Mental Health in the Transit Context: Evidence from 10 Countries

Abstract

Most interventions for mental health and psychosocial support (MHPSS) have been developed in contexts and with populations that differ significantly from the realities of migration. There is an urgent need for MHPSS in transit; however, transit-specific aspects of MHPSS provision are often neglected due to the inherent challenges transit poses to traditional conceptualizations of practice. The Delphi method, which consisted of three iterative rounds of surveys, was applied with the goal of identifying challenges to and adaptations of MHPSS in the transit context. Twenty-six MHPSS providers working with refugees in 10 European transit countries participated; 69% of participants completed all three survey rounds. There was consensus that a flexible model of MHPSS, which can balance low intensity interventions and specialized care, is needed. Agreement was high for practice-related and sociopolitical factors impacting MHPSS in transit; however, the mandate of MHPSS providers working in the transit context achieved the lowest consensus and is yet to be defined. There is a need to rethink MHPSS in the refugee transit context. Providing MHPSS to refugees on the move has specificities, most of which are related to the instability and uncertainty of the context. Future directions for improving mental health protection for refugees, asylum seekers, and migrants in transit are highlighted.

Improving Retention in Mental Health and Psychosocial Support Interventions: An Analysis of Completion Rates Across a Multi-Site Trial with Displaced and Host Populations in Latin America

“…The contrast in how destinations are used by migrants can explain why participants in Tulcán accounted for most of the reasons for missing classified as unreachable, and why Panama had the highest completion rate. This finding supports previous research that suggest difficulties in reaching migrants "in transit" as an important barrier of intervention implementation [22,23]. Although needs among migrant communities may be similar, reach to a population that is in transit or to which time of contact is going to be limited will require novel approaches that explore evidence-based interventions that are less time consuming or that can be provided along the way.…”

“…However, other reasons for participants enrolling in the intervention but never attending any session and being classified as unreachable must be considered. Previous authors have described how access to certain populations can become difficult in contexts in which women share their phone or own a phone that is controlled by male family members [22,23]. Also, relaying on technology to maintain contact can be difficult because of unstable internet access or network coverage, lack of devices, selling of phones to meet other needs, or low technological literacy [23].…”

Improving Retention in Mental Health and Psychosocial Support Interventions: An Analysis of Completion Rates across a Multi-Site Trial with Refugee, Migrant, and Host Communities in Latin America

“…The contrast in how destinations are used by migrants can explain why participants in Tulcán accounted for most of the reasons for missing classified as unreachable, and why Panama had the highest completion rate. This finding supports previous research that suggests difficulties in reaching migrants "in transit" as an important barrier to intervention implementation [25,26]. Although the needs among migrant communities may be similar, reaching a population that is in transit or to which the period of contact is going to be limited will require novel approaches that explore evidence-based interventions that are less time consuming or that can be provided along the way.…”

Implementation Evaluation of Community-Based Mental Health and Psychosocial Support Intervention for Refugee Newcomers in the United States

“…In addition, our study brings forth the novelty of fexible, implementer-driven models in CB-MHPSS interventions. Tis approach allows for a more nuanced and adaptive response to the diverse needs of refugee and asylee populations, flling a gap in the U.S. context where there are limited low-intensity, adaptable mental health intervention models [39,40]. Te skill development in facilitators proved crucial for ensuring a comprehensive understanding and response to these adaptations.…”