SSM - Mental Health (Dec 2022)
A brief psychological intervention for improving the mental health of Venezuelan migrants and refugees: A mixed-methods study
Abstract
The last decade has seen a rising interest in brief and affordable psychological interventions delivered by lay providers to address the unmet need for mental health care in low resource settings. This study sought to (i) determine whether the implementation of a culturally-adapted low-intensity psychological intervention – Problem Management Plus or PM+ – is associated with improved mental health among a sample of 72 Venezuelan migrants and refugees and Colombian returnees and, (ii) to identify context-specific factors determining its implementation. A randomised wait-list control trial was conducted to ascertain whether PM+ was associated with improved subjective wellbeing, as assessed by the World Health Organization-Five Wellbeing Index (WHO-5); quality of life, as assessed by the WHO Quality of Life – BREF; and self-identified problems, as assessed by the PSYCHLOPS. Three focus group discussions and eight semi-structured interviews with participants, supervisors and providers were conducted to understand the factors influencing the implementation of PM+ in this context. A univariate analysis of co-variance of the PM + group's (n = 38) post-intervention scores and the waitlisted groups' scores (n = 25), controlling for baseline scores, sex, age, level of education, indicated significant effects for the PM + group across all outcome measures: WHO-5 η2 = 0.75, p = <.001), WHOQOL-BREF Physical (η2 = 0.6, p = <.001); WHOQOL-BREF Psychological (η2 = 0.78, p = <.001); WHOQOL-BREF Social Relationships (η2 = 0.64, p = <.001) and WHOQOL-BREF Environment (η2 = 0.48, p = <.001). In addition to baseline scores, female sex had a significant effect on the WHO-5 scores (η2 = 0.06, p = .05). Cohen's d and Hedge's g were above 2.5 across all study outcomes. The following factors were found to influence the implementation of PM+: trust, engagement, integrated approach, teamwork, autonomy, supervision, acceptability and inclusion. Findings suggest that PM+ is an acceptable approach, associated with improved subjective wellbeing and quality of life of displaced populations.
