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 com...
Saved in:
| Main Authors: | , , , , , , , , , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Cambridge University Press
2025-01-01
|
| Series: | Cambridge Prisms: Global Mental Health |
| Subjects: | |
| Online Access: | https://www.cambridge.org/core/product/identifier/S2054425125100241/type/journal_article |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1849688339990446080 |
|---|---|
| author | 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 |
| author_facet | 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 |
| author_sort | Beatrice Compri |
| collection | DOAJ |
| description | 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. |
| format | Article |
| id | doaj-art-e337b81b14d34922aa59114a320b1c0e |
| institution | DOAJ |
| issn | 2054-4251 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | Cambridge University Press |
| record_format | Article |
| series | Cambridge Prisms: Global Mental Health |
| spelling | doaj-art-e337b81b14d34922aa59114a320b1c0e2025-08-20T03:22:03ZengCambridge University PressCambridge Prisms: Global Mental Health2054-42512025-01-011210.1017/gmh.2025.10024Context, implementation and mechanisms of impact of a stepped-care WHO psychological intervention for migrants with psychological distressBeatrice Compri0Giulia Turrini1https://orcid.org/0000-0001-7150-8862Marianna Purgato2https://orcid.org/0000-0002-3783-8195Richard Bryant3https://orcid.org/0000-0002-9607-819XPaula Cristobal4Josep Maria Haro5Raffael Kalisch6Vincent Lorant7David McDaid8https://orcid.org/0000-0003-0744-2664Kerry R. McGreevy9Roberto Mediavilla10Michela Nosè11A-La Park12Papoula Petri-Romão13Aurélia Roversi14Marit Sijbrandij15https://orcid.org/0000-0001-5430-9810Andrea Tortelli16Anke Witteveen17https://orcid.org/0000-0002-9636-7522Corrado Barbui18WHO Collaborating Centre for Research and Training in Mental Health and Service Evaluation, Department of Neurosciences, Biomedicine and Movement Sciences, Section of Psychiatry, https://ror.org/039bp8j42 University of Verona , Verona, ItalyWHO Collaborating Centre for Research and Training in Mental Health and Service Evaluation, Department of Neurosciences, Biomedicine and Movement Sciences, Section of Psychiatry, https://ror.org/039bp8j42 University of Verona , Verona, ItalyWHO Collaborating Centre for Research and Training in Mental Health and Service Evaluation, Department of Neurosciences, Biomedicine and Movement Sciences, Section of Psychiatry, https://ror.org/039bp8j42 University of Verona , Verona, ItalySchool of Psychology, https://ror.org/03r8z3t63 University of New South Wales , Sydney, NSW, AustraliaParc Sanitari Sant Joan de Deu, Institut de Recerca Sant Joan de Deu (IRSJD), Sant Boi de Llobregat, Barcelona, SpainParc Sanitari Sant Joan de Deu, Institut de Recerca Sant Joan de Deu (IRSJD), Sant Boi de Llobregat, Barcelona, Spainhttps://ror.org/00q5t0010 Leibniz Institute for Resilience Research , Mainz, GermanyInstitute of Health and Society, UCLouvain, BelgiumCare Policy and Evaluation Centre, Department of Health Policy, London School of Economics and Political Science, London, UKSchool of Medicine, Universidad Autónoma de Madrid, Madrid, Spain Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid, SpainSchool of Medicine, Universidad Autónoma de Madrid, Madrid, Spain Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid, SpainWHO Collaborating Centre for Research and Training in Mental Health and Service Evaluation, Department of Neurosciences, Biomedicine and Movement Sciences, Section of Psychiatry, https://ror.org/039bp8j42 University of Verona , Verona, ItalyCare Policy and Evaluation Centre, Department of Health Policy, London School of Economics and Political Science, London, UKhttps://ror.org/00q5t0010 Leibniz Institute for Resilience Research , Mainz, GermanyINSERM, Institut Pierre Louis d’Epidémiologie et de Santé Publique, (IPLESP), Equipe de Recherche en Epidémiologie Sociale, https://ror.org/02en5vm52 Sorbonne Université , Paris, FranceDepartment of Clinical, Neuro- and Developmental Psychology, WHO Collaborating Center for Research and Dissemination of Psychological Interventions, Amsterdam Public Health Institute, Vrije Universiteit Amsterdam, Amsterdam, The NetherlandsGHU Paris, Psychiatrie & Neurosciences – Pôle Psychiatrie Précarité, Paris, FranceDepartment of Clinical, Neuro- and Developmental Psychology, WHO Collaborating Center for Research and Dissemination of Psychological Interventions, Amsterdam Public Health Institute, Vrije Universiteit Amsterdam, Amsterdam, The NetherlandsWHO Collaborating Centre for Research and Training in Mental Health and Service Evaluation, Department of Neurosciences, Biomedicine and Movement Sciences, Section of Psychiatry, https://ror.org/039bp8j42 University of Verona , Verona, ItalyMigrants 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.https://www.cambridge.org/core/product/identifier/S2054425125100241/type/journal_articleprocess evaluationmental healthpsychological interventionmigrantspsychological distress |
| spellingShingle | 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 Context, implementation and mechanisms of impact of a stepped-care WHO psychological intervention for migrants with psychological distress Cambridge Prisms: Global Mental Health process evaluation mental health psychological intervention migrants psychological distress |
| title | Context, implementation and mechanisms of impact of a stepped-care WHO psychological intervention for migrants with psychological distress |
| title_full | Context, implementation and mechanisms of impact of a stepped-care WHO psychological intervention for migrants with psychological distress |
| title_fullStr | Context, implementation and mechanisms of impact of a stepped-care WHO psychological intervention for migrants with psychological distress |
| title_full_unstemmed | Context, implementation and mechanisms of impact of a stepped-care WHO psychological intervention for migrants with psychological distress |
| title_short | Context, implementation and mechanisms of impact of a stepped-care WHO psychological intervention for migrants with psychological distress |
| title_sort | context implementation and mechanisms of impact of a stepped care who psychological intervention for migrants with psychological distress |
| topic | process evaluation mental health psychological intervention migrants psychological distress |
| url | https://www.cambridge.org/core/product/identifier/S2054425125100241/type/journal_article |
| work_keys_str_mv | AT beatricecompri contextimplementationandmechanismsofimpactofasteppedcarewhopsychologicalinterventionformigrantswithpsychologicaldistress AT giuliaturrini contextimplementationandmechanismsofimpactofasteppedcarewhopsychologicalinterventionformigrantswithpsychologicaldistress AT mariannapurgato contextimplementationandmechanismsofimpactofasteppedcarewhopsychologicalinterventionformigrantswithpsychologicaldistress AT richardbryant contextimplementationandmechanismsofimpactofasteppedcarewhopsychologicalinterventionformigrantswithpsychologicaldistress AT paulacristobal contextimplementationandmechanismsofimpactofasteppedcarewhopsychologicalinterventionformigrantswithpsychologicaldistress AT josepmariaharo contextimplementationandmechanismsofimpactofasteppedcarewhopsychologicalinterventionformigrantswithpsychologicaldistress AT raffaelkalisch contextimplementationandmechanismsofimpactofasteppedcarewhopsychologicalinterventionformigrantswithpsychologicaldistress AT vincentlorant contextimplementationandmechanismsofimpactofasteppedcarewhopsychologicalinterventionformigrantswithpsychologicaldistress AT davidmcdaid contextimplementationandmechanismsofimpactofasteppedcarewhopsychologicalinterventionformigrantswithpsychologicaldistress AT kerryrmcgreevy contextimplementationandmechanismsofimpactofasteppedcarewhopsychologicalinterventionformigrantswithpsychologicaldistress AT robertomediavilla contextimplementationandmechanismsofimpactofasteppedcarewhopsychologicalinterventionformigrantswithpsychologicaldistress AT michelanose contextimplementationandmechanismsofimpactofasteppedcarewhopsychologicalinterventionformigrantswithpsychologicaldistress AT alapark contextimplementationandmechanismsofimpactofasteppedcarewhopsychologicalinterventionformigrantswithpsychologicaldistress AT papoulapetriromao contextimplementationandmechanismsofimpactofasteppedcarewhopsychologicalinterventionformigrantswithpsychologicaldistress AT aureliaroversi contextimplementationandmechanismsofimpactofasteppedcarewhopsychologicalinterventionformigrantswithpsychologicaldistress AT maritsijbrandij contextimplementationandmechanismsofimpactofasteppedcarewhopsychologicalinterventionformigrantswithpsychologicaldistress AT andreatortelli contextimplementationandmechanismsofimpactofasteppedcarewhopsychologicalinterventionformigrantswithpsychologicaldistress AT ankewitteveen contextimplementationandmechanismsofimpactofasteppedcarewhopsychologicalinterventionformigrantswithpsychologicaldistress AT corradobarbui contextimplementationandmechanismsofimpactofasteppedcarewhopsychologicalinterventionformigrantswithpsychologicaldistress |