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Mental health in refugees and asylum seekers (MEHIRA): study design and methodology of a prospective multicentre randomized controlled trail investigating the effects of a stepped and collaborative care model

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Abstract

The sudden arrival of culturally diverse asylum seekers and refugees into Germany has created a strong demand for recognizing and appropriately treating those suffering from mental health issues. Due to many systemic, organizational, cultural and socio-linguistic barriers, psychiatric treatment of refugees is posing a major challenge to Germany’s mental health care system. Thus, there is a need for alternative models that allow for increased access to adequate, effective and efficient culturally sensitive mental health care services. Here, we describe the Mental Health in Refugees and Asylum Seekers (MEHIRA) project, a multicentre randomized controlled trial investigating a stepped collaborative care model (SCCM) for providing mental health treatment in this vulnerable population. The proposed SCCM aims to decrease the aforementioned barriers. Adult and adolescent participants will be screened for depressive symptoms and matched to appropriate psychological interventions, including group-level interventions (START intervention, Empowerment/Gender-sensitive/Peer to peer), and other innovative, digital treatment approaches (Smartphone application). The therapeutic effect of the SCCM will be compared to TAU (treatment-as-usual). All interventions have been designed to be culturally sensitive, and offered in two different languages: Arabic and Farsi. The outcome of this study may contribute significantly to future clinical and legal guidelines in developing parallel and efficient new structures of treatment. Collected data will inform primary and secondary mental health care providers with recommendations concerning the design and implementation of effective treatment models and programmes. Guidelines and recommendations may also potentially be adopted by other host countries, developing countries and also in humanitarian aid programmes.

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Acknowledgements

The authors declared no potential conflicts of interest with respect to the research, authorship or publication of this article.

Funding

The MEHIRA study is funded by the Innovationsfond, Ministry of Health (01VSF16061).

Author information

Author notes

  1. Kerem Böge and Carine Karnouk have a shared first authorship.

Authors and Affiliations

  1. Department of Psychiatry and Psychotherapy, Charité - Universitätsmedizin, Campus Benjamin Franklin, Berlin, Germany

    Kerem Böge, Carine Karnouk, Eric Hahn & Malek Bajbouj

  2. Department of Psychiatry and Psychotherapy, RWTH Aachen University and JARA-Institute Brain Structure Function Relationship (INM 10), Research Center Jülich and RWTH, Aachen, Germany

    Frank Schneider & Ute Habel

  3. Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany

    Tobias Banaschewski, Andreas Meyer-Lindenberg & Hans Joachim Salize

  4. Department of Psychiatry and Psychotherapy, Psychosomatics and Psychotherapy, Faculty of Human Medicine, Philipps-University Marburg, Marburg, Germany

    Inge Kamp-Becker

  5. Department of Psychiatry and Psychotherapy, University Hospital LMU, Munich, Germany

    Frank Padberg, Alkomiet Hasan & Peter Falkai

  6. Department of Social and Preventive Medicine, University of Potsdam, Potsdam, Germany

    Michael A. Rapp

  7. Department of Child and Adolescent Psychiatry, Medical University of Vienna, Vienna, Austria

    Paul L. Plener

  8. Department of Child and Adolescent Psychiatry and Psychotherapy, University of Ulm, Ulm, Germany

    Paul L. Plener

  9. Department of Psychiatry and Psychotherapy, Charité - Universitätsmedizin, Campus Mitte, Berlin, Germany

    Thomas Stamm & Andreas Heinz

  10. Department of Psychiatry, Psychotherapy and Psychosomatics, Medical School Brandenburg Theodor Fontane, Neuruppin, Germany

    Thomas Stamm

  11. Department of Psychiatry and Psychotherapy, Universitätsmedizin Mainz, Mainz, Germany

    Nehal Elnahrawy & Klaus Lieb

  12. University Hospital Düsseldorf, Düsseldorf, Germany

    Frank Schneider

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  1. Kerem Böge
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  2. Carine Karnouk
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  3. Eric Hahn
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  4. Frank Schneider
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Correspondence to Malek Bajbouj.

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Böge, K., Karnouk, C., Hahn, E. et al. Mental health in refugees and asylum seekers (MEHIRA): study design and methodology of a prospective multicentre randomized controlled trail investigating the effects of a stepped and collaborative care model. Eur Arch Psychiatry Clin Neurosci 270, 95–106 (2020). https://doi.org/10.1007/s00406-019-00991-5

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