School-based Psychosocial Interventions' Effectiveness in Strengthening Refugee and Migrant Adolescents' Mental Health, Resilience, and Social Relations: A Four-country Cluster Randomized Study.

School-based psychosocial interventions are increasingly put forward as a way to support young refugees' and migrants' well-being and mental health in resettlement. However, the evidence on these interventions' effectiveness remains scarce and scholars denounce particular gaps in the evidence to date, pointing to a lack of large-scale, controlled studies and studies including social outcome measures. This cluster randomized study aims to strengthen the evidence base on school-based psychosocial interventions for refugee and migrant youth by assessing the effect of two interventions, Classroom Drama and Welcome to School, on youth's mental health, resilience, and social relations in Belgium, Denmark, Norway, and the United Kingdom. Multilevel analyses were conducted separately for the two interventions (Classroom Drama, n = 307, ages 11-19; Welcome to School, n = 251, ages 11-23), using separate no-treatment control groups. Our analyses indicated a significant main, positive effect of Classroom Drama on perceived family support, and an effect on perceived support from friends that was moderated by country: in the United Kingdom, the intervention group reported an increase in perceived friend support, whereas the control group reported a decrease. Furthermore, baseline resilience moderated the effect of the Classroom Drama intervention on behavioral difficulties and well-being. No effects of Welcome to School on any of the outcome variables were found. Overall, this study provides novel, nuanced evidence on school-based psychosocial interventions for refugee and migrant adolescents.

Cada vez se proponen más las intervenciones psicosociales centradas en la escuela como ayuda al bienestar de jóvenes refugiados y migrantes en su realojamiento. No obstante hay pocas pruebas sobre la eficacia de tales intervenciones y los expertos denuncian fallas en dichas pruebas hasta el momento debido a la falta de estudios controlados a gran escala que incluyan medidas de los resultados sociales. El presente estudio de grupos aleatorizados pretende potenciar la base de pruebas sobre intervenciones psicosociales centradas en la escuela con jóvenes refugiados y migrantes analizando el efecto de dos intervenciones, "El drama en el aula" y "Bienvenido al colegio", en la salud mental, la resiliencia y las relaciones sociales de los jóvenes en Bélgica, Dinamarca, Noruega y el Reino Unido. Se efectuaron análisis multinivel por separado para las dos intervenciones ("El drama en el aula", n = 307, edad entre 11 y 19 años; "Bienvenido al colegio", n = 251, edad entre 11 y 23 años) con grupos de control sin tratamiento separados. Los análisis mostraron un efecto positivo principal significativo de "El drama en el aula" en el apoyo familiar percibido y un efecto en el apoyo percibido de los amigos moderado por el país: en el Reino Unido el grupo de intervención presentó un aumento del apoyo percibido de los amigos, mientras que en el grupo control disminuyó. Además la resiliencia básica moderaba el efecto de la intervención de "El drama en el aula" en las dificultades conductuales y en el bienestar. No se apreció efecto de "Bienvenido al colegio" en ninguna de las variables resultado. En términos generales el estudio supone un inédito y detallado aval de las intervenciones psicosociales centradas en la escuela en el caso de adolescentes refugiados y migrantes.

School-based Psychosocial Interventions’ Effectiveness in Strengthening Refugee and Migrant Adolescents’ Mental Health, Resilience, and Social Relations: A Four-country Cluster Randomized Study / [La eficacia de las intervenciones psicosociales centradas en la escuela para potenciar la salud mental, la resiliencia y las relaciones sociales de adolescentes refugiados y migrantes: un estudio de grupos aleatorizados en cuatro países]

School-based psychosocial interventions are increasingly put forward as a way to support young refugees’ and migrants’ well-being and mental health in resettlement. However, the evidence on these interventions’ effectiveness remains scarce and scholars denounce particular gaps in the evidence to date, pointing to a lack of large-scale, controlled studies and studies including social outcome measures. This cluster randomized study aims to strengthen the evidence base on school-based psychosocial interventions for refugee and migrant youth by assessing the effect of two interventions, Classroom Drama and Welcome to School, on youth’s mental health, resilience, and social relations in Belgium, Denmark, Norway, and the United Kingdom. Multilevel analyses were conducted separately for the two interventions (Classroom Drama, n = 307, ages 11-19; Welcome to School, n = 251, ages 11-23), using separate no-treatment control groups. Our analyses indicated a significant main, positive effect of Classroom Drama on perceived family support, and an effect on perceived support from friends that was moderated by country: in the United Kingdom, the intervention group reported an increase in perceived friend support, whereas the control group reported a decrease. Furthermore, baseline resilience moderated the effect of the Classroom Drama intervention on behavioral difficulties and well-being. No effects of Welcome to School on any of the outcome variables were found. Overall, this study provides novel, nuanced evidence on school-based psychosocial interventions for refugee and migrant adolescents.(AU)

Cada vez se proponen más las intervenciones psicosociales centradas en la escuela como ayuda al bienestar de jóvenes refugiados y migrantes en su realojamiento. No obstante hay pocas pruebas sobre la eficacia de tales intervenciones y los expertos denuncian fallas en dichas pruebas hasta el momento debido a la falta de estudios controlados a gran escala que incluyan medidas de los resultados sociales. El presente estudio de grupos aleatorizados pretende potenciar la base de pruebas sobre intervenciones psicosociales centradas en la escuela con jóvenes refugiados y migrantes analizando el efecto de dos intervenciones, “El drama en el aula” y “Bienvenido al colegio”, en la salud mental, la resiliencia y las relaciones sociales de los jóvenes en Bélgica, Dinamarca, Noruega y el Reino Unido. Se efectuaron análisis multinivel por separado para las dos intervenciones (“El drama en el aula”, n = 307, edad entre 11 y 19 años; “Bienvenido al colegio”, n = 251, edad entre 11 y 23 años) con grupos de control sin tratamiento separados. Los análisis mostraron un efecto positivo principal significativo de “El drama en el aula” en el apoyo familiar percibido y un efecto en el apoyo percibido de los amigos moderado por el país: en el Reino Unido el grupo de intervención presentó un aumento del apoyo percibido de los amigos, mientras que en el grupo control disminuyó. Además la resiliencia básica moderaba el efecto de la intervención de “El drama en el aula” en las dificultades conductuales y en el bienestar. No se apreció efecto de “Bienvenido al colegio” en ninguna de las variables resultado. En términos generales el estudio supone un inédito y detallado aval de las intervenciones psicosociales centradas en la escuela en el caso de adolescentes refugiados y migrantes.(AU)

Effectiveness of Promotive and Preventive Psychosocial Interventions on Improving the Mental Health of Finnish-Born and Immigrant Adolescents.

BACKGROUND: Schools are considered natural environments in which to enhance students' social-emotional skills and mental health in general, but they can be especially important for students with refugee and immigrant backgrounds. The current study tested the effectiveness of two school-based interventions in enhancing the mental health and wellbeing of adolescents of native, refugee, and immigrant backgrounds. It further analyzed the role of age, gender, daily stressors, and discrimination in affecting the interventions' effectiveness. METHODS: A three-arm cluster RCT with parallel assignment was applied among the 16 schools. Schools were randomized to three conditions of two active interventions and a waiting-list control condition. Students (n = 1974) filled in an online questionnaire at baseline before the interventions, after the interventions, and at follow-up an average of 9 months after the interventions. The effectiveness criteria were internalizing and externalizing problems, resilience, and prosocial behavior. RESULTS: Interventions were generally not effective in decreasing mental health problems and increasing psychosocial resources. The expected positive intervention effects were dependent on students' age and gender and exposure to socioeconomic daily stressors. CONCLUSION: Interventions enhancing teacher awareness and peer relationships at school should be carefully tailored according to the strengths and vulnerabilities of participating students, especially their daily stress exposure, but also age and gender.

Effectiveness of psychosocial school interventions in Finnish schools for refugee and immigrant children, "Refugees Well School" in Finland (RWS-FI): a protocol for a cluster randomized controlled trial.

BACKGROUND: Schools are natural environments in which to enhance young people's social and emotional skills, mental health, and contact between diverse groups, including students from refugee and immigrant backgrounds. A layered or tiered provision of services is recommended as it can be effective to meet the needs of war-affected adolescents who variably show mental health problems (such as posttraumatic stress disorder (PTSD)). The current protocol describes the study design for a multi-layered intervention model. The study will test the effectiveness of two interventions: a teacher-training intervention In-Service Teacher Training (INSETT) combined with targeted cognitive-behavioral treatment-based Teaching Recovery Techniques (TRT) and a classroom-focused preventive intervention Peer Integration and Enhancement Resources (PIER). We analyze, first, whether the interventions are effective in decreasing psychological distress and increasing positive resources, i.e., prosocial behavior and resilience among refugee and immigrant students. Second, we analyze which student-, school-, and parent-related factors mediate the possible beneficial changes. Third, we look at which groups the interventions are most beneficial to. METHODS: A three-arm cluster RCT with parallel assignment, with a 1:1:1 allocation ratio, is applied in 16 schools that agreed to participate in the Refugees Well School interventions and effectiveness study. Schools were randomized to three conditions of two active interventions and a waiting list control condition. Students, their parents, and teachers in intervention and control schools participated in the study at baseline before the interventions, after the interventions, and at 6 to 12 months after the interventions. The primary effectiveness criterion variables are psychological distress (SDQ) symptoms, resilience (CYRM-12), and prosocial behavior (SDQ). DISCUSSION: The current study presents a recommended universal approach of layered interventions aiming to reduce psychological distress and increase resilience among refugee and immigrant students. A combination of promotive, preventive, and targeted interventions may offer a holistic, ecological intervention package for schools to better address the needs of the whole group. TRIAL REGISTRATION: ISRCTN ISRCTN64245549 . Retrospectively registered on 10 June 2020.

Mental Health of Refugee and Non-refugee Migrant Young People in European Secondary Education: The Role of Family Separation, Daily Material Stress and Perceived Discrimination in Resettlement.

While scholarly literature indicates that both refugee and non-refugee migrant young people display increased levels of psychosocial vulnerability, studies comparing the mental health of the two groups remain scarce. This study aims to further the existing evidence by examining refugee and non-refugee migrants' mental health, in relation to their migration history and resettlement conditions. The mental health of 883 refugee and 483 non-refugee migrants (mean age 15.41, range 11-24, 45.9% girls, average length of stay in the host country 3.75 years) in five European countries was studied in their relation to family separation, daily material stress and perceived discrimination in resettlement. All participants reported high levels of post-traumatic stress symptoms. Family separation predicted post-trauma and internalizing behavioral difficulties only in refugees. Daily material stress related to lower levels of overall well-being in all participants, and higher levels of internalizing and externalizing behavioral difficulties in refugees. Perceived discrimination was associated with increased levels of mental health problems for refugees and non-refugee migrants. The relationship between perceived discrimination and post-traumatic stress symptoms in non-refugee migrants, together with the high levels of post-traumatic stress symptoms in this subsample, raises important questions on the nature of trauma exposure in non-refugee migrants, as well as the ways in which experiences of discrimination may interact with other traumatic stressors in predicting mental health.