From our previous studies, we know that urban refugee youth commonly report depressive symptoms. The primary aim of this study is to compare the effectiveness of youth-tailored interventions to improve mental health literacy and reduce mental health stigma among urban refugee youth in Kampala, Uganda. There will be two intervention arms and one control arm. The first intervention arm will involve a VR experience that focuses on mental health literacy and coping strategies, as well as SMS check-ins from peer navigators (PN) trained in psychological first aid. The second intervention arm will involve an adapted version of the WHO's Group Problem Management Plus. The primary outcomes are to a) increase mental health literacy (knowledge and understanding of mental health generally and of specific disorders; b) increase attitudes towards mental health help-seeking, c) reduce depression, d) increase adaptive coping strategies; e) reduce mental health stigma, f) improve mental wellbeing, and g) increase level of functioning. Participants will complete a pre- and post-intervention survey as well as a follow-up survey.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
330
The intervention will include: 1) a Virtual Reality (VR) interactive and immersive 30-minute session viewed using a low cost VR headset; and 2) an 8-week program of weekly WelTel SMS check-ins managed by Peer Navigators (PNs), weekly WelTel SMS blasts informed by Psychological First Aid (PFA) with mental health literacy (MHL) messages developed with PN, and weekly WelTel web-based secure platform social group discussions on MHL, stress coping, and stigma moderated by PN alongside a trained Coordinator. Weekly MHL WelTel platform moderated discussion foci will address MHL, stigma and stress coping strategies, including self-compassion and other strategies that emerge from the urban refugee youth interviews and focus groups, through diverse methods, including: 'scenarios' mimicking real life situations; a 'question box'; sharing photos demonstrating stress coping strategies; memes; songs; and ways participants interrupted stigma in their daily lives.
Participants will attend small groups (5-6 participants with a PN and a coordinator supporting) outdoors with physically distancing, for Group PM+ sessions following the adapted WHO Group-PM+ manual (adaptations made in Phase 1 explain above) 5 weekly 3-hour sessions delivered by PN who will co-facilitate sessions with the Coordinator. Each session has a mechanism of action: 1. Managing stress: mechanism of action-identify goals, learn deep breathing and techniques for stress management 2. Managing problems: mechanism of action-identify 1 solvable practical problem, brainstorm possible solutions together 3. Get going, keep doing: mechanism of action-learn about depression and inactivity, identify and plan small enjoyable activities 4. Strengthen social support: mechanism of action-discuss a range of social support resources, make plan to increase social support 5. Staying well: mechanism of action- this session reviews all of the mechanisms of action in the prior 4 sessions
Mental health literacy
Measured using a modified depression literacy scale validated in Low- and Middle- Income Countries (LMICs)
Time frame: change from baseline at 16 weeks
Attitudes towards mental health help seeking
Measured using the Inventory of Attitudes towards Seeking Mental Health Services
Time frame: change from baseline at 16 weeks
Depression
Measured using the PHQ-9
Time frame: change from baseline at 16 weeks
Adaptive coping strategies
Measured by the Kidcope and Self-Compassion Scale for Youth
Time frame: change from baseline at 16 weeks
Mental Health Stigma
Measured using the Brief Version of the Internalized Stigma of Mental Illness (ISMI) Scale
Time frame: change from baseline at 16 weeks
Mental wellbeing
Measured using the WHO-Five Wellbeing Scale
Time frame: change from baseline at 16 weeks
Level of functioning
Measured usingWHO Disability Assessment Schedule
Time frame: change from baseline at 16 weeks
This platform is for informational purposes only and does not constitute medical advice. Always consult a qualified healthcare professional.