Readiness of Allied Professionals to Join the Mental Health Workforce: A Qualitative Evaluation of Trained Lay Trauma Counsellors’ Experiences When Refugee Youth Disclose Suicidal Ideation

Abstract

The recent refugee crisis presented a huge challenge for the Swedish mental health workforce. Hence, innovative mental health workforce solutions were needed. Unaccompanied refugee minors (URM) are a particularly vulnerable refugee group. Teaching Recovery Techniques (TRT) was introduced as a community-based intervention utilising trained lay counsellors in a stepped model of care for refugee youth experiencing trauma symptoms. Professionals (e.g., teachers, social workers) can deliver the Cognitive Behavioural Therapy-based intervention after a brief training. A point of debate in this workforce solution is the readiness of trained lay counsellors to deal with potentially demanding situations like disclosure of suicidal ideation. This study aimed to explore the TRT trained lay counsellors’ experiences of procedures upon URM’s disclosure of suicidal ideation. Individual semi-structured interviews with TRT trained lay counsellors were conducted, then analysed using systemic text condensation. The analysis revealed four themes: “Importance of safety structures”, “Collaboration is key”, “Let sleeping dogs lie” and “Going the extra mile”. Dealing with suicidal ideation is challenging and feelings of helplessness occur. Adding adequate supervision and specific training on suicidal ideation using role play is recommended. Collaboration between agencies and key stakeholders is essential when targeting refugee mental health in a stepped care model.

Preventing suicide in refugees and asylum seekers: a rapid literature review examining the role of suicide prevention training for health and support staff

“…The benefit of role play in training was also identified by Löfving Gupta et al [ 30 ] amongst a range of other training elements. The Swedish study examined the experience of Teaching Recovery Techniques (TRT) trained counsellors in regards to knowledge, feelings of safety and competence to respond to suicidal distress in unaccompanied refugee youth clients, and asked counsellors what training elements would be required for them to appropriately respond to and manage suicidal risk in refugee clients.…”

“…The Swedish study examined the experience of Teaching Recovery Techniques (TRT) trained counsellors in regards to knowledge, feelings of safety and competence to respond to suicidal distress in unaccompanied refugee youth clients, and asked counsellors what training elements would be required for them to appropriately respond to and manage suicidal risk in refugee clients. Training elements that were identified by counsellors as important were the need for repeat training sessions to support ongoing practice, training content regarding safety planning in practice, information about safety protocol including defining the boundaries between professional support when suicidal ideation is disclosed, and roleplay and examples of conversations to respond to suicidal ideation [ 30 ]. Similarly, a 2021 study by Ferguson et al highlighted the benefit of repeat training session and the inclusion of safety planning suicide prevention training [ 31 ].…”

“…With reference to the studies cited in this rapid literature review, specific refugee and asylum seeker suicide prevention training should consider incorporating content that: increases the knowledge and confidence of training participants to assist refugees and asylum seekers experiencing psychological distress [ 29 ]. develops the competency of participants to respond to and manage suicide risk in refugees and asylum seekers [ 29 , 30 ]. addresses the importance of trauma informed and culturally appropriate approaches when working with refugees and asylum seekers [ 9 , 28 , 31 , 34 ].…”

“…develops the competency of participants to respond to and manage suicide risk in refugees and asylum seekers [ 29 , 30 ].…”

The Future Health Workforce: Integrated Solutions and Models of Care

“…Innovative health workforce solutions were needed for the Swedish mental health workforce due to the recent refugee crisis. Sandra Gupta and colleagues from Uppsala University Sweden explored the experiences of mental health workers towards new training solutions to effectively manage unaccompanied refugee minors [9]. They suggest that dealing with suicidal ideation can be challenging and feelings of helplessness can occur.…”