Brief psychological interventions to improve mental health outcomes in refugee populations: A systematic review

Abstract

AbstractBackgroundRefugees, asylum seekers, and internally displaced people experience a high burden of mental health problems owing to their experiencing traumas and stressful events.ObjectiveTo summarise the available evidence and analyse the efficacy of brief psychological interventions (< 3 months) on improving mental health outcomes, including depression, anxiety, and post-traumatic stress disorder (PTSD)-related symptoms in refugees.MethodWe searched Medline, EMBASE, PsycINFO, CINAHL, and Global Index Medicus from inception to 19 December 2023. We included controlled studies using any cognitive behavioural therapy (CBT) or CBT-based therapies delivered over a short time (< 3 months), which reported mental health outcomes pre-and post-intervention. We conducted meta-analyses using random effects to derive pooled summary statistics.Results34 eligible studies across 36 publications were retrieved for analysis, and 33 studies were included in the meta-analysis. There was an overall improvement in immediate mental health outcomes for all three domains, with analysis of 13 studies on anxiety outcomes (SMD −1.12, 95% CI −1.72 to −0.52), 20 studies on depression (SMD −1.04, 95% CI −1.97 to −0.11), and 24 studies on PTSD (SMD −0.82, 95% CI −1.20 to −0.45). At 3 to 6-month follow-up, however, analysis of mental health outcomes shows no significant change from baseline, with standard mean differences of 0.24 (95% CI −0.94 to 1.42) across 4 studies, −0.73 (95% CI −2.14 to 0.68) across 9 studies, and 0.29 (95% CI −0.94 to 1.53) across 12 studies for anxiety, depression, and PTSD respectively.ConclusionLow-level evidence shows brief psychological interventions positively affect refugees and internally displaced people’s mental well-being. Heterogeneity was high, even among subgroups, impacting our findings’ generalisability.HIGHLIGHTS-We analysed the evidence on the use of brief CBT-based psychological interventions to improve mental health outcomes in forcibly displaced persons.-These interventions had a positive effect on anxiety, depression, and PTSD, though there was high heterogeneity between studies.-Positive effects on mental health disappeared at long-term follow-up.