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Advancing Science for Global Health
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Home > Global Health Matters Jan/Feb 2022 > Researchers study refugee families’ mental health needs Print

Researchers study refugee families’ mental health needs

January/ February 2022 | Volume 21 Number 1

A family from Syria now living in Turkey pose for a photo: Three children, a mother and a father. Photo by Adam Patterson/Panos/DFID Fogarty grantees are developing family-focused interventions—that include men—designed to reduce post-traumatic stress disorder, anxiety and depression among Syrian refugees.

Researchers investigating how best to provide mental health services to Syrian refugees wanted to ensure entire families were targeted in their approach. That meant including men, who can be difficult to reach since they spend much of their time working at low-wage jobs to provide for their families.

About 3.6 million Syrian refugees now live in Turkey, many of them in Istanbul. Dr. Stevan Weine of the University of Illinois is conducting research in several urban neighborhoods there to determine how best to provide services to refugees who may be at risk of post-traumatic stress disorder, anxiety and depression. “Most have been displaced as families and Syrian culture is very family-oriented. So why not deliver mental health services that try to help the entire family?” Men are integral to his research because of the power they wield within patriarchal family structures, said Weine. “If you want to be able to impact the family, you have to go through the person in power.” Cultural sensitivities which prohibit men or even women from talking to wives and daughters also necessitate a father’s participation. Weine’s exploratory research grant was awarded through Fogarty’s global brain disorders program, with funding from the NIH’s National Institute of Mental Health.

Weine said his project aims to strengthen family members’ ability to communicate with each other, help them discuss difficult subjects, and improve their capacity to support each other’s emotional and mental health needs. “These are issues around which there’s a lot of stigma, a lot of shame, a sense of personal failure and weakness, so it helps to be able to have those discussions with the whole family,” Weine noted.

Applying lessons learned in previous work with Bosnian refugees, the research team developed a multi-family group model intervention to provide a safe space for families living in similar circumstances to interact. “Imagine a room with six or eight families together, eating pastries, drinking coffee or tea, like they would be in a cafe in their village or city,” said Weine. “It's a comfortable atmosphere that we’re trying to create, instead of the feeling of a clinic or hospital, which has negative associations.”

Working with groups of families instead of just one also increases potential positive effects. “Frequently refugee families are isolated and don't want other families to know their troubles. In these meetings they overcome their fears and end up becoming friends,” Weine observed. They learn to listen to one other and sometimes offer advice. “It’s empowering when you have the ability to help somebody else. This becomes an important part of their own recovery.” In the pilot study, Weine collaborated with the Turkish Red Crescent and other organizations to recruit 72 families that attended four gatherings each, usually on weekends. To run the sessions, Weine enlisted Syrian refugees with the “people” skills necessary to lead conversations on painful topics, engage children in the discussion and create an atmosphere where everyone felt able to participate. He provided the hosts with 30 hours of training, including how to teach breathing exercises and other stress-reduction techniques.

Nearly 90% of families attended all four meetings, while fathers, “under pressure to work all the time,” came to half, said Weine. “We specifically spoke to the fathers at the beginning—we told them we wanted and needed them here because they’re important in the family.” Fathers who could not make the sessions, watched with their families videos recorded in Arabic that conveyed key lessons. At the program’s conclusion, Weine’s research team recorded significant decreases in emotional distress and post-traumatic stress disorder, as well as increases in mental health literacy.

Looking ahead, Weine believes adapting this intervention for others would not be difficult. Having worked with refugees in different countries for 30 years, he noted that “their experiences are more similar than different.”

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