstract
After several years of downturn in new resettlement, the United States is projected to admit 125,000 refugees in the current fiscal year. Refugee communities have known risks of developing mental health problems due to high rates of exposure to war and conflict-related trauma and chronic stressors associated with displacement and resettlement. In this commentary, we examine limitations in the current system of mental health care available to newly arriving refugee communities and make recommendations for expanding and redesigning services to better meet the needs of culturally diverse refugee communities. This includes drawing on public health and prevention frameworks to implement a continuum of services including basic services and security, trauma-informed prevention services to meet the needs of individuals, families and communities and specialized clinical care for those that need it. Across all services, we recommend robust engagement and partnership with refugee community leaders to design and deliver programs.
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Affiliation(s)
- Mary Bunn
- University of Illinois Chicago, Department of Psychiatry, United States
| | - Deepika Khanna
- University of Illinois Chicago, College of Medicine, United States
| | | | - Eleanor Esbrook
- University of Illinois Chicago, College of Medicine, United States
| | - Heidi Ellis
- Boston Children’s Hospital and Harvard Medical School, United States
| | | | - Stevan Weine
- University of Illinois Chicago, Department of Psychiatry, United States
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8
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Spaas C, Said-Metwaly S, Skovdal M, Primdahl NL, Jervelund SS, Hilden PK, Andersen AJ, Opaas M, Soye E, Watters C, Verelst A, Derluyn I, Colpin H, Haene LD. School-based Psychosocial Interventions' Effectiveness in Strengthening Refugee and Migrant Adolescents' Mental Health, Resilience, and Social Relations: A Four-country Cluster Randomized Study. PSYCHOSOCIAL INTERVENTION 2023; 32:177-189. [PMID: 37691715 PMCID: PMC10484026 DOI: 10.5093/pi2023a12] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/04/2023] [Accepted: 05/30/2023] [Indexed: 09/12/2023]
Abstract
School-based psychosocial interventions are increasingly put forward as a way to support young refugees' and migrants' well-being and mental health in resettlement. However, the evidence on these interventions' effectiveness remains scarce and scholars denounce particular gaps in the evidence to date, pointing to a lack of large-scale, controlled studies and studies including social outcome measures. This cluster randomized study aims to strengthen the evidence base on school-based psychosocial interventions for refugee and migrant youth by assessing the effect of two interventions, Classroom Drama and Welcome to School, on youth's mental health, resilience, and social relations in Belgium, Denmark, Norway, and the United Kingdom. Multilevel analyses were conducted separately for the two interventions (Classroom Drama, n = 307, ages 11-19; Welcome to School, n = 251, ages 11-23), using separate no-treatment control groups. Our analyses indicated a significant main, positive effect of Classroom Drama on perceived family support, and an effect on perceived support from friends that was moderated by country: in the United Kingdom, the intervention group reported an increase in perceived friend support, whereas the control group reported a decrease. Furthermore, baseline resilience moderated the effect of the Classroom Drama intervention on behavioral difficulties and well-being. No effects of Welcome to School on any of the outcome variables were found. Overall, this study provides novel, nuanced evidence on school-based psychosocial interventions for refugee and migrant adolescents.
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Affiliation(s)
- Caroline Spaas
- KU Leuven UniversityBelgiumKU Leuven University, Belgium;
| | - Sameh Said-Metwaly
- KU Leuven UniversityBelgiumKU Leuven University, Belgium;
- Damanhour UniversityEgyptDamanhour University, Egypt;
| | - Morten Skovdal
- University of CopenhagenDenmarkUniversity of Copenhagen, Denmark;
| | | | | | - Per Kristian Hilden
- Norwegian Centre for Violence and Traumatic Stress StudiesOsloNorwayNorwegian Centre for Violence and Traumatic Stress Studies, NKVTS, Oslo, Norway;
| | - Arnfinn J. Andersen
- Norwegian Centre for Violence and Traumatic Stress StudiesOsloNorwayNorwegian Centre for Violence and Traumatic Stress Studies, NKVTS, Oslo, Norway;
| | - Marianne Opaas
- Norwegian Centre for Violence and Traumatic Stress StudiesOsloNorwayNorwegian Centre for Violence and Traumatic Stress Studies, NKVTS, Oslo, Norway;
| | - Emma Soye
- University of SussexSchool of Education and Social WorkUKSchool of Education and Social Work, University of Sussex, UK;
| | - Charles Watters
- University of SussexSchool of Education and Social WorkUKSchool of Education and Social Work, University of Sussex, UK;
| | - An Verelst
- Ghent UniversityBelgiumGhent University, Belgium
| | - Ilse Derluyn
- Ghent UniversityBelgiumGhent University, Belgium
| | - Hilde Colpin
- KU Leuven UniversityBelgiumKU Leuven University, Belgium;
| | - Lucia De Haene
- KU Leuven UniversityBelgiumKU Leuven University, Belgium;
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9
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Thabet A, Ghandi S, Barker EK, Rutherford G, Malekinejad M. Interventions to enhance psychological resilience in forcibly displaced children: a systematic review. BMJ Glob Health 2023; 8:bmjgh-2021-007320. [PMID: 36731918 PMCID: PMC9896216 DOI: 10.1136/bmjgh-2021-007320] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2021] [Accepted: 03/07/2022] [Indexed: 02/04/2023] Open
Abstract
BACKGROUND Children represent nearly 40% of forcibly displaced populations and are subject to stressors that affect well-being. Little is known about the effects of interventions to enhance psychological resilience in these children, outside clinical settings. METHODS We conducted a systematic review, following Cochrane methods. Eligible studies tested resilience-enhancing interventions outside clinical settings in forcibly displaced children/adolescents. We included longitudinal quantitative studies with comparator conditions irrespective of geographical scope or language. We searched articles published between January 2010 and April 2020 in PubMed, Embase, Cochrane Library, Web of Science, PsycINFO and the WHO's Global Index Medicus. To standardise effect sizes across the different reported outcomes, we transformed reported mean differences to standardised mean differences using Hedge's g statistic with associated 95% CI. We pooled data for meta-analysis where appropriate. We used Cochrane tools to assess study risk of bias and used Grading of Recommendations Assessment, Development and Evaluation to determine evidence quality for meta-analysed outcomes. RESULTS Searches yielded 4829 results. Twenty-three studies met inclusion criteria. Studies reported 18 outcomes measured by 48 different scales; only 1 study explicitly measured resilience. Eight studies were randomised controlled trials; the rest were non-randomised pre-post studies. Interventions were diverse and typically implemented in group settings. Studies reported significant improvement in outcomes pertinent to behavioural problems, coping mechanisms and general well-being but not to caregiver support or psychiatric symptoms. In meta-analysis, resilience was improved (gav=0.194, 95% CI 0.018 to 0.369), but anxiety symptoms and quality of life were not (gav=-0.326, 95% CI -0.782 to 0.131 and gav=0.325, 95% CI -0.027 to 0.678, respectively). Risk of bias varied. Quality of evidence for most graded outcomes was very low. CONCLUSIONS The multiplicity of study designs, intervention types, outcomes and measures incumbered quantifying intervention effectiveness. Future resilience research in this population should use rigorous methods and follow reporting guidelines. PROSPERO REGISTRATION NUMBER CRD42020177069.
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Affiliation(s)
- Aya Thabet
- Institute for Global Health Sciences, University of California, San Francisco, California, USA
| | - Sonia Ghandi
- Institute for Global Health Sciences, University of California, San Francisco, California, USA
| | - Erin K Barker
- Institute for Global Health Sciences, University of California, San Francisco, California, USA
| | - Geroge Rutherford
- Institute for Global Health Sciences, University of California, San Francisco, California, USA,Department of Epidemiology and Biostatistics, University of California, San Francisco, California, USA
| | - Mohsen Malekinejad
- Institute for Global Health Sciences, University of California, San Francisco, California, USA,Department of Epidemiology and Biostatistics, University of California, San Francisco, California, USA
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10
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Patel SG, Bouche V, Thomas I, Martinez W. Mental health and adaptation among newcomer immigrant youth in United States educational settings. Curr Opin Psychol 2023; 49:101459. [PMID: 36502587 DOI: 10.1016/j.copsyc.2022.101459] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2022] [Accepted: 08/17/2022] [Indexed: 12/15/2022]
Abstract
Schools play a vital role in the acculturation process of newly migrated youth. Social and academic factors within school settings predict a wide variety of adaptation outcomes. Age and grade also impact the ways that school experiences can shape the post-migration adjustment trajectories of migrant youth. Negative school experiences can exacerbate migration trauma, whereas positive school experiences play an important protective role in overcoming migration-related challenges and adjusting to a new cultural context. Emerging research also suggests that the school environment presents a valuable opportunity for service delivery, as students are readily accessible during the school day which reduces systemic barriers to engagement. Socio-emotional prevention and intervention can address migration trauma, foster resiliency, and help lead the way to acculturative and academic success. Teachers, counselors, coaches and mentors who engage with newcomer immigrant youth in schools can play a pivotal role in easing migration-related challenges by encouraging positive emotional attachments, linking to resources, and helping to navigate new systems. These professionals benefit from specialized training on the unique needs and best practices for supporting the learning, engagement, development, and adaptation of newcomer youth.
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Affiliation(s)
- Sita G Patel
- Palo Alto University, 1791 Arastradero Road, Palo Alto, CA, 94304, USA.
| | - Vicky Bouche
- Palo Alto University, 1791 Arastradero Road, Palo Alto, CA, 94304, USA; Children's Hospital of Orange County, 1201 West La Veta Avenue, Orange, CA, 92868, USA
| | - Irene Thomas
- Palo Alto University, 1791 Arastradero Road, Palo Alto, CA, 94304, USA
| | - William Martinez
- University of California, San Francisco/Zuckerberg San Francisco General Hospital, 1001 Potrero Ave. Building 5, Suite 6B, San Francisco, CA 94110, USA
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11
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Ziaian T, Puvimanasinghe T, Miller E, Augoustinos M, Esterman A, Baddeley M, Arthur N, de Anstiss H, Tsoulis E, Stewart-Jones T, Ghassemi E, Pir T. Rebuilding life after migration: Research protocol of a mixed methods study on settlement experiences of refugee and migrant youth. PLoS One 2023; 18:e0285023. [PMID: 37115787 PMCID: PMC10146506 DOI: 10.1371/journal.pone.0285023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2022] [Accepted: 04/10/2023] [Indexed: 04/29/2023] Open
Abstract
Internationally, there is an urgent need to understand factors promoting successful settlement and integration of people with forced or voluntary migration experiences (i.e., refugee and non-refugee migrants). This paper provides a protocol of a mixed-methods investigation of contextual factors of successful settlement and service utilization of youth and their families, as young people could be at higher risk due to stressors associated with pre-migration trauma, post-migration settlement stressors, and adolescent development. This large-scale mixed-methods study will be conducted across three countries. A questionnaire survey will seek responses from 1200 youth aged 15-24 years residing in South Australia, Ontario, Canada, and California, United States of America. The qualitative component of the study will comprise 54 focus groups (324 participants) with youth and their parents/caregivers. The study design allows a range of important phenomena (e.g., different migration pathways and settlement countries) and key questions (e.g., regarding the intersection of migration, settlement, and wellbeing) to be addressed. It also allows for generalizability of findings to be tested across different communities and countries. Findings will support recommendations for policy and practice and may be generalized to advance research with youth and their families. This study is one of the largest, most comprehensive studies of youth settlement.
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Affiliation(s)
- Tahereh Ziaian
- University of South Australia, Justice and Society, Adelaide, Australia
- Centre for Workplace Excellence, University of South Australia, Adelaide, Australia
| | - Teresa Puvimanasinghe
- University of South Australia, Justice and Society, Adelaide, Australia
- Centre for Workplace Excellence, University of South Australia, Adelaide, Australia
| | - Emily Miller
- University of South Australia, Justice and Society, Adelaide, Australia
- Centre for Workplace Excellence, University of South Australia, Adelaide, Australia
| | | | - Adrian Esterman
- University of South Australia, Allied Health & Human Performance, Adelaide, Australia
| | | | - Nancy Arthur
- University of South Australia, Business, Adelaide, Australia
| | - Helena de Anstiss
- Multicultural Youth South Australia, Adelaide, South Australia, Australia
| | - Eugenia Tsoulis
- Australian Migrant Resource Centre, Adelaide, South Australia, Australia
| | | | | | - Tara Pir
- Institute for Multicultural Counseling and Education Services, Los Angeles, California, United States of America
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12
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Catani C, Wittmann J, Schmidt TL, Wilker S, Neldner S, Neuner F. School-based mental health screenings with Ukrainian adolescent refugees in Germany: Results from a pilot study. Front Psychol 2023; 14:1146282. [PMID: 37143592 PMCID: PMC10151552 DOI: 10.3389/fpsyg.2023.1146282] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2023] [Accepted: 03/30/2023] [Indexed: 05/06/2023] Open
Abstract
Since the Russian invasion of Ukraine in February 2022, high numbers of Ukrainians, mostly women and children, have left the country. As of today, Germany has accepted more than one million refugees fleeing from Ukraine including ~200,000 children and adolescents registered in German schools. Since refugee minors are typically affected by high rates of mental health issues, the identification of potential psychological problems at an early stage after arrival is essential in order to make timely referrals for vulnerable youth to diagnostic or treatment services possible. The aim of the present study was to test the feasibility of a classroom-based mental health screening procedure and to assess symptoms of PTSD, depression, and anxiety in a small sample of adolescents who had fled to Germany. Forty-two adolescents (n = 20 girls) took part in the study. Screening results showed that more than half of the sample had elevated ratings in the Refugee Health Screener (RHS) and about 45% reported clinically significant levels of PTSD. Overall, the amount of both mental health problems and current worries related to the war was significantly higher in girls compared to boys. In general, screenings were well received by the adolescents. The findings of this pilot study point to a considerable level of mental health problems and distress in adolescent refugees affected by the recent war in Ukraine. Brief psychological screenings within the school setting might represent a promising approach to identifying potential mental health disorders as early as possible in newly arriving refugee youth.
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13
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Bunn M, Zolman N, Smith CP, Khanna D, Hanneke R, Betancourt TS, Weine S. Family-based mental health interventions for refugees across the migration continuum: A systematic review. SSM - MENTAL HEALTH 2022. [PMID: 37529116 PMCID: PMC10392776 DOI: 10.1016/j.ssmmh.2022.100153] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
This study reviewed the literature on family-based mental health interventions for refugees across migration contexts and settings to identify types of interventions and intervention components, implementation approaches and to assess effectiveness. The review used a systematic approach, and ten intervention studies were retained for analysis. The findings identified three primary types of family-based mental health interventions used with diverse refugee communities in settings in the Global North and South-parenting groups, multiple family groups and home visiting interventions. Findings indicated that non-specialized or peer providers were frequently utilized to deliver the interventions though additional details on the workforce and workforce development strategies are needed to better understand how to sustain and support such providers. The findings suggest that family-based mental health interventions are potentially effective for improving a range of child and caregiver mental health outcomes and improving family processes and functioning among refugee families. However, the empirical evidence is quite limited to date, with a need for additional rigorous studies, especially with refugee families in humanitarian settings, to further build the evidence base.
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Mental health in refugee children. Curr Opin Psychol 2022; 48:101460. [PMID: 36130437 DOI: 10.1016/j.copsyc.2022.101460] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2022] [Revised: 08/14/2022] [Accepted: 08/17/2022] [Indexed: 01/28/2023]
Abstract
Almost half of the world's forcibly displaced population are children, most commonly originating from Syria, Iraq, and Afghanistan. Health disparities are well documented, especially for mental health, but not consistent across groups, time or context. Despite high exposure to trauma and stress, refugee children also show remarkable resilience. An ecological model of refugee health including both risk and resilience factors is therefore recommended. The model also includes the dynamic inter-relationship of past traumatic experiences, ongoing daily stressors and the disruptions of basic systems affecting both the individual and families as a whole, offering a framework to better understand the health disparities and appropriate interventions for refugee children.
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Access to Support Services for Newcomer Youth Through the Process of School Integration: A Critical Narrative Literature Review. CANADIAN JOURNAL OF SCHOOL PSYCHOLOGY 2022; 37:307-327. [DOI: 10.1177/08295735221130442] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
While the numbers of newcomer youth continue to grow in Canada, few studies have sought to critically capture experiences of school integration and access to school-based psychosocial support services during their transition. Guided by a critical social justice lens, this research seeks to investigate issues of inequity due to the marginalization of newcomer youth in schools. The intent of this critical narrative review is to summarize, interpret, critique, and synthesize what is currently known about the ways newcomer youth access and experience school-based psychosocial support services (S-BPSS) throughout the process of school integration. This paper presents the critical narrative literature review process, a discussion of the themes that emerged from the review, and a discussion of the literature within the context of school integration. The following themes that underscore the experiences of newcomer youth accessing school-based psychosocial support services were identified: (a) underutilization/discrimination, (b) culture shift, (c) transition planning, and (d) lived experience. Important directions for future research, including the importance of studies that prioritize the perspectives of newcomer youth themselves and the implications of their lived experience for S-BPSS are provided.
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Peltonen K, Aalto S, Vänskä M, Lepistö R, Punamäki RL, Soye E, Watters C, de Wal Pastoor L, Derluyn I, Kankaanpää R. Effectiveness of Promotive and Preventive Psychosocial Interventions on Improving the Mental Health of Finnish-Born and Immigrant Adolescents. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19063686. [PMID: 35329374 PMCID: PMC8955200 DOI: 10.3390/ijerph19063686] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/08/2022] [Revised: 03/16/2022] [Accepted: 03/17/2022] [Indexed: 01/27/2023]
Abstract
Background: Schools are considered natural environments in which to enhance students’ social–emotional skills and mental health in general, but they can be especially important for students with refugee and immigrant backgrounds. The current study tested the effectiveness of two school-based interventions in enhancing the mental health and wellbeing of adolescents of native, refugee, and immigrant backgrounds. It further analyzed the role of age, gender, daily stressors, and discrimination in affecting the interventions’ effectiveness. Methods: A three-arm cluster RCT with parallel assignment was applied among the 16 schools. Schools were randomized to three conditions of two active interventions and a waiting-list control condition. Students (n = 1974) filled in an online questionnaire at baseline before the interventions, after the interventions, and at follow-up an average of 9 months after the interventions. The effectiveness criteria were internalizing and externalizing problems, resilience, and prosocial behavior. Results: Interventions were generally not effective in decreasing mental health problems and increasing psychosocial resources. The expected positive intervention effects were dependent on students’ age and gender and exposure to socioeconomic daily stressors. Conclusion: Interventions enhancing teacher awareness and peer relationships at school should be carefully tailored according to the strengths and vulnerabilities of participating students, especially their daily stress exposure, but also age and gender.
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Affiliation(s)
- Kirsi Peltonen
- Department of Child Psychiatry, University of Turku, 20014 Turku, Finland
- INVEST Research Flagship Center, University of Turku, 20014 Turku, Finland
- Faculty of Social Sciences/Psychology, Tampere University, 33100 Tampere, Finland; (S.A.); (M.V.); (R.L.); (R.-L.P.); (R.K.)
- Correspondence:
| | - Sanni Aalto
- Faculty of Social Sciences/Psychology, Tampere University, 33100 Tampere, Finland; (S.A.); (M.V.); (R.L.); (R.-L.P.); (R.K.)
| | - Mervi Vänskä
- Faculty of Social Sciences/Psychology, Tampere University, 33100 Tampere, Finland; (S.A.); (M.V.); (R.L.); (R.-L.P.); (R.K.)
| | - Riina Lepistö
- Faculty of Social Sciences/Psychology, Tampere University, 33100 Tampere, Finland; (S.A.); (M.V.); (R.L.); (R.-L.P.); (R.K.)
| | - Raija-Leena Punamäki
- Faculty of Social Sciences/Psychology, Tampere University, 33100 Tampere, Finland; (S.A.); (M.V.); (R.L.); (R.-L.P.); (R.K.)
| | - Emma Soye
- School of Education and Social Work, University of Sussex, Falmer Brighton BN1 9RH, UK; (E.S.); (C.W.)
| | - Charles Watters
- School of Education and Social Work, University of Sussex, Falmer Brighton BN1 9RH, UK; (E.S.); (C.W.)
| | - Lutine de Wal Pastoor
- Danish Research Centre for Migration, Ethnicity and Health, University of Copenhagen, 1353 Copenhagen, Denmark;
| | - Ilse Derluyn
- Department of Social Work and Social Pedagogy, Centre for the Social Study of Migration and Refugees, Ghent University, 9000 Gent, Belgium;
| | - Reeta Kankaanpää
- Faculty of Social Sciences/Psychology, Tampere University, 33100 Tampere, Finland; (S.A.); (M.V.); (R.L.); (R.-L.P.); (R.K.)
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Kankaanpää R, Aalto S, Vänskä M, Lepistö R, Punamäki RL, Soye E, Watters C, Andersen A, Hilden PK, Derluyn I, Verelst A, Peltonen K. Effectiveness of psychosocial school interventions in Finnish schools for refugee and immigrant children, "Refugees Well School" in Finland (RWS-FI): a protocol for a cluster randomized controlled trial. Trials 2022; 23:79. [PMID: 35086535 PMCID: PMC8793091 DOI: 10.1186/s13063-021-05715-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2020] [Accepted: 10/12/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Schools are natural environments in which to enhance young people's social and emotional skills, mental health, and contact between diverse groups, including students from refugee and immigrant backgrounds. A layered or tiered provision of services is recommended as it can be effective to meet the needs of war-affected adolescents who variably show mental health problems (such as posttraumatic stress disorder (PTSD)). The current protocol describes the study design for a multi-layered intervention model. The study will test the effectiveness of two interventions: a teacher-training intervention In-Service Teacher Training (INSETT) combined with targeted cognitive-behavioral treatment-based Teaching Recovery Techniques (TRT) and a classroom-focused preventive intervention Peer Integration and Enhancement Resources (PIER). We analyze, first, whether the interventions are effective in decreasing psychological distress and increasing positive resources, i.e., prosocial behavior and resilience among refugee and immigrant students. Second, we analyze which student-, school-, and parent-related factors mediate the possible beneficial changes. Third, we look at which groups the interventions are most beneficial to. METHODS A three-arm cluster RCT with parallel assignment, with a 1:1:1 allocation ratio, is applied in 16 schools that agreed to participate in the Refugees Well School interventions and effectiveness study. Schools were randomized to three conditions of two active interventions and a waiting list control condition. Students, their parents, and teachers in intervention and control schools participated in the study at baseline before the interventions, after the interventions, and at 6 to 12 months after the interventions. The primary effectiveness criterion variables are psychological distress (SDQ) symptoms, resilience (CYRM-12), and prosocial behavior (SDQ). DISCUSSION The current study presents a recommended universal approach of layered interventions aiming to reduce psychological distress and increase resilience among refugee and immigrant students. A combination of promotive, preventive, and targeted interventions may offer a holistic, ecological intervention package for schools to better address the needs of the whole group. TRIAL REGISTRATION ISRCTN ISRCTN64245549 . Retrospectively registered on 10 June 2020.
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Affiliation(s)
- Reeta Kankaanpää
- Faculty of Social Sciences/Psychology, Tampere University, Tampere, Finland
| | - Sanni Aalto
- Faculty of Social Sciences/Psychology, Tampere University, Tampere, Finland
| | - Mervi Vänskä
- Faculty of Social Sciences/Psychology, Tampere University, Tampere, Finland
| | - Riina Lepistö
- Faculty of Social Sciences/Psychology, Tampere University, Tampere, Finland
| | | | - Emma Soye
- School of Education and Social Work, University of Sussex, FIN-33014 Tampere, Finland
| | - Charles Watters
- School of Education and Social Work, University of Sussex, FIN-33014 Tampere, Finland
| | - Arnfinn Andersen
- Section for Trauma, Catastrophes and Forced Migration - Adults and Elderly, Norwegian Centre for Violence and Traumatic Stress Studies, Oslo, Norway
| | - Per Kristian Hilden
- Section for Trauma, Catastrophes and Forced Migration - Adults and Elderly, Norwegian Centre for Violence and Traumatic Stress Studies, Oslo, Norway
| | - Ilse Derluyn
- Department of Social Pedagogy, Ghent University, Ghent, Belgium
| | - An Verelst
- Department of Social Pedagogy, Ghent University, Ghent, Belgium
| | - Kirsi Peltonen
- Faculty of Social Sciences/Psychology, Tampere University, Tampere, Finland
- Research Centre for Child Psychiatry, University of Turku, Turku, Finland
- INVEST Research Flagship Center, University of Turku, Turku, Finland
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Stark L, Seff I, Yu G, Salama M, Wessells M, Allaf C, Bennouna C. Correlates of Suicide Ideation and Resilience Among Native- and Foreign-Born Adolescents in the United States. J Adolesc Health 2022; 70:91-98. [PMID: 34412951 DOI: 10.1016/j.jadohealth.2021.07.012] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/04/2021] [Revised: 07/01/2021] [Accepted: 07/12/2021] [Indexed: 01/12/2023]
Abstract
PURPOSE Nearly 20% of U.S. adolescents have considered suicide. Yet, gaps remain in understanding correlates of resilience and suicide risk, especially among populations born outside the United States who may face unique migration- and acculturation-related stressors. This study adds to the literature by exploring correlates of suicide ideation among a diverse population. METHODS This study analyzes quantitative data (N = 357) from the Study of Adolescent Lives after Migration to America, in Detroit and Harrisonburg. More than 40% of the sample was born outside the United States, with the majority born in the Middle East and North Africa. Path analysis was used to model dual outcomes of resilience and suicide ideation using measures of hope, school belonging, stressful life events, and being born outside the United States. RESULTS Suicide ideation and resilience were negatively correlated (ß = -.236[.069]; p < .001). Adolescents with greater hope (ß = .367; p < .001) and school belonging (ß = .407; p < .001) reported higher resilience, while lower levels of school belonging correlated with higher levels of suicide ideation (ß = -.248; p = .009). More stressful life events were associated with suicide ideation (ß = .243; p < .001), while fewer were correlated with resilience (ß = -.106; p = .003). Being born outside the United States was associated with suicide ideation (ß = .186; P-.015), with this finding driven by those from the Middle East and North Africa region, who faced significantly increased risk of suicide ideation (ß = .169; p = .036). CONCLUSIONS Findings suggest that adolescents born in the Middle East and North Africa region may represent a vulnerable group needing targeted and culturally responsive interventions to destigmatize mental health and psychosocial well-being, boost existing sources of resilience, and encourage help-seeking behaviors.
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Affiliation(s)
- Lindsay Stark
- Brown School at Washington University in St. Louis, St. Louis, Missouri.
| | - Ilana Seff
- Brown School at Washington University in St. Louis, St. Louis, Missouri
| | - Gary Yu
- Rory Meyers College of Nursing, New York University, New York, New York
| | - Mariam Salama
- Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland
| | - Michael Wessells
- Mailman School of Public Health, Columbia University, New York, New York
| | | | - Cyril Bennouna
- Department of Political Science, Brown University, Providence, Rhode Island
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Trimboli C, Parsons L, Fleay C, Parsons D, Buchanan A. A systematic review and meta-analysis of psychosocial interventions for 6–12-year-old children who have been forcibly displaced. SSM - MENTAL HEALTH 2021. [DOI: 10.1016/j.ssmmh.2021.100028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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20
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Stark L, Robinson MV, Gillespie A, Aldrich J, Hassan W, Wessells M, Allaf C, Bennouna C. Supporting mental health and psychosocial wellbeing through social and emotional learning: A participatory study of conflict-affected youth resettled to the U.S. BMC Public Health 2021; 21:1620. [PMID: 34488688 PMCID: PMC8419992 DOI: 10.1186/s12889-021-11674-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2020] [Accepted: 08/29/2021] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND A growing literature has drawn attention to the central role that schools play in supporting the adjustment of resettled refugee youth and promoting their mental health and psychosocial wellbeing. In particular, the recent proliferation of school-based social and emotional learning (SEL) initiatives presents an opportunity to strengthen supports for resettled adolescents. This participatory research study aims to understand how high school students resettled from countries in the Middle East and North Africa region are experiencing the challenges and opportunities of acculturation and the ways in which they believe schools can better support them in this process. METHODS We analyzed primary data collected during focus group discussions as part of the SALaMA study. During these discussions, we used participatory ranking methodology to elicit adolescents' suggestions on how high schools can better support students both academically and psychosocially after resettlement. Fourteen focus group discussions were held with male (n = 38) and female (n = 31) adolescents aged 14-20 years, who were selected purposively across six public high schools in Harrisonburg, Virginia, Austin, Texas, and Detroit, Michigan. Participants offered suggestions and then ranked them in order of importance using consensus ranking. RESULTS Thematic analysis of the PRM results across sites produced a wealth of suggestions centered around three broad themes, namely: skills related to navigating social and academic challenges, culturally responsive teaching, and socially and culturally equitable learning environments. CONCLUSIONS Findings reported illustrate limitations of the conventional, universal SEL model and shed light on how schools can adapt transformative SEL strategies to serve their students better, especially newcomers from conflict-affected countries.
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Affiliation(s)
- Lindsay Stark
- Brown School at Washington University in St. Louis, Campus Box 1196, One Brookings Drive, St. Louis, MO, 63130, USA.
| | - Mackenzie V Robinson
- Brown School at Washington University in St. Louis, Campus Box 1196, One Brookings Drive, St. Louis, MO, 63130, USA
| | - Alli Gillespie
- Brown School at Washington University in St. Louis, Campus Box 1196, One Brookings Drive, St. Louis, MO, 63130, USA
| | | | - Wafa Hassan
- Global Educational Excellence, Ann Arbor, USA
| | - Michael Wessells
- Mailman School of Public Health, Columbia University, New York, USA
| | - Carine Allaf
- Qatar Foundation International, Washington, D.C., USA
| | - Cyril Bennouna
- Department of Political Science, Brown University, Providence, USA
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21
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Bennouna C, Brumbaum H, McLay MM, Allaf C, Wessells M, Stark L. The role of culturally responsive social and emotional learning in supporting refugee inclusion and belonging: A thematic analysis of service provider perspectives. PLoS One 2021; 16:e0256743. [PMID: 34437627 PMCID: PMC8389371 DOI: 10.1371/journal.pone.0256743] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2021] [Accepted: 08/13/2021] [Indexed: 11/26/2022] Open
Abstract
Young refugees resettled to the U.S. from the Middle East and North Africa (MENA) region face significant acculturative stressors, including language barriers, unfamiliar norms and practices, new institutional environments, and discrimination. While schools may ease newcomer adjustment and inclusion, they also risk exacerbating acculturative stress and social exclusion. This study seeks to understand the opportunities and challenges that schoolwide social and emotional learning (SEL) efforts may present for supporting refugee incorporation, belonging, and wellbeing. We completed semi-structured interviews with a purposive sample of 40 educators and other service providers in Austin, Texas, Harrisonburg, Virginia, and Detroit Metropolitan Area, Michigan as part of the SALaMA project. We conducted a thematic analysis with transcripts from these interviews guided by the framework of culturally responsive pedagogy. The findings revealed that students and providers struggled with acculturative stressors and structural barriers to meaningful engagement. Schoolwide SEL also provided several mechanisms through which schools could facilitate newcomer adjustment and belonging, which included promoting adult SEL competencies that center equity and inclusion, cultivating more meaningfully inclusive school climates, and engaging families through school liaisons from the newcomer community. We discuss the implications of these findings for systemwide efforts to deliver culturally responsive SEL, emphasize the importance of distinguishing between cultural and structural sources of inequality, and consider how these lessons extend across sectors and disciplinary traditions.
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Affiliation(s)
- Cyril Bennouna
- Department of Political Science, Brown University, Providence, Rhode Island, United States of America
| | - Hannah Brumbaum
- Brown School, Washington University in St. Louis, Saint Louis, Missouri, United States of America
| | - Molly M. McLay
- Brown School, Washington University in St. Louis, Saint Louis, Missouri, United States of America
| | - Carine Allaf
- Qatar Foundation International, Washington, Columbia, United States of America
| | - Michael Wessells
- Mailman School of Public Health, Columbia University, New York, New York, United States of America
| | - Lindsay Stark
- Brown School, Washington University in St. Louis, Saint Louis, Missouri, United States of America
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22
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Warner G, Osman F, McDiarmid S, Sarkadi A. Giving schools a nudge: can behavioural insights improve recruitment of schools to randomised controlled trials? BMC Res Notes 2021; 14:99. [PMID: 33726793 PMCID: PMC7962076 DOI: 10.1186/s13104-021-05509-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2020] [Accepted: 03/02/2021] [Indexed: 11/13/2022] Open
Abstract
Objective It is widely acknowledged that recruitment to randomised controlled trials (RCTs) is challenging, particularly trials that operate across multiple sites. A research area in need of further high-quality evaluation, including RCTs, is school-based mental health interventions for refugee children and adolescents. However, engaging schools with interventions and associated evaluations can be challenging. This paper explores the application of behavioural insights, i.e. evidence-based understanding of how people behave and make decisions, to RCT recruitment at the school level via email communications. A pilot study of applying behavioural insights to mail outs attempting to recruit schools to a RCT of a trauma-focused group intervention for refugee children and adolescents experiencing symptoms of post-traumatic stress is reported. Rates of school involvement between the behavioural insights approach (n = 31) and a standard outreach approach (n = 65) are compared. Results Schools were more likely to give a positive response to the mail out designed using the behavioural insights framework than standard outreach. Accounts of recruitment strategies such as this are valuable additions to the literature on RCT methodology given the potential for recruitment issues to affect trial operations.
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Affiliation(s)
- Georgina Warner
- Child Health and Parenting (CHAP), Department of Public Health and Caring Sciences, Uppsala University, BMC, Husargatan 3, 751 22, Uppsala, Sweden.
| | - Fatumo Osman
- School of Education, Health and Social Studies, Dalarna University, Falun, Sweden.,Social Development Lab, Department of Psychology, University of Waterloo, Waterloo, ON, Canada
| | - Serena McDiarmid
- Social Development Lab, Department of Psychology, University of Waterloo, Waterloo, ON, Canada
| | - Anna Sarkadi
- Child Health and Parenting (CHAP), Department of Public Health and Caring Sciences, Uppsala University, BMC, Husargatan 3, 751 22, Uppsala, Sweden
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Kelman I, Ayeb-Karlsson S, Rose-Clarke K, Prost A, Ronneberg E, Wheeler N, Watts N. A review of mental health and wellbeing under climate change in small island developing states (SIDS). ENVIRONMENTAL RESEARCH LETTERS : ERL [WEB SITE] 2021; 16:033007. [PMID: 34149865 PMCID: PMC8208624 DOI: 10.1088/1748-9326/abe57d] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/18/2020] [Revised: 02/07/2021] [Accepted: 02/11/2021] [Indexed: 05/03/2023]
Abstract
Small island developing states (SIDS) are often at the forefront of climate change impacts, including those related to health, but information on mental health and wellbeing is typically underreported. To help address this research lacuna, this paper reviews research about mental health and wellbeing under climate change in SIDS. Due to major differences in the literature's methodologies, results, and analyses, the method is an overview and qualitative evidence synthesis of peer-reviewed publications. The findings show that mental health and wellbeing in the context of climate change have yet to feature prominently and systematically in research covering SIDS. It seems likely that major adverse mental health and wellbeing impacts linked to climate change impacts will affect SIDS peoples. Similar outcomes might also emerge when discussing climate change related situations, scenarios, and responses, irrespective of what has actually happened thus far due to climate change. In the context of inadequate health systems and stigmatisation of mental health diagnoses and treatments, as tends to occur globally, climate change narratives might present an opening for conversations about addressing mental health and wellbeing issues for SIDS.
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Affiliation(s)
- Ilan Kelman
- University College London (UCL), London, United Kingdom
- University of Agder, 4630 Kristiansand, Norway
| | - Sonja Ayeb-Karlsson
- University of Sussex, Brighton BN1 9RH, United Kingdom
- United Nations University Institute for Environment and Human Security, D-53113 Bonn, Germany
| | | | - Audrey Prost
- University College London (UCL), London, United Kingdom
| | - Espen Ronneberg
- Secretariat of the Pacific Regional Environment Programme (SPREP), Apia, Samoa
| | - Nicola Wheeler
- Consultant (World Health Organization), Associate (Outsight International), London, United Kingdom
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Seff I, Gillespie A, Bennouna C, Hassan W, Robinson MV, Wessells M, Allaf C, Stark L. Psychosocial Well-Being, Mental Health, and Available Supports in an Arab Enclave: Exploring Outcomes for Foreign-Born and U.S.-Born Adolescents. Front Psychiatry 2021; 12:632031. [PMID: 33897491 PMCID: PMC8060490 DOI: 10.3389/fpsyt.2021.632031] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/23/2020] [Accepted: 03/15/2021] [Indexed: 11/21/2022] Open
Abstract
Introduction: Few studies have assessed the impact of displacement, resettlement, and discrimination on well-being outcomes for adolescent refugees resettled within the U.S. Conducted in three charter schools in the intergenerational Arab enclave of the Detroit Metropolitan Area, this mixed-methods study assessed the mental health and psychosocial support for both U.S.- and foreign-born adolescents from the Middle East and North Africa region. Methods: A quantitative survey was used to collect data on 176 students. Key outcomes included hope, prosocial behaviors, resilience, depressive, anxiety, externalizing symptoms, stressful life events, perceived social support, and sense of school belonging. Differences in outcomes between U.S.- and foreign-born students were compared using T-tests. Regression analysis explored whether outcomes were gendered and correlated with years in the U.S. for foreign-born students. Qualitative data collection included key informant interviews with school staff and community service providers, student focus group discussions, and caregiver interviews. Interview transcripts were analyzed using thematic analysis and the constant comparative method. Results: No statistically significant differences between the foreign-born and U.S.-born groups were observed. However, analysis revealed that resilience decreased for male students with time spent in the U.S. Qualitative themes illuminated these results; shared cultural heritage allowed newcomer students to access relevant language and psychosocial support, while inter- and intra-group peer relationships strengthened students' dual language skills and identity formation. However, shifting gender expectations and role hierarchies for newcomer students revealed boys' increased stressors in the family domain and girls' better accessed support in the school context. Conclusion: The existence of an immigrant paradox in this enclave setting was not supported. Instead, findings highlight the reciprocal value of peer-based mentorships and friendships between U.S.- and foreign-born students with similar cultural backgrounds, the importance of social and emotional curricula and cultural competency training within schools, and the gendered effects of acculturation.
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Affiliation(s)
- Ilana Seff
- Mailman School of Public Health, Columbia University, New York City, NY, United States
| | - Alli Gillespie
- Brown School at Washington University in St. Louis, St. Louis, MO, United States
| | - Cyril Bennouna
- Department of Political Science, Brown University, Providence, RI, United States
| | - Wafa Hassan
- Global Educational Excellence, Ann Arbor, MI, United States
| | - Mackenzie V Robinson
- Brown School at Washington University in St. Louis, St. Louis, MO, United States
| | - Michael Wessells
- Mailman School of Public Health, Columbia University, New York City, NY, United States
| | - Carine Allaf
- Qatar Foundation International, Washington, DC, United States
| | - Lindsay Stark
- Brown School at Washington University in St. Louis, St. Louis, MO, United States
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25
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Takubo Y, Nemoto T, Iwai M, Kashima M, Yamaguchi E, Maruyama A, Miura S, Saito H, Tsujino N, Mizuno M. Demographic and clinical characteristics of foreign nationals accessing psychiatric services in Japan: a multicentre study in a metropolitan area. BMC Psychiatry 2020; 20:569. [PMID: 33267861 PMCID: PMC7713363 DOI: 10.1186/s12888-020-02951-z] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/20/2020] [Accepted: 11/12/2020] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND International immigration to Japan, where homogeneous ethnicity is a population characteristic, has been growing. Although immigration is recognised as a risk factor for multiple mental-health related issues, there are few regional reports on foreign nationals accessing the psychiatric services in Japan. We aimed to reveal their current status and provide information to develop an optimal service system. METHODS A multicentre retrospective document review research was conducted. The subjects were foreign nationals who resided in Japan and presented at the psychiatry departments in three core regional hospitals in the Keihin region, which faces Tokyo Bay and is well known to include the largest traditional industrial zone in Japan, over a period of 3 years. We investigated the patients' demographic and clinical information including country/region of origin, spoken language, use of a medical interpreter, pathway to hospitals and outcome. RESULTS The percentage of foreign patients among all patients (1.4%) was quite low. Their age distribution (45.8 years on average) was dissociated from the age distribution of foreign nationals who resided in Japan. Regarding the country/region of origin, China (35.1%) was the most common country, followed by the Philippines, Korea and Brazil. Several subjects (22.9%) could not speak Japanese; therefore, interpretation was required by family members/friends (17.1%) or a professional interpreter (5.4%). Neurotic and stress-related disorders were the most common diagnosis (24.4%). The proportion of psychoactive substance use was higher than that for Japanese national data as immigrants are known to be at risk for it. CONCLUSIONS The results suggest that foreign nationals who reside in Japan are less likely to contact appropriate services for mental illness, especially young people at relatively high risk of mental illness do not access services. Furthermore, lack of medical interpreters may impede the mental health conditions of foreign nationals. The development of a community-based integrated care system accessible to foreign nationals seems to be indispensable.
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Affiliation(s)
- Youji Takubo
- grid.26999.3d0000 0001 2151 536XDepartment of Neuropsychiatry, Toho University Graduate School of Medicine, 5-21-16 Omori-nishi, Ota-ku, Tokyo, 143-8540 Japan ,Department of Psychiatry, Saiseikai Yokohamashi Tobu Hospital, 3-6-1 Shimosueyoshi, Tsurumi-ku, Yokohama, Kanagawa 230-8765 Japan
| | - Takahiro Nemoto
- Department of Neuropsychiatry, Toho University Faculty of Medicine, 6-11-1 Omori-nishi, Ota-ku, Tokyo, 143-8541, Japan.
| | - Momoko Iwai
- grid.265050.40000 0000 9290 9879Department of Neuropsychiatry, Toho University Faculty of Medicine, 6-11-1 Omori-nishi, Ota-ku, Tokyo, 143-8541 Japan
| | - Minako Kashima
- grid.415107.60000 0004 1772 6908Department of Neuropsychiatry, Kawasaki Municipal Hospital, 12-1 Shinkawadori, Kawasaki-ku, Kawasaki, Kanagawa 210-0013 Japan
| | - Eriko Yamaguchi
- grid.26999.3d0000 0001 2151 536XDepartment of Neuropsychiatry, Toho University Graduate School of Medicine, 5-21-16 Omori-nishi, Ota-ku, Tokyo, 143-8540 Japan
| | - Akiko Maruyama
- grid.443341.50000 0004 0375 6380Shoin University Faculty of Nursing, 9-1 Morinosato-wakamiya, Atsugi, Kanagawa 243-0124 Japan
| | - Sachio Miura
- grid.174567.60000 0000 8902 2273Nagasaki University, 1-12-4 Sakamoto, Nagasaki, Nagasaki 852-8523 Japan ,NPO MAIKEN, 2-1935-7 Motohachioji-machi, Hachioji, Tokyo, 193-0826 Japan
| | - Hisaaki Saito
- grid.415107.60000 0004 1772 6908Department of Neuropsychiatry, Kawasaki Municipal Hospital, 12-1 Shinkawadori, Kawasaki-ku, Kawasaki, Kanagawa 210-0013 Japan
| | - Naohisa Tsujino
- Department of Psychiatry, Saiseikai Yokohamashi Tobu Hospital, 3-6-1 Shimosueyoshi, Tsurumi-ku, Yokohama, Kanagawa 230-8765 Japan ,grid.265050.40000 0000 9290 9879Department of Neuropsychiatry, Toho University Faculty of Medicine, 6-11-1 Omori-nishi, Ota-ku, Tokyo, 143-8541 Japan
| | - Masafumi Mizuno
- grid.265050.40000 0000 9290 9879Department of Neuropsychiatry, Toho University Faculty of Medicine, 6-11-1 Omori-nishi, Ota-ku, Tokyo, 143-8541 Japan
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Linking adolescent future expectations to health in adulthood: Evidence and mechanisms. Soc Sci Med 2020; 263:113282. [DOI: 10.1016/j.socscimed.2020.113282] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Revised: 07/14/2020] [Accepted: 08/02/2020] [Indexed: 01/15/2023]
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Bennouna C, Ocampo MG, Cohen F, Basir M, Allaf C, Wessells M, Stark L. Ecologies of care: mental health and psychosocial support for war-affected youth in the U.S. Confl Health 2019; 13:47. [PMID: 31641372 PMCID: PMC6802323 DOI: 10.1186/s13031-019-0233-x] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2019] [Accepted: 10/01/2019] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Youth resettling to the U.S. from conflict-affected countries in the Middle East and North Africa (MENA) face countless challenges. As they cope with their experiences of armed conflict and forced migration, these girls and boys must also adjust to the language and social norms of their new society, often encountering prejudice and discrimination along the way. Previous studies indicate that schools can play a central role in facilitating this adjustment while also promoting mental health and psychosocial wellbeing. This qualitative study aims to understand the lived experiences of MENA newcomers resettled in Austin, Texas and Harrisonburg, Virginia and to assess how schools, families, and communities support their mental and psychosocial wellbeing. METHODS We held six focus group discussions across the two cities with a total of 30 youths (13-23 years) from Iraq, Syria, and Sudan. We also conducted semi-structured interviews with 30 caregivers and 27 key informants, including teachers, administrators, service providers, and personnel from community-based organizations. RESULTS Guided by Bioecological Theory, our thematic analysis identifies several means by which various actors work together to support resettled adolescents. We highlight promising efforts that seek to enhance these supports, including sheltered instruction, school-parent collaboration, peer support programming, social and emotional learning initiatives, and integrated mental health centers. CONCLUSION While this study underscores the resilience of newcomers and the value of local support systems, it also reflects the importance of investment in schools, mental health systems, and resettlement programs that can enable newcomers to achieve their full potential.
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Affiliation(s)
- Cyril Bennouna
- Department of Political Science, Brown University, Providence, USA
| | | | - Flora Cohen
- Brown School at Washington University in St. Louis, Missouri, USA
| | - Mashal Basir
- Mailman School of Public Health, Columbia University, New York City, NY USA
| | - Carine Allaf
- Qatar Foundation International, Washington, D.C, USA
| | - Michael Wessells
- Mailman School of Public Health, Columbia University, New York City, NY USA
| | - Lindsay Stark
- Brown School at Washington University in St. Louis, Missouri, USA
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