Please select the eligibility criteria that correspond to the clinical trial below.
Title: Refugee Emergency: DEFining and Implementing Novel Evidence-based Psychosocial Interventions
Brief Summary: Background The flow of asylum seekers and refugees moving to European and bordering countries has progressively increased in the last years. This population is exposed to physical and mental challenges before and during displacement, and suffer continuing hardships after arrival in a High-Income Country. As a consequence, asylum seekers and refugees are extremely vulnerable to some common mental health conditions, i.e., post-traumatic stress disorder, anxiety, depression and other forms of disabling psychological distress. The World Health Organization has developed a new 5-session self-help intervention called Self-Help Plus (SH+) for managing stress and coping with adversity. SH+ has been evaluated in RCTs in low- and middle-income countries, however, there is no rigorous evidence on its cost-effectiveness in preventing the onset of mental disorders in HIC.

Objectives To evaluate the effectiveness and cost-effectiveness of the SH+ in asylum seekers and refugees with psychological distress resettled in six sites of five European countries (Italy, Austria, Germany, Finland, and two sites in the UK), as compared with enhanced treatment as usual (ETAU). The primary outcome is the reduction in the incidence of any mental disorders. Secondary outcomes are mental health symptoms, psychological functioning, well-being, drop-out rates, and economic outcomes.

Design This is a multicentre parallel-group randomized controlled trial, in which participants will have an equal probability (1:1) of being randomly allocated to the SH+ or the ETAU.

Methodology Asylum seekers and refugees who screen positive at the General Health Questionnaire (≥ 3) and without a formal diagnosis of any psychiatric disorders according to the M.I.N.I. International Neuropsychiatric Interview will enter the study. After random allocation they will receive the SH+ or the ETAU. Assessments will be performed by masked assessors immediately after intervention, at 6 months, and a 12 months after randomization.

Time frame The recruitment phase will last 12 months. After the screening, eligible participants will be assessed at baseline, post-intervention, and at 6- and 12-month follow-up. The SH+ delivery will be conducted in around 5 weeks.

Expected outcomes A reduction in the incidence of psychiatric diagnoses at 6-month follow-up, and a general improvement in mental health symptoms, psychological functioning, well-being, and economic outcomes at each assessment.


Options:
A: Inclusion Criteria:

* All probable cases will be examined by a trained clinician (AD) to confirm the diagnosis of dementia according to DSM IV criteria and graded using the Clinical Dementia Rating (CDR) Scale.
* CDR mild and moderate dementia.
* The principal caregiver, as identified by the family, was enrolled for the trial. The principal caregiver was generally the spouse, although in some instances another family member was the principal caregiver, particularly when the spouse was not in a position to care.

Exclusion Criteria:

* CDR severe dementia or severe co-morbid physical health conditions.
B: Inclusion Criteria:

* Community-dwelling residents registered to the selected village, and thus also registered patients of the village's PCP.
* Age ≥ 60 years, the typical retirement age in rural China.
* Clinically significant depression defined as baseline PHQ-9 score ≥ 10.
* Diagnosis of hypertension
* Intact cognitive functioning (6-Item Screener score \<3) to assure ability to participate with the treatment team in management of their conditions.
* Capable of independent communication
* Capacity to give informed consent.

Exclusion Criteria:

* Incapable (no capacity) of giving verbal consent to this study.
* Acute high suicide risk at baseline assessment. Patients assessed to be dangerously suicidal at later assessments will be discontinued from the study, their providers notified, and their safety guaranteed.
* Psychosis, alcoholism. We exclude patients with psychosis or active alcoholism in the past 6 months.
C: Inclusion Criteria:

1. Age 18 or above;
2. Able to speak and understand the target languages: Arabic, and/or Urdu, and/or Dari, and/or English;
3. Asylum seeker or refugee;
4. Presence of psychological distress, as shown by a score of 3 or more at the 12 item General Health Questionnaire (GHQ-12 ≥ 3);
5. Both oral and written informed consent to enter the study.

Exclusion Criteria:

1. Presence of any mental disorders according to DSM-V and ICD-10, as shown by a positive M.I.N.I.;
2. Acute medical conditions contraindicating study participation, based on clinical judgment of the health care professional with a clinical background who performs the screening;
3. Clinical evidence of imminent suicide risk or suicide risk scored as "moderate or high" (or a positive suicidality behaviour disorder) by the M.I.N.I. (section SUICIDALITY);
4. Clinical evidence that the decision-making capacity is impaired.
D: Inclusion Criteria:

* 1. Public (government health system) 2. No psychiatric nurse allocated

Exclusion Criteria:

* mhGAP training in the previous 3 years

Answer: C