The Danish Trauma Database for Refugees (DTD): A Multicenter Database Collaboration—Overcoming the Challenges and Enhancing Mental Health Treatment and Research for Refugees

Abstract

Mental health of trauma-affected refugees is an understudied area, resulting in inadequate and poorer treatment outcomes. To address this, more high-quality treatment studies that include predictive analyses, long-term evaluations, cultural adaptations, and take account for comorbidities, are needed. Moreover, given the complex intertwining of refugees’ health with post-migration stressors and other social factors, it is crucial to examine the social determinants of refugee mental health. The Danish Trauma Database for Refugees (DTD) is a multicenter research database uniting six national centers that provide outpatient treatment for trauma-affected refugees. Through the database, we collect clinical and sociodemographic data from approximately 1200 refugees annually and will merge the database with Danish population register data. The purpose of the DTD is two-fold; clinical and research. The DTD offers data-driven guidance for routine clinical treatment planning of the individual patient, as well as exceptional research opportunities for testing treatment interventions in clinical settings, with larger sample sizes, and more representative heterogeneity of the population. Complex analyses of risk and protective factors, barriers, access to treatment, and societal and transgenerational aspects of trauma are possible with the DTD. This conceptual paper introduces the DTD, the historical background, the development process and implementation strategy, and the associated challenges with developing and running a multicenter database. Most importantly, it highlights the clinical and research potential of the DTD for advancing the understanding and treatment of trauma-affected refugees.

Bridging technology and care: integrating web-based PROMs in mental health services for refugees: a study on clinician training and technology adoption

“…The study, a longitudinal study on the experiences of a training program, was part of a larger study on implementing a systematic collection of PROMs and sociodemographic data named The Danish Trauma Database (DTD) ( Thøgersen et al, 2023 ). The PROM assessment battery includes information covering PTSD/CPTSD, anxiety, pain, and disability/general functioning.…”

“…The development of the contract for the collaboration on the DTD required 2 years of extensive legal work due to the intricate legalities needed to secure data across Danish regions. With this work completed, the DTD project rigorously protects patient data, adhering to the General Data Protection Regulation (GDPR) standards to ensure secure and confidential administration of data ( Thøgersen et al, 2023 ). This emphasis on data security is essential for building trust with refugees with PTSD, who may have heightened vulnerability and mistrust.…”

“…A comprehensive legal framework, developed with the assistance of a team of lawyers and GDPR experts, supports the ethical handling of data. This framework includes detailed procedures for data collection, storage, and patient consent, ensuring the protection of patients’ rights ( Thøgersen et al, 2023 ). Patients are verbally informed about data collection by clinicians and provide consent via a written form containing all pertinent details.…”