Beatrice Compri, Giulia Turrini, Marianna Purgato, Richard Bryant, Paula Cristobal, Josep Maria Haro, Raffael Kalisch, Vincent Lorant, David McDaid, Kerry R McGreevy, Roberto Mediavilla, Michela Nosè, A-La Park, Papoula Petri-Romão, Aurélia Roversi, Marit Sijbrandij, Andrea Tortelli, Anke Witteveen, Corrado Barbui
{"title":"世卫组织对有心理困扰的移徙者实施阶梯式心理干预的背景、实施和影响机制。","authors":"Beatrice Compri, Giulia Turrini, Marianna Purgato, Richard Bryant, Paula Cristobal, Josep Maria Haro, Raffael Kalisch, Vincent Lorant, David McDaid, Kerry R McGreevy, Roberto Mediavilla, Michela Nosè, A-La Park, Papoula Petri-Romão, Aurélia Roversi, Marit Sijbrandij, Andrea Tortelli, Anke Witteveen, Corrado Barbui","doi":"10.1017/gmh.2025.10024","DOIUrl":null,"url":null,"abstract":"<p><p>Migrants often experience psychological distress due to pre-, peri- and post-migration stressors. Scalable interventions like Doing What Matters in Times of Stress (DWM) and Problem Management Plus (PM+) have been developed to address these challenges. This study evaluates a stepped-care program combining DWM and PM+ for migrants in Italy, examining its context, implementation, and mechanisms of impact. A mixed-methods process evaluation was conducted alongside a randomized controlled trial (RCT), following the Medical Research Council (MRC) framework. Post-trial qualitative data were collected through individual interviews with intervention participants (n = 10) and stakeholders (n = 10), as well as a focus group with intervention providers (n = 8). Thematic analysis was performed using NVivo. Cultural stigma and practical barriers influenced engagement, while community leaders fostered trust and participation. Interventions were feasible and acceptable. Digital delivery improved accessibility for some but posed challenges for those with low technological literacy or private spaces. The stepped-care approach supported gradual engagement with mental health strategies, enhancing self-care and emotional awareness, while provider relationships were key to sustaining motivation. The stepped-care model alleviated psychological distress and was well-received. Findings underscore the need for cultural sensitivity, digital accessibility and community engagement to optimize migrant mental health support.</p>","PeriodicalId":48579,"journal":{"name":"Global Mental Health","volume":"12 ","pages":"e62"},"PeriodicalIF":3.3000,"publicationDate":"2025-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12186560/pdf/","citationCount":"0","resultStr":"{\"title\":\"Context, implementation and mechanisms of impact of a stepped-care WHO psychological intervention for migrants with psychological distress.\",\"authors\":\"Beatrice Compri, Giulia Turrini, Marianna Purgato, Richard Bryant, Paula Cristobal, Josep Maria Haro, Raffael Kalisch, Vincent Lorant, David McDaid, Kerry R McGreevy, Roberto Mediavilla, Michela Nosè, A-La Park, Papoula Petri-Romão, Aurélia Roversi, Marit Sijbrandij, Andrea Tortelli, Anke Witteveen, Corrado Barbui\",\"doi\":\"10.1017/gmh.2025.10024\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><p>Migrants often experience psychological distress due to pre-, peri- and post-migration stressors. 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Digital delivery improved accessibility for some but posed challenges for those with low technological literacy or private spaces. The stepped-care approach supported gradual engagement with mental health strategies, enhancing self-care and emotional awareness, while provider relationships were key to sustaining motivation. The stepped-care model alleviated psychological distress and was well-received. 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Context, implementation and mechanisms of impact of a stepped-care WHO psychological intervention for migrants with psychological distress.
Migrants often experience psychological distress due to pre-, peri- and post-migration stressors. Scalable interventions like Doing What Matters in Times of Stress (DWM) and Problem Management Plus (PM+) have been developed to address these challenges. This study evaluates a stepped-care program combining DWM and PM+ for migrants in Italy, examining its context, implementation, and mechanisms of impact. A mixed-methods process evaluation was conducted alongside a randomized controlled trial (RCT), following the Medical Research Council (MRC) framework. Post-trial qualitative data were collected through individual interviews with intervention participants (n = 10) and stakeholders (n = 10), as well as a focus group with intervention providers (n = 8). Thematic analysis was performed using NVivo. Cultural stigma and practical barriers influenced engagement, while community leaders fostered trust and participation. Interventions were feasible and acceptable. Digital delivery improved accessibility for some but posed challenges for those with low technological literacy or private spaces. The stepped-care approach supported gradual engagement with mental health strategies, enhancing self-care and emotional awareness, while provider relationships were key to sustaining motivation. The stepped-care model alleviated psychological distress and was well-received. Findings underscore the need for cultural sensitivity, digital accessibility and community engagement to optimize migrant mental health support.
期刊介绍:
lobal Mental Health (GMH) is an Open Access journal that publishes papers that have a broad application of ‘the global point of view’ of mental health issues. The field of ‘global mental health’ is still emerging, reflecting a movement of advocacy and associated research driven by an agenda to remedy longstanding treatment gaps and disparities in care, access, and capacity. But these efforts and goals are also driving a potential reframing of knowledge in powerful ways, and positioning a new disciplinary approach to mental health. GMH seeks to cultivate and grow this emerging distinct discipline of ‘global mental health’, and the new knowledge and paradigms that should come from it.