UK Public Health Rapid Support Team: What Does It Take to Be Ready to Deploy within 48 Hours?

#### Pre-departure, in the field, and post deployment processes


## **EmpowermentRemote: A Pilot Project on Video-Based Group Psychotherapy for Refugees**

**Michael Strupf1, Maren Wiechers1, Andreas Hoell2, Johanna Schneider1, Max Burger1, Peter Falkai1, Malek Bajbouj3, Aline Übleis1, and Frank Padberg1**

**<sup>1</sup>** Department of Psychiatry and Psychotherapy, University Hospital LMU Munich, Munich, Germany <sup>2</sup> Department of Psychiatry and Psychotherapy, Central Institute for Mental Health, Mannheim, Germany

3 Department of Psychiatry and Psychotherapy, Charité – Universitätsmedizin, Campus Benjamin Franklin, Berlin, Germany

Refugees commonly report high levels of mental distress upon arrival in Western countries of asylum. The urgent need for psychosocial care in refugee populations remains widely uncovered due to the scarcity of culture-sensitive treatment, multiple barriers to accessing healthcare services, and, most recently, the COVID-19 pandemic. Western healthcare systems are in charge of providing low- threshold accessible mental health interventions that are specifically tailored toward the needs of refugees in the post-migration setting. Here, we present an innovative video-based group therapy for refugees with affective disorders named *EmpowermentRemote*. The intervention relies on the evidence- based therapy manual Empowerment, which has been shown to be effective and cost-efficient in a multicenter trial. In *EmpowermentRemote* groups, we aim to apply the intervention in a video-assisted setting by reaching out to refugee patients via tablet or smartphone. Refugees are equipped with the knowledge and skills to cope with depressive symptoms and stressors of the post-migration environment. To ensure culture-sensitive treatment, *EmpowermentRemote* groups are supported by professional language mediators, and Western concepts of psychotherapy are culturally adapted.

Video-based group psychotherapy bears great potential as we can treat a larger number of refugees at lower costs and independent of location or service hours, involve translators of diverse languages, and reduce the risk of SARS-CoV-2 infections. Preliminary data indicated that *EmpowermentRemote* is feasible. We aim to investigate the effectiveness of *EmpowermentRemote* in a multicenter trial and implement the intervention in our routine healthcare structure to provide culture-sensitive treatment for refugees in times of the COVID-19 pandemic.

*Figure 1. Main migration routes across the globe. Source: UNHCR. Retrieved from https://news.nationalgeographic.com*

#### Methods and Results


*Figure 2. Care model of the EmpowermentRemote group therapy vs. Treatment-as-usual Figure 3. Content overview of the EmpowermentRemote intervention*

#### Discussion


#### References

Blackmore R, Boyle JA, Fazel M, Ranasinha S, Gray KM, Fitzgerald G, et al. (2020) The prevalence of mental illness in refugees and asylum seekers: A systematic review and meta-analysis. PLoS Med 17(9): e1003337

Satinsky, E., Fuhr, D. C., Woodward, A., Sondorp, E., & Roberts, B. (2019). Mental health care utilization and access among refugees and asylum seekers in Europe: A systematic review. *Health Policy, 123*, 851-863.

Wiechers, M., Übleis, A., & Padberg, F. (2019). *Empowerment für Menschen mit affektiven Erkrankungen und Migrationserfahrungen. Therapiemanual für Einzel- und Gruppensettings*. Stuttgart: Schattauer.

#### Acknowledgements

The *Empowerment* intervention was developed within the Mental Health in Refugees and Asylum Seekers (MEHIRA) project and funded by the Innovationsfond of G-BA (Gemeinsamer Bundesausschuss). The authors declare no conflicts of interest.
