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Strengths Protocol Workshop

Background:

Recent crises in the Middle East, most notably in Syria, have resulted in an unprecedented increase in the number of refugees seeking asylum in neighbouring countries as well as in Europe. The refugee crisis imposes highly challenging demands on health systems in

Europe and the Middle East. The STRENGTHS (Syrian REfuGees MeNTal HealTH Care Systems) project a 5-year research project funded bythe European Commission focusing on implementation of a trans-diagnostic mental health intervention related to the current Syrian refugee crisis. STRENGTHS will take place in Germany, Switzerland, Sweden, the Netherlands, Egypt, Jordan, Lebanon and Turkey.

It is led by the Free University of Amsterdam and involves a consortium of academic and operational agencies, including the London School of Hygiene & Tropical Medicine.

The overall aim of STRENGTHS is to provide effective community-based health care implementation strategies to scale-up the delivery and uptake of effective mental health interventions in different country contexts. STRENGTHS seeks to:

Outline necessary steps needed to integrate evidence based low-intensity psychological interventions for common mental disorders (the PM+ programmes) into the health systems. These include key preparatory steps in the local political, regulatory and governance processes for uptake and scaling-up of the intervention and key contextual and system-related factors for its integration. These steps will be validated for the real-life impact on the responsiveness of the system.

Adapt the PM+ programmes and training materials to the recipients of care within the specific health systems and co-create the necessary local conditions for implementation and up-scaling, e.g. training a workforce and develop internet-delivery modality and supporting tools.

Scale-up the PM+ programmes successfully in terms of health-system performance, effectiveness, affordability and sustainability and identify barriers and facilitators to this end.

Determine the invested cost and effort in terms of organisational, resource and political-economic requirements relative to the reduction of economic burden of the large-scale implementation of the specific PM+ programmes into the health systems in the different contexts.

Disseminate the evidence-base for PM+ programmes as well as the validated implementation strategies and step-guides to maintain its sustainability and engage with new stakeholders and health systems to further scaling up across Europe and beyond.

The London School of Hygiene & Tropical Medicine, through ECOHOST, will be leading one of the project work packages (and contributing to others). The work package led by London School of Hygiene & Tropical Medicine seeks to analyse the responsiveness of health systems to the scaling-up of PM+ across European host countries and LAMIC bordering Syria in addressing the mental health needs of refugees. Further technical input will be provided from KIT in Amsterdam. The objectives of the London School of Hygiene & Tropical Medicine-led work package are to:

Analyse the responsiveness of health systems across European host countries and LAMIC bordering Syria in addressing the mental health care needs of refugees.

Examine how contextual factors such as socio-economic, cultural, and political-economy factors influence the responsiveness of health systems to the mental health care needs of refugees in the project countries.

Explore how the scaling-up of the low-intensity PM+ programmes can support health system responsiveness to the mental health care needs of refugees in the project countries

Compare the responsiveness before and after implementation of the PM+ programmes of the health systems of European and LAMI countries bordering Syria.

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