Staged care model to promote the mental health of refugees -

(MEntalHealthinRefugeesand AsylumSeekers)

unaccompanied refugees, accompanied refugees, staged care model, smartphone app, intervention, START, care, stages

• Prof Dr Malek Bajbouj, Charité - Universitätsmedizin Berlin

Project coordination Ulm:

• Prof. Dr Paul L. Plener, Head of the Department of Child and Adolescent Psychiatry at the Medical University of Vienna
• Thorsten Sukale, child and adolescent psychotherapist, Clinic for Child and Adolescent Psychiatry (KJP) at Ulm University Hospital

Sub-project Adolescents (SP1):

• Prof Dr Dr Tobias Banaschewski, Central Institute of Mental Health Mannheim (sub-project leader), Prof Dr Paul Plener, Medical University of Vienna (deputy leader), Prof Dr Inge Kamp-Becker, Philipps University Marburg (deputy leader)

Sub-project Peer-to-Peer Intervention (TP2):

• Prof. Dr Dr Andreas Heinz, Charité - Universitätsmedizin Berlin, Prof. Dr Dr Michael Rapp, University of Potsdam

Gender-sensitive intervention sub-project (SP3):

• Prof. Dr Dr Frank Schneider, University Hospital Aachen, Rheinisch-Westfälische Technische Universität (sub-project leader), Prof. Dr Ute Habel, University Hospital Aachen, Rheinisch-Westfälische Technische Universität (deputy)

Sub-project Empowerment (TP4):

• Prof. Dr Peter Falkai, Ludwig-Maximilians-Universität München (sub-project leader), PD Dr Alkomiet Hasan, Ludwig-Maximilians-Universität München (deputy), Prof. Dr Frank Padberg; Ludwig-Maximilians-Universität München (deputy)

Sub-project Health Services Research/Health Economics (SP5):

• Prof. Dr Andreas Meyer-Lindenberg, Central Institute of Mental Health Mannheim (sub-project leader), Prof. Dr Hans-Joachim Salize, Central Institute of Mental Health Mannheim (deputy)

Planned start of studies: 13/03/2018

Expected end of studies: 14.11.2020

A significant proportion of refugees suffer from mental illness due to traumatic experiences. Young people, who according to the BAMF accounted for 31.1% of all asylum seekers in 2016, are often exposed to multiple stressors and are more susceptible to illness due to their younger age. The chances of receiving adequate treatment are often significantly impeded for this patient group due to language, cultural and institutional barriers. Preventive measures, timely diagnosis and low-threshold and culturally sensitive services are therefore of paramount importance in reducing the individual burden on patients.

A model developed for staged healthcare is to be tested and later be transferable for routine care. By participating in the study, young people who have experienced flight are to be supported in maintaining their mental health and reducing individual suffering, and medical and psychotherapeutic care for refugees in Germany is to be improved.

The study is aimed at male and female young refugees aged between 14 and 21. Questionnaires are used to assess the presence of clinically relevant emotional symptoms. With regard to the severity of the symptoms, the subjects are randomly assigned to a control (1) or experimental group (2):

1) Treatment-as-usual: examinations by doctors and/or therapists (routine care,)

2) Stepped care model: also conventional care ("watchful waiting"), treatment via smartphone app, group training ("START") or individual psychotherapy

The stepped care model (Stepped and Collaborative Care Model, SCCM) consists of a total of five sub-projects (TP) across Germany. The higher an intervention is localised on the SCCM step-by-step plan, the more frequent and longer contacts with psychotherapists and psychiatrists take place (see Figure 1).

Figure 1: Stepped and collaborative care model

Each condition includes the regular completion of questionnaires. Interpreters and psychiatric and psychotherapeutic staff are available at all times.

Innovation fund