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Scientists from the University of New South Wales in Sydney, in partnership with Settlement Services International (SSI), have created an online program to help traumatized refugees overcome the stigma of mental health.
The first global intervention program for refugee men suffering from Post Traumatic Stress Disorder (PTSD) proved promising in a trial, encouraging them to obtain additional help.
A randomized controlled trial showed that the online intervention had successfully helped men with PTSD. Men who participated in the trial then asked for more help than those in the control group and experienced less self-stigma compared to the control group.
Associate Trial Professor Angela Nickerson of the Trauma Treatment and Refugee Recovery Program at the UNSW School of Psychology of Science said more than 70 million people are being forcibly displaced in the aftermath of wars and persecutions. Their rates of psychological disorders are high.
"The prevalence of PTSD among people of refugee origin is five times higher than in the general population of Australia." PTSD is therefore a devastating burden for the mental health of people living with HIV / AIDS. refugees, "she said.
"But even if the mental health needs of the group are high, their treatment is little used, which is a big problem: those who do not have access to treatment are more likely to suffer distress and permanent problems. .
Ms. Nickerson said that one of the main barriers to seeking help is self-stigma or negative beliefs about psychological symptoms commonly experienced as a result of exposure to trauma and looking for help.
Aim to reduce stigma
Greg Benson, general manager of client services and operations at SSI, the study's partner, pointed out the reality of the stigma badociated with the mental health of recent refugee arrivals.
"SSI is a leading provider of inbound support services for refugees in New South Wales, and we are directly seeing the psychological symptoms and barriers to seeking help in our front line work with refugees." . "
This is the problem the researchers wanted to solve with this intervention – aimed at reducing stigma and improving help seeking behaviors.
Professor Nickerson said this intervention was the first of its kind. "Before our project, there was no intervention aimed at specifically reducing the stigma of mental health among refugees -" Tell Your Story "(TYS) is the first program of its kind and it is so exciting to see its results after years of work. "
Interactive Web Modules
TYS consists of 11 short interactive Web modules containing information, short videos and activities. Participants followed up to three modules per week over a four-week period.
"The focus of the intervention was videos showing men speaking Arabic, Farsi and Tamil sharing their personal experiences to overcome the stigma and describing how they had managed to get support for PTSD" said Prof. Nickerson.
"Other interactive activities helped inform users about PTSD and help them develop personalized plans for seeking help. There was no therapeutic badistance, but a computer algorithm was used to return responses to various activities to help men develop a plan for seeking help.
"SSI has seen tangible benefits from this partnership in trials like this one, where an online intervention is available for refugees in the community languages," Benson said.
Encouraging results: more men looking for help
103 refugee men with symptoms of PTSD of Arabic, Farsi or Tamil origin were randomly badigned to either receive the TYS intervention, or to be part of a control group of men who have been put on a waiting list.
TYS participants conducted an online badessment of their symptoms of PTSD and their behavior in seeking help before the procedure, just after the procedure and one month after the end.
"One of the key findings is that the men who participated in the intervention asked for more help from new sources than the control group," says Professor Nickerson.
Dr. Yulisha Byrow, Postdoctoral Fellow of the Trauma and Recovery Program for Refugees, and the project leader believe that the positive impact of this intervention is related to the nature of the content.
"We think it worked so well, because the videos provided participants with concrete examples of the potential benefits of seeking help.
"For example, some of the study participants told us that realistic stories and information helped them understand the psychological state they were going through and that psychological treatment could help them overcome these symptoms.
"Study participants have often expressed their appreciation for a culturally sensitive resource that has been developed based on their experiences, culture and language."
The results suggest that stigma reduction strategies are beneficial
The findings suggest that evidence-based stigma reduction strategies are useful for targeting self-stigma related to seeking help and increasing the search for help. among the refugees.
"Social contact online interventions can be a promising avenue to remove barriers to helping with the symptoms of mental health problems among traumatized refugees – this is consistent with previous research," says Teacher. Nickerson.
"What is very encouraging is that participants had access to more sources of support between post-intervention and follow-up than the control group.
"This is important because previous studies have shown that it is particularly difficult to achieve behavioral change from self-stigma interventions."
Extension of research to larger trials – and to women
The authors now wish to conduct larger randomized controlled trials to test some of these hypotheses and unravel the exact mechanisms of their results.
"We also plan to expand the program to women – we have focused on refugee men in this study because they are less likely to benefit from psychological treatment than refugee women, but we would also like to Extend to women, "said prof. Nickerson.
"Through this study, we have also already put guidelines for stigma reduction available to stakeholders."
"These guidelines have been helpful to front-line ISS staff working with refugees to better understand ways to reduce stigma," Benson said.
Helen Christensen, professor at Scientia, chief scientist and chief scientist of the Black Dog Institute, and research badociate, points out that it is important to rely on this database.
"Refugees arriving on our shores often experience significant trauma and desperately need culturally appropriate mental health resources and services; therefore, it is imperative that we understand the obstacles that could prevent our refugees from asking for this help if necessary.
"This research is a decisive step in the right direction," said Christensen.
"Our next step is to expand this evidence base to address the stigma that prevents all refugees from seeking help, regardless of age, gender or religion."
The initiative is a partnership between the Trauma and Refugee Recovery Program (RTRP) led by Professor Nickerson of the School of Psychology at UNSW, Settlement Services International (SSI) and the Black Dog Institute. It was funded by Beyond Blue with donations from the Movember Foundation.
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