Scaling up psychological interventions for Syrian refugees

Recent decades have shown a steep increase in the number of people forcibly displaced, including over 43.3 million refugees. The Syrian civil war that started in 2011 has been a main driver of refugees worldwide. The prevalence of common mental disorders among Syrians is high, yet there is a significant treatment gap. The main aim of this dissertation was to investigate strategies to scale up psychological interventions for Syrian refugees. It evaluated the feasibility, acceptability, and effectiveness of potentially scalable psychological interventions developed by the World Health Organization (WHO). These include individual Problem Management Plus (PM+), group PM+ and the digital intervention Step-by-Step (SbS). The interventions were evaluated among Syrian refugees in eight countries in the Middle East and Europe. The four research questions of this dissertation are: 1. What is the diagnostic test accuracy of Arabic-language screening measures to detect common mental disorders? 2. What is the feasibility, acceptability and effectiveness of PM+ among Syrian refugees in the Netherlands on the short- and long-term? 3. What is the effectiveness of PM+ and related psychological interventions among Syrian refugees across various settings, and what works for whom? 4. What is the potential for scale-up of PM+ in the Netherlands? The studies presented in this dissertation have demonstrated that brief, non-specialist delivered or task-shared psychological interventions are feasible, acceptable and effective in alleviating symptoms of CMDs among Syrian refugees across various settings, and potentially scalable in a high-income country. These scalable interventions may contribute to reducing the mental health treatment gap worldwi