Refereed journal article or data article (A1)

Long-term effectiveness of Self-Help Plus in refugees and asylum seekers resettled in Western Europe: 12-month outcomes of a randomised controlled trial

List of Authors: Turrini G, Purgato M, Tedeschi F, Acartürk C, Anttila M, Au T, Carswell K, Churchill R, Cuijpers P, Friedrich F, Gastaldon C, Klein T, Kosters M, Lantta T, Nosé M, Ostuzzi G, Papola D, Popa M, Sijbrandij M, Tarsitani L, Todini L, Uygun E, Välimäki M, Walker L, Wancata J, White RG, Zanini E, van Ommeren M, Barbui C


Publication year: 2022

Journal: Epidemiology and Psychiatric Sciences


Journal acronym: EPIDEMIOL PSYCH SCI

Volume number: 31

Number of pages: 10

ISSN: 2045-7960

eISSN: 2045-7979



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As refugees and asylum seekers are at high risk of developing mental disorders, we assessed the effectiveness of Self-Help Plus (SH + ), a psychological intervention developed by the World Health Organization, in reducing the risk of developing any mental disorders at 12-month follow-up in refugees and asylum seekers resettled in Western Europe.

Refugees and asylum seekers with psychological distress (General Health Questionnaire-12 ⩾ 3) but without a mental disorder according to the Mini International Neuropsychiatric Interview (M.I.N.I.) were randomised to either SH + or enhanced treatment as usual (ETAU). The frequency of mental disorders at 12 months was measured with the M.I.N.I., while secondary outcomes included self-identified problems, psychological symptoms and other outcomes.

Of 459 participants randomly assigned to SH + or ETAU, 246 accepted to be interviewed at 12 months. No difference in the frequency of any mental disorders was found (relative risk [RR] = 0.841; 95% confidence interval [CI] 0.389–1.819; p-value = 0.659). In the per protocol (PP) population, that is in participants attending at least three group-based sessions, SH + almost halved the frequency of mental disorders at 12 months compared to ETAU, however so few participants and events contributed to this analysis that it yielded a non-significant result (RR = 0.528; 95% CI 0.180–1.544; p-value = 0.230). SH + was associated with improvements at 12 months in psychological distress (p-value = 0.004), depressive symptoms (p-value = 0.011) and wellbeing (p-value = 0.001).

The present study failed to show any long-term preventative effect of SH + in refugees and asylum seekers resettled in Western European countries. Analysis of the PP population and of secondary outcomes provided signals of a potential effect of SH + in the long-term, which would suggest the value of exploring the effects of booster sessions and strategies to increase SH + adherence.

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Last updated on 2022-17-08 at 15:37