RE-DEFINE is designed to go through three phases. Firstly, the SH+ programme will be translated and adapted for the context and needs of the refugees and asylum seekers. Secondly the SH+ programme will be tested for acceptability and cost-effectiveness in two large randomized control trials. Thirdly, the SH+ programme and the results of the trials will be widely disseminated.
The Re-Define project has three main phases:
SH+ will be translated and contextually adapted to the needs of the refugees and asylum seekers participating in the programme. The translation and adaptation will be inclusive with respect to gender, age, language, religion, and regional diversity between different ethnic groups.
A situational assessment will be carried out to identify migration flows across different countries inside and outside Europe and local needs in relation to these elements.
Then the SH+ programme will be translated into three languages according to the situational assessment and adapted to the relevant cultures. The cultural adaptation will follow the adaptation protocol developed by the WHO and partners, which ensures that the process of adaptation is systematic and well-documented and focuses on understandability, acceptability and relevance of translated and adapted product. This phase is strongly interdisciplinary because it relies on ethnographic input from the different partners as well as stakeholders. In this phase, local and cultural elements, religious perspectives, and linguistic idiosyncrasies will be recognised as key aspects for meeting mental health needs of the refugee and asylum seeker population.
During phase 2 two large, pragmatic randomized control trials (RCT) will be carried out to evaluate cost-effectiveness and acceptability of SH+ programme.
The trials will test the capacity of the SH+ programme to be implemented within mental health systems in terms of reduction of psychological distress, disability and health costs. In all the participating countries, beneficiaries will be adult refugees and asylum seekers who show increased psychological distress but no mental disorder. The SH+ programme will be delivered by trained non-specialist facilitators/cultural mediators with a refugee or migrant background or with the same/similar culture.
The main objective of the health economic evaluation is to determine whether implementation of the SH+ programme reduces economic burden of common mental health symptoms in refugees and asylum seekers.
Dissemination is crucial to scaling-up, and stakeholder’s engagement will already start at the beginning of the project, but dissemination activities will be more prominent later in the project.
Refugees and asylum seekers, policy makers and the scientific community will be included as recipients, and also to facilitate distribution and dissemination of the SH+ programme to the project countries and beyond. This phase will engage with policy makers, financial donors NGOs, national and international scientists, professionals and para-professionals.