Scaling-up mental health interventions for Syrian refugees in Türkiye: A qualitative study

Around the world, there are nearly 100 million people who are forcibly displaced due to war, conflict, and human rights violations. Although it has been 13 years since the conflict in Syria started, the displacement that occurred due to this conflict is still considered one of the major crises in the world. Syrian refugees are at risk of developing mental health problems due to the traumatic events they experienced pre-, during and post-migration. Türkiye's health system is overburdened as a country that hosts around 3.4 million Syrian refugees. There exists a gap between the mental health needs in the country and the resources it has, which is called the mental health gap. Scaling-up mental health interventions with the aim of narrowing this gap is recommended to improve the well-being of refugees. Problem Management Plus (PM+) is a scalable mental health intervention that was developed by the World Health Organization. Previous studies investigated the factors affecting the scaling-up process and the barriers and facilitators of scaling-up, especially in low- and middle-income countries. However, to our knowledge, no qualitative studies have been conducted on scaling up brief mental health interventions in Türkiye. Therefore, the current study was conducted to acquire in-depth information about a potential scaling-up of PM+ in Türkiye to guide the process of increasing Syrian refugees' access to mental health services. Semi-structured interviews were conducted with key informants, PM+ facilitators, and beneficiaries who previously received the PM+ intervention. The results showed that there was a need for PM+ to be scaled-up but there were also facilitators and barriers that should be considered during scaling-up. The findings also included recommendations that may guide this process. Key Words: Refugees, Scaling-up, Mental Health Gap, Mental Health Interventions, Qualitative Research