Brief CBT-based psychological interventions to improve mental health outcomes in refugee populations: a systematic review and meta-analysis
Creators: name: Daniel, Nadia A.
name: Liu, Xin
name: Thomas, Elizabeth T.
name: Eraneva-Dibb, Emily
name: Ahmad, Al-Maz
name: Heneghan, Carl
Publisher: name: Taylor & Francis
Year: 2024
Subjects: subject: Medicine
subject: Biotechnology
subject: Sociology
subject: FOS: Sociology
subject: Biological Sciences not elsewhere classified
subject: Science Policy
subject: Mental Health

description: <b>Background:</b> Refugees, asylum seekers, and internally displaced people experience a high burden of mental health problems owing to their experiencing traumas and stressful events. <b>Objective:</b> To summarise the available evidence and analyse the efficacy of brief psychological interventions (&lt; 3 months) on improving mental health outcomes, including depression, anxiety, and post-traumatic stress disorder (PTSD)-related symptoms in refugees. <b>Method:</b> We searched Medline, EMBASE, PsycINFO, CINAHL, and Global Index Medicus from inception to 19 December 2023. We included controlled studies using any cognitive behavioural therapy (CBT) or CBT-based therapies delivered over a short time (&lt; 3 months), which reported mental health outcomes pre-and post-intervention. We conducted meta-analyses using random effects to derive pooled summary statistics. The quality of the evidence was assessed with the Cochrane Risk of Bias (RoB2) and ROBINS-I tools. This study is registered on the Open Science Framework, DOI 10.17605/OSF.IO/9CXU4. <b>Results:</b> 34 eligible studies across 37 publications were retrieved for analysis, and 33 studies with 4479 participants were included in the meta-analysis. There was an overall improvement in immediate mental health outcomes for all three domains, with analysis of 13 studies on anxiety outcomes (SMD −1.12, 95% CI −1.72 to −0.52), 20 studies on depression (SMD −1.04, 95% CI −1.97 to −0.11), and 24 studies on PTSD (SMD −0.82, 95% CI −1.20 to −0.45). At 3 to 6-month follow-up, however, analysis of mental health outcomes shows no significant change from baseline, with a SMD of 0.24 (95% CI −0.94 to 1.42) across 4 studies, −0.73 (95% CI −2.14 to 0.68) across 9 studies, and 0.29 (95% CI −0.94 to 1.53) across 12 studies for anxiety, depression, and PTSD respectively. <b>Conclusion:</b> Low-quality evidence shows brief psychological interventions have a positive immediate effect on refugees and internally displaced people's mental well-being. However, these effects do not persist in the short-term follow up. Heterogeneity was high, even among subgroups, impacting our findings’ generalisability. We analysed the evidence on the use of brief CBT-based psychological interventions to improve mental health outcomes in forcibly displaced persons.These interventions had a positive effect on anxiety, depression and PTSD, though there was high heterogeneity between studies.Positive effects on mental health disappeared at long-term follow-up. We analysed the evidence on the use of brief CBT-based psychological interventions to improve mental health outcomes in forcibly displaced persons. These interventions had a positive effect on anxiety, depression and PTSD, though there was high heterogeneity between studies. Positive effects on mental health disappeared at long-term follow-up.