Project Abstract: The rapidly growing scale of humanitarian crises requires new response capabilities geared towards addressing populations with prolonged high vulnerability to mental health consequences and little to no access to mental health, health, and social resources. This new R21 application responds to PAR-17-313 by developing and pilot testing a novel model for helping urban refugee families in LMICs with little to no access to evidence-based mental health services, by delivering a transdiagnostic family intervention for common mental disorders in health sector and non-health sector settings. The proposed project is located in Istanbul, Turkey. Aim 1 forms a Family Support Design Team (FSDT) to adopt the PM+ and CAFES manuals into a family support (FS) intervention for use with refugee families by lay providers in community sites and nurses in clinical sites using a four-session multiple family group format. Aim 2 pilots FS with families in community and clinical sites, and then through observations and qualitative interviews, assesses FS’s feasibility, fidelity, the impact of context and local capacity, the experiences of intervention delivery, and practitioner and organizational perspectives on scale up. Aim 3 conducts pre, immediate post, and 3-month post assessments of the refugee families who received FS through all the sites, to demonstrate the kind of pre-post changes that have been reported for comparable interventions and to determine key parameters of interest with sufficient accuracy and precision. Project collaborators include the University of Illinois at Chicago (UIC), Medeniyet University, the Centre for Global Health at the University of Prishtina and 3 community and 3 clinical organizations in Istanbul. This exploratory investigation, conducted with the support and advice of the World Health Organization, will strengthen the research capabilities of the academic and community partners in Istanbul and will develop new evidence-based mental health services for refugees in Turkey and other LMICs, as well as for refugees and migrants in low resource communities in the United States.

Refugee families in LMICs face multiple war and displacement related adversities, and often have one or more members with common mental disorders, but have little to no access to evidence-based mental health services. This project uses a low intensity intervention approach to develop and test for feasibility of Family Support (FS), a novel trans-diagnostic intervention for refugee families with common mental disorders. FS is delivered in a multiple family group format by community workers or nurses. Augmenting Dr. Weine’s existing D43 research training program, this project will advance the capacities of researchers, academic institutions, and their community partners, in Istanbul. This research, conducted with the support and advice of the World Health Organization, will develop an evidence-based program and build research capacity in academic and community organizations that can enhance Turkey’s humanitarian response to 3 million Syrian refugees.