There has been an increasing number of applications from unaccompanied asylum-seeking children (UASC) in the United Kingdom in recent years. It is well-known that this population is at high-risk of developing mental health disorders, which require early detection and intervention to facilitate successful integration. This paper describes the introduction of mental health screening for unaccompanied asylum-seeking children in a National Health Service (NHS) outpatient clinic in central London. This follows the results of a two-year retrospective analysis of the health needs of the population in our clinic, which identified a high incidence of disturbance to mood and sleep. We describe the selection process for a culturally appropriate and validated screening tool, piloting the Refugee Health Screener (RHS) tool with 20 UASC in clinic, and using preliminary findings to inform a more targeted referral to community Child and Adolescent Mental Health Services (CAMHS). We conclude that implementation of the RHS-13 is feasible for widespread mental health screening for UASC in an NHS setting, and provide suggestions for future research directions within this field.

Forcibly displaced persons (FDPs) exposed to torture and trauma require multidisciplinary therapies to address their complex needs in mental and physical health. In this systematic review and meta-analysis, we explored the efficacy of models of care that integrated psychological and physical interventions for PTSD outcomes. We searched the Cochrane Central Register of Controlled Trials, Cochrane Database of Systematic Reviews, PubMed, EMBASE, CINAHL, PsychINFO, and Web of Science databases. We performed the meta-analysis on studies with randomized controlled trials and non-randomized controlled trial designs, followed by a subgroup analysis of moderators. In all meta-analyses, a random-effects model was used with standardized mean differences to accommodate for the heterogeneity of studies and outcome measures. In a meta-analysis of a between-group analysis of 11 studies comprising 610 participants, integrated intervention showed a moderate effect size (Hedges’ g = −0.46 (95% CI −0.80 to −0.12) in reducing PTSD symptoms. The proportion of variation in observed effects reflects 82% of variation in true effects (I2 = 82%). The efficacy of transdisciplinary interventions was higher compared to multidisciplinary models. Moderator analysis found that the type of PTSD measure, format of intervention, and type of personnel providing the intervention were significant predictors of efficacy. Integrated interventions are efficacious in reducing PTSD outcomes for people with FDPs and those exposed to war trauma. Factors such as the type of integration of interventions and service delivery need to be further studied with high-quality designs and larger numbers in future studies.

This Diary written by twentieth-generation sake brewer of Futaba, Tomisawa Shūhei, from March 11, 2011 until April 21, 2011, depicts the experience of his family as they navigated the forced evacuation of their ancestral home as a result of the disastrous nuclear meltdown at the Fukushima Daiichi nuclear power plant. The Diary is translated to reflect the original and only occasionally adds names or descriptions for clarity.

In a time of unprecedented displacement, hostility toward refugees is widespread. Two common strategies refugee advocates pursue to counter hostility and promote inclusion are perspective-getting exercises and providing information that corrects misperceptions. In this study, we evaluate whether these strategies are effective across four outcomes commonly used to measure outgroup inclusion: warmth toward refugees, policy preferences, behavior, and beliefs about a common misperception concerning refugees. Using three studies with nearly 15,000 Americans, we find that information and perspective-getting affect different outcomes. We show that combining both interventions produces an additive effect on all outcomes, that neither strategy enhances the other, but that bundling the strategies may prevent backfire effects. Our results underscore the promise and limits of both strategies for promoting inclusion.

Providing Mental Health and Psychosocial Support interventions (MHPSS) for forcibly displaced Ukrainians in Central and Eastern Europe poses numerous challenges due to various socio-cultural and infrastructural factors. This qualitative study explored implementation barriers reported by service providers of in-person and digital MHPSS for Ukrainian refugees displaced to Poland, Romania and Slovakia due to the war. In addition, the study aimed to generate recommendations to overcome these barriers. Semi-structured Free List and Key Informant interviews were conducted using the Design, Implementation, Monitoring and Evaluation protocol with 18 and 13 service providers, respectively. For in-person interventions, barriers included stigma, language, shortage of MHPSS providers, lack of financial aid and general lack of trust among refugees. For digital MHPSS, barriers included generational obstacles, lack of therapeutic relationships, trust issues, and lack of awareness. Recommendations included advancing public health strategies, organizational interventions, building technical literacy and support, enhancing the credibility of digital interventions and incorporating MHPSS into usual practice. By implementing the recommendations proposed in this study, policymakers, organizations and service providers can work towards enhancing the delivery of MHPSS and addressing the mental health needs of Ukrainian refugees in host countries, such as Poland, Romania and Slovakia.

Evidence on the effectiveness and implementation of mental health and psychosocial support (MHPSS) interventions for men in humanitarian settings is limited. Moreover, engagement and retention of men in such interventions has been challenging. Adaptations may therefore be required to improve the appropriateness and acceptability of these interventions for men. This study conducted formative research and examined the feasibility of combining an MHPSS intervention, Self-Help Plus, with a brief intervention to reduce harmful alcohol use among refugee men in Uganda. We conducted a cluster randomized feasibility trial comparing the combined alcohol intervention and Self-Help Plus, Self-Help Plus alone and enhanced usual care. Participants were 168 South Sudanese refugee men in Rhino Settlement who reported moderate or high levels of psychological distress. Session attendance was adequate: all sessions had at least 69% of participants present. Participant outcome measures, including symptoms of psychological distress, functional impairment, self-defined problems, depressive symptoms, post-traumatic stress symptoms, overall substance use risk, substance specific risk (alcohol, cannabis, stimulants and sedatives) and well-being, were sensitive to change. A combined approach to addressing mental health and alcohol use appears feasible among men in refugee settings, but further research is needed to examine the effectiveness of combined interventions among men.

This article is a response to Christians in public and private life who favor policies, employ rhetoric, and view migrants in ways that contravene their faith traditions. Speaking primarily from the perspective of Christian migrant-serving, faith-based organizations in the United States, the author examines their challenges, sources of consolation, and understanding of migrants in light of their work and religious touchstones in an era of political polarization and unprecedented forced displacement. He outlines an inclusive path forward, rooted in a commitment to the common good, to solidarity with the displaced, and to a deeper understanding of the hopes, aspirations, and gifts of migrants.

Multiple epidemiological studies have shown an increased prevalence of adverse mental health outcomes in refugee populations and have highlighted children and adolescents to be particularly at risk. This commentary considers a Cochrane Review examining the efficacy of community-based interventions at improving the mental health of refugee children and adolescents in high-income countries. The review concludes that community-based interventions are ineffective at improving mental health in such populations. Notably, the data are limited by significant risk of bias and a small sample size. This article aims to critically appraise this systematic review, extrapolate implications for current practice and identify avenues for further research.

Armed conflict and forced displacement can significantly strain nurturing family environments, which are essential for child well-being. Yet, limited evidence exists on the effectiveness of family-systemic interventions in these contexts. We conducted a two-arm, single-masked, feasibility Randomised Controlled Trial (fRCT) of a whole-family intervention with Syrian, Iraqi and Jordanian families in Jordan. We aimed to determine the feasibility of intervention and study procedures to inform a fully-powered RCT. Eligible families were randomised to receive the Nurturing Families intervention or enhanced usual care (1:1). Masked assessors measured outcomes at baseline and endline; primary outcome measures were caregiver psychological distress, family functioning, and parenting practices. Families and implementing staff participated in qualitative interviews at endline. Of the 62 families screened, 60 (98%) were eligible, 97% completed the baseline and 90% completed the endline. Qualitative feedback indicated specific improvements in adolescent well-being, caregiver distress and parenting, and family relationships. Data highlighted high participant engagement and adequate facilitator fidelity and competence. Outcome measures had good psychometric properties (most α > 0.80) and sensitivity to change, with significant changes seen on most measures in the intervention but not control group. Findings indicate the acceptability and feasibility of intervention and study procedures. Subsequent full-scale evaluation is needed to determine effectiveness.