WITHDRAWN: Linking up Intervention Strategies to Promote Better Mental Health for Refugee Children and Families

Introduction: The Syrian crisis and the flow of refugees into other countries represents one of the greatest challenges of recent times. The impact of conflict and displacement on the mental health of children and adults is very significant, and the scale of the problem is enormous. There is increasing recognition that families are the first line of defence for children's mental health, but there are very few studies systematically investigating the potential for family-based approaches to prevent mental health difficulties, particularly immediately following flight and in displacement, often into very low resource settings, before families are resettled in stable environments. The need for a public health pyramid of interventions and psychological first aid has been highlighted.

Methods: A set of qualitative research studies identified the needs and current coping strategies of parents in displacement, and has been examining the potential for the development of brief, focused psychological first aid for children and families. This information, together with evidence-based strategies identified in the literature has been used to design a brief parent skills program to integrate with an existing intervention for traumatic stress, Teaching Recovery Techniques, designed for children post emergency. This has created a new, brief integrated program for parents and caregivers for use in humanitarian and low resource settings, Teaching Recovery Techniques Plus Parenting. The combined program has been piloted with families living in displacement close to the border with Syria, and a new trial is ongoing.

Results: Qualitative research highlighted parents’ coping strategies, and the need they felt for simple advice to cope with the behavioural and emotional changes that they saw in their children through conflict and displacement. The Teaching Recovery Techniques Plus Parenting programme pilot with 14 families found 100% attendance, improvement across a range of parenting variables, and in interviews, parents described positive changes they noticed in their children and their capacity to interact more calmly with them.

Conclusions: This new integrated approach shows promise as an intervention for families who have lived through conflict and displacement. The approach also has the potential to be used with recently arrived families who are resettled in high income countries. Components of the parent skills identified are also presented in brief leaflets and booklets, enabling integrated and coherent information to be disseminated in different ways, depending on local resources and needs.