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The majority of studies of mental health interventions for young adolescents have only evaluated short-term benefits. This study evaluated the longer-term effectiveness of a non-specialist delivered group-based intervention (Early Adolescent Skills for Emotions; EASE) to improve young adolescents’ mental health.
Methods
In this single-blind, parallel, controlled trial, Syrian refugees aged 10-14 years in Jordan who screened positive for psychological distress were randomised to receive either EASE or enhanced usual care (EUC). Primary outcomes were scores on the Paediatric Symptom Checklist (PSC) assessed at Week 0, 8-weeks, 3-months, and 12 months after treatment. Secondary outcomes were disability, posttraumatic stress, school belongingness, wellbeing, and caregivers’ reports of distress, parenting behaviour, and their perceived children’s mental health.
Results
Between June, 2019 and January, 2020, 185 adolescents were assigned to EASE and 286 to EUC, and 149 (80.5%) and 225 (78.7%) were retained at 12 months, respectively. At 12 months there were no significant differences between treatment conditions, except that EASE was associated with less reduction in depression (estimated mean difference -1.6, 95% CI –3.2 to -0.1; p=.03; effect size, -0.3), and a greater sense of school belonging (estimated mean difference -0.3, 95% CI –5.7 to -0.2; p=.03; effect size, 5.0).
Conclusions
Although EASE led to significant reductions in internalising problems, caregiver distress, and harsh disciplinary parenting at 3-months, these improvements were not maintained at 12 months relative to EUC. Scalable psychological interventions for young adolescents need to consider their ongoing mental health needs. Prospectively registered: ACTRN12619000341123.
This chapter explores whether the arguments in this book can extend to the third type of strategic displacement – depopulation – and not just forced relocation. To do so, it examines the use of displacement by pro-government forces during the civil war in Syria. This chapter analyzes quantitative and qualitative data from a range of sources, including media reports, human rights records, data on violence and displacement collected by nongovernmental organizations, and interviews with activists, journalists, combatants, and regime defectors that were conducted in Syria, Turkey, and Lebanon. The findings question the common characterization of state-induced displacement in Syria as ethno-sectarian cleansing and challenge the notion that these tactics have been intended solely, or even primarily, to achieve demographic change. The regime induced displacement to separate and differentiate the loyal from the disloyal, improve the “legibility” of local communities, and extract much-needed revenues, military recruits, and symbolic benefits from the population – showing that strategies of depopulation can also exhibit the sorting logic of strategic displacement, similar to strategies of forced relocation.
This chapter introduces cases motivating the book and presents a three-step argument about the effects of forced migration on societal cooperation, state capacity, and economic development. It reviews evidence from post-WWII displacement in Poland and West Germany, discusses the applicability of the findings to other cases, and highlights the main contributions of the book.
The epilogue brings the narrative from the early years of the new century to recent events, just before sending the manuscript to print, in mid 2024. It tells of the changing attitudes in Germany both towards Jews living in that country and towards Israel and its policies of occupation in the Palestinian West Bank. The unique German–Israeli relationship during the last two decades is sketched against the background of the past, and finally, it is attempted to draw a balance between the apparent achievement of a decent Jewish life in Germany, on the one hand, and the new dangers of a rising politically organized right, simultaneously with a growing critique of Israel and the apparent emergence of a new antisemitism, on the other hand.
This chapter investigates how civilians sort truth from lies in the context of the Syrian civil war. In particular, it plumbs a rich batch of semi-structured interviews conducted with Syrian refugees in Turkey that was generously shared by Schon (2020). These interviews include people’s confidence in their truth discernment ability – their ability to distinguish true vs. false information – during the war, along with detailed information on what they heard and experienced while they were in Syria. The chapter analyzes these interviews with a mixed-methods approach. Quantitative analyses show that those who spent longer in Syria, witnessed a wider range of events in the war, and explicitly rely on personal experience to assess new information are much more confident in their truth discernment ability. This is supported by ample qualitative material from the interviews, which demonstrates how Syrian refugees put stock in many of these same factors and drew many of these same connections themselves when discussing informational dynamics in the war.
What explains voter attitudes toward immigration in Latin America? This article argues that increased refugee arrivals moderate the impact of social identities on immigration attitudes. We propose that informational cues associated with increased immigration make cosmopolitan identities less important—and exclusionary national identities more important—determinants of immigration preferences. Analyzing 12 Latin American countries from the 2017–2022 wave of the World Values Survey, we demonstrate that cosmopolitanism is positively associated with pro-immigration attitudes, but only in countries experiencing low-to-moderate refugee inflows. Conversely, nationalism is negatively associated with pro-immigrant attitudes, and increasingly so as refugee inflows increase. The uneven distribution of refugee migration has therefore reshaped public opinion in Latin America by moderating the effects of competing social identities (i.e., cosmopolitanism and nationalism). These findings contribute to broader debates on the behavioral impacts of immigration by highlighting an indirect mechanism by which increased immigration may generate anti-immigrant hostility.
Each year, millions of people are uprooted from their homes by wars, repression, natural disasters, and climate change. In Uprooted, Volha Charnysh presents a fresh perspective on the developmental consequences of mass displacement, arguing that accommodating the displaced population can strengthen receiving states and benefit local economies. Drawing on extensive research on post-WWII Poland and West Germany, Charnysh shows that the rupture of social ties and increased cultural diversity in affected communities not only decreased social cohesion, but also shored up the demand for state-provided resources, which facilitated the accumulation of state capacity. Over time, areas that received a larger and more diverse influx of migrants achieved higher levels of entrepreneurship, education, and income. With its rich insights and compelling evidence, Uprooted challenges common assumptions about the costs of forced displacement and cultural diversity and proposes a novel mechanism linking wars to state-building.
Forcibly displaced people, such as refugees and asylum-seekers (RAS), are at higher risk of mental disorders, mainly post-traumatic stress disorder (PTSD), depression and anxiety. Little is known about the complex relationships between these mental disorders among culturally and linguistically diverse RAS. To investigate this, the present study applied a novel network analytical approach to examine and compare the central and bridge symptoms within and between PTSD, depression and anxiety among Afghan and Syrian RAS in Türkiye.
Methods
A large-scale online survey study with 785 Afghan and 798 Syrian RAS in Türkiye was conducted in 2021. Symptoms of PTSD (the short form of Post-Traumatic Stress Disorders Checklist [PCL-5]), depression and anxiety (Hopkins Symptoms Checklist-25) [HSCL-25]) were measured via self-administrated validated instruments. We conducted network analysis to identify symptoms that are most strongly connected with other symptoms (central symptoms) and those that connect the symptoms of different disorders (bridge symptoms) in R Studio using the qgraph package.
Results
Overall, Afghans and Syrians differed in terms of network structure, but not in network strength. Results showed that feeling blue, feeling restless and spells of terror or panic were the most central symptoms maintaining the overall symptom structure of common mental disorders among Afghan participants. For Syrian participants, worrying too much, feeling blue and feeling tense were identified as the central symptoms. For both samples, anger and irritability and feeling low in energy acted as a bridge connecting the symptoms of PTSD, depression and anxiety.
Conclusion
The current findings provide insights into the interconnectedness within and between the symptoms of common mental disorders and highlight the key symptoms that can be potential targets for psychological interventions for RAS. Addressing these symptoms may aid in tailoring existing evidence-based interventions and enhance their effectiveness. This contributes to reducing the overall mental health burden and improving well-being in this population.
Within weeks of Russia’s invasion of Ukraine in February 2022, millions of people had fled to neighbouring countries and across Europe. People throughout Europe were mobilised into action, and from the outset, the response to the unfolding humanitarian emergency in Ukraine was a complex and often messy web of private and public initiatives. In this article, we focus on the unique British humanitarian response to the greatest movement of refugees in Europe since the Second World War, known as ‘Homes for Ukraine’ (HfU). We develop our argument in three steps. First, we situate HfU within existing scholarship on ‘everyday humanitarianism’ and private refugee hosting in Europe, locating these within longer histories of private humanitarian action. Secondly, we show how HfU shifts the humanitarian space into the private and domestic sphere, a move reliant on particular conceptions of the ‘home’ as a space of sanctuary and safety. Finally, we unpack the gendered and racialised conceptions of the home and humanitarian hospitality more broadly, and how HfU sits within and outside of the broader bordering practices of the United Kingdom’s refugee response.
This article explores aspects of the organization of refugee education in imperial Austria during the First World War. Authorities in charge of refugees’ control and their eventual assistance interpreted access to education in two ways. First, it was an avenue of relief through schooling, aimed to counter the effects of uprootedness and, thus, safeguard some continuity in refugee children’s lives. Second, it was a way to ensure the making of productive and loyal citizens. In this context, this article looks at various policies regarding organization of schooling for displaced children. Moreover, it analyzes the ways language entered the realm of the refugee-focused classroom. Officials used schooling in refugee students’ vernacular to relieve the effects of their displacement and to reinforce ethnonational classifications of imperial subjects. At the same time, education through refugee children’s growing exposure to German language courses became a measure of a gradual inculcation of an imperial consciousness. Furthermore, it was a civilizing dimension of displacement management and, in this way, it became an avenue to consolidate a war-feeble state.
The aspirations-ability framework proposed by Carling has begun to place the question of who aspires to migrate at the center of migration research. In this article, building on key determinants assumed to impact individual migration decisions, we investigate their prediction accuracy when observed in the same dataset and in different mixed-migration contexts. In particular, we use a rigorous model selection approach and develop a machine learning algorithm to analyze two original cross-sectional face-to-face surveys conducted in Turkey and Lebanon among Syrian migrants and their respective host populations in early 2021. Studying similar nationalities in two hosting contexts with a distinct history of both immigration and emigration and large shares of assumed-to-be mobile populations, we illustrate that a) (im)mobility aspirations are hard to predict even under ‘ideal’ methodological circumstances, b) commonly referenced “migration drivers” fail to perform well in predicting migration aspirations in our study contexts, while c) aspects relating to social cohesion, political representation and hope play an important role that warrants more emphasis in future research and policymaking. Methodologically, we identify key challenges in quantitative research on predicting migration aspirations and propose a novel modeling approach to address these challenges.
Migrants and refugees face elevated risks for mental health problems but have limited access to services. This study compared two strategies for training and supervising nonspecialists to deliver a scalable psychological intervention, Group Problem Management Plus (gPM+), in northern Colombia. Adult women who reported elevated psychological distress and functional impairment were randomized to receive gPM+ delivered by nonspecialists who received training and supervision by: 1) a psychologist (specialized technical support); or 2) a nonspecialist who had been trained as a trainer/supervisor (nonspecialized technical support). We examined effectiveness and implementation outcomes using a mixed-methods approach. Thirteen nonspecialists were trained as gPM+ facilitators and three were trained-as-trainers. We enrolled 128 women to participate in gPM+ across the two conditions. Intervention attendance was higher in the specialized technical support condition. The nonspecialized technical support condition demonstrated higher fidelity to gPM+ and lower cost of implementation. Other indicators of effectiveness, adoption and implementation were comparable between the two implementation strategies. These results suggest it is feasible to implement mental health interventions, like gPM+, using lower-resource, community-embedded task sharing models, while maintaining safety and fidelity. Further evidence from fully powered trials is needed to make definitive conclusions about the relative cost of these implementation strategies.
Recent years have seen a surge of politicians campaigning on policies that aim to deter asylum applicants. We present a game-theoretic model in which foreign nationals consider applying for asylum and bureaucrats decide their case if they apply. We show that while policies that make the asylum application less attractive decrease the probability that foreign nationals apply, they also endogenously raise the credibility of applicants’ claims to political persecution and, therefore, may not decrease the number of admitted refugees. Investigating how these competing effects shape asylum policy-making, we show how policy choices depend on bureaucrats’ leniency and politicians’ objectives. Our analysis speaks to the causes of restrictive asylum policies and their limited effectiveness in reducing immigration.
Women from Black, South Asian and other ethnic minority groups experience gendered racism. Gender and race intersect in such a way that Black and ethnic minoritised women are not only sometimes afraid of seeking help from mental care, but also are invisible to services and their needs are ignored. There has been a significant tension in feminism between respecting culture and faith and attention to women’s human rights (cultural relativism). However, when women feel entrapped within their families and culture and are subject to forced marriage, domestic violence or FGM, resulting in major mental health problems and suicide, we cannot condone abuse and violence. Black women’s mental health and wellbeing is an important focus for Black feminism, which was largely excluded from second-wave feminism. Concepts of ‘mental illness’ do not always fit easily with personal healing that focuses on emotional and spiritual growth and overcoming oppression. Cultural humility is essential and its crucial for services to collaborate with NGOs that are trusted by the women in communities and run by them. As women we must call out discrimination and racism and challenge it.
Despite high levels of psychological distress, mental health service use among Syrian refugees in urban settings is low. To address the mental healthcare gap, the World Health Organization developed group problem management plus (gPM+), a scalable psychological intervention delivered by non-specialist peer facilitators. The study aimed to evaluate the effectiveness of gPM+ in reducing symptoms of depression and anxiety among Syrian refugees in Istanbul, Türkiye.
Methods
A randomized controlled trial was conducted among 368 distressed (Kessler Psychological Distress Scale, K10 > 15) adult Syrian refugees with impaired functioning (World Health Organization Disability Assessment Schedule, WHODAS 2.0 > 16). Participants were recruited between August 2019 and September 2020 through a non-governmental organization providing services to refugees. Participants were randomly allocated to gPM+ and enhanced care as usual (gPM+/E-CAU) (184 participants) or E-CAU only (184 participants). Primary outcomes were symptoms of depression and anxiety (Hopkins Symptom Checklist (HSCL-25)) at 3-month follow-up. Secondary outcomes were post-traumatic stress disorder (PTSD) symptoms (PTSD Checklist for Diagnostic and Statistical Manual of Mental Disorders-5; PCL-5), functional impairment (WHODAS 2.0), and self-identified problems (psychological outcome profiles).
Results
Intent-to-treat analyses showed no significant effect of gPM+ on symptoms of anxiety, depression, PTSD and self-identified problems. Yet, there was a significant reduction in functional impairment in gPM+/E-CAU compared to E-CAU at 3-month follow-up (adjusted mean difference 1.66, 95 % CI 0.04, 3.27, p = 0.045, d = 0.19). Post-hoc subgroup analyses among participants with probable baseline depression or anxiety showed that there was a small but significant reduction in depression (adjusted mean difference −0.17, 95 % CI −0.32, −0.02, p = 0.028, d = 0.27) and anxiety (adjusted mean difference −0.21, 95 % CI −0.37, −0.05, p = 0.009, d = 0.30) symptoms comparing gPM+/E-CAU to E-CAU only at 1-week post assessment, but not at 3-month follow-up. There was a significant difference between conditions on functional impairment at 3-month follow-up, favouring gPM+/E-CAU condition (adjusted mean difference −1.98, 95 % CI −3.93, −0.02, p = 0.048, d = 0.26).
Conclusion
In this study in an urban setting in Türkiye, gPM+ did not alleviate symptoms of depression and anxiety among Syrian refugees experiencing psychological distress and daily living difficulties. However, participants with higher distress at baseline seemed to benefit from gPM+, but treatment gains disappeared in the long term. Current findings highlight the potential benefit of tailored psychosocial interventions for highly distressed refugees in volatile low-resource settings.
One of the most immediate effects of the Russian war against Ukraine was the unprecedented influx of Ukrainian refugees in some countries. This article analyzes temporary protection for Ukrainian refugees in two countries—the Czech Republic and Poland, which represent the countries most exposed to immigration from Ukraine. The authors compare the political and legal response of both countries to the institute of temporary protection to reveal similarities and differences in the scope, tools, and nature of temporary protection, including causes and consequences. Both countries go beyond the minimum standards set in the EU Temporary Protection Directive and differ in their approach to its implementation. The authors claim that although the concept of temporary protection has expanded with the current situation, it allows significant benefits in allowing fast-track integration into the labor market, which aligns with the concept of refugees’ “deservingness.” However, the duration of temporary protection is a major limitation to refugees’ integration due to the emphasis on voluntary return to the country of origin.
The article explores the discursive representations of Syrian and Ukrainian refugees in the European Parliament (EP). The theoretical framework draws on Critical Securitisation Theory, pointing out the implicit hierarchies that affect the European Union (EU) reception policies in terms of race and gender. The main hypothesis is that a stigmatisation process based on race and gender affects the representation of refugees in the EU. Against this backdrop, the manuscript delves into how speech acts can either cast refugees as urgent threats or even facilitate the de-construction of the refugee as a threat. These are investigated through Computational Text-Analysis tools, such as Word- and Bigram-Frequency Analysis, Term Frequency-Inverse Document Frequency test and Structural Topic Modelling. On the one hand, contrary to expectations of a securitisation of Syrian refugees primarily based on race, what emerges is also a process of de-personalisation that helps justify the anti-migration stand of some members of the EP (MEPs). On the other hand, the assumption that deconstruction of the refugee as a threat would mainly occur through an emphasis on cultural proximity between Ukrainian people and the EU is challenged. Instead, our analysis shows a gender-based victimisation of Ukrainian refugees, which contributes leading to protective measures being enacted by the EU.
In recent years, anti-refugee hate crimes have soared across Europe. We know this violence has spread fear among refugees, but we know less about its effects on the non-refugee population. This is an oversight, as research suggests political violence often has effects on the broader population. Those effects can range from increased solidarity with the targets of the violence to reduced pro-social behavior and less support for the targets of the violence. In this research note, we examine the effects of exposure to anti-refugee hate crimes in Germany. Our results suggest no direct effect of exposure to anti-refugee hate crimes on support for refugees. These results have several implications for our understanding of political divides over refugees in Europe.