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The Capital Region of Denmark - a part of Copenhagen University Hospital

PTF6: The Effect of Integrating Cross-sectoral Collaboration with the Municipality in Psychosocial Treatment of Trauma-affected Refugees; a Randomised Controlled Trial

Project: Types of projectsProject

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Postmigration conditions in resettlement countries may moderate or exacerbate mental health outcomes in refugees. Ongoing stresses related to social problems may lead to difficulties focusing on the content and process of treatment for trauma-related mental health problems. This could reduce treatment
outcomes. Cross-sectoral collaboration and coordination of municipal social interventions and regional psychiatric treatment are currently limited.
The aim of this project is to investigate the effect of integrating cross-sectoral collaboration with the municipality in psychosocial treatment of trauma-affected refugees. Additionally, the project will also comprise a qualitative investigative on the patients' experiences': what do the gain from treatment and how are they doing when treatment and collaborations have ended.

Number of participants (N): 230.
Included in the study are refugees with post-traumatic stress disorder, who are unemployed and attending a municipal job centre or sickness-benefit unit in one of the five collaborating municipalities; Frederikssund, Gladsaxe, Hillerød, København, or Lyngby-Taarbæk.
The randomised controlled trial is comparing treatment as usual comprising 10 sessions with a medical doctor (pharmacological treatment and psycho-education) and 16 sessions with a psychologist (cognitive behavioural therapy) with add-on of the cross-sectoral social intervention. The core of the
intervention consists of three meetings between the patient, the municipal case counsellor and clinicians from CTP. The meetings are held at the beginning, half-way and end of an 8-10 months multidisciplinary treatment course. The patient’s self-perceived social stressors are addressed and a comprehensive action plan for handling the patient’s challenges is made. In-between the meetings the involved parties will be in ongoing contact. In addition, qualitative data will be collected for approximately 20 participants throughout the
treatment period and 6 months after treatment has ended. The qualitative part will focus on how the participants have experienced the cross-sectoral collaboration, psychiatric recovery, treatment outcome, social recovery and whether the participants are left with a better plan and overview of life situation and circumstances. It will primarily consist of interviews and observations of
the meetings at several points in time.
The primary outcome is WHODAS 2.0 together with a variety of secondary outcomes measuring psychiatric symptoms, quality of life and social factors (HTQ, HSCL-25, WHO-5, EQ6D, CHAI, HAM17-D+A, GAF-F+S). Different qualitative analysis will be carried out in accordance with the nature of the
data material.
The qualitative study will recruite 20 participants from the interventions group and follow them through their entire course of treatment. All collaborative meetings will be observed and information conversations conducted with all those participating in the meeting. Individual in-depts interviews will be carried out at the end of treatment and six months after treatment and collaborations have ended. Focus group interviews will be carried out with clinicians when data from obervations and individual interviews have been analysed.

Expected Results:
We expect the integrated cross-sectoral intervention to enhance outcomes of treatment. We expect the qualitativ study to produce knowledge on what works for who, why and in what context. Additionally, we expect to illuminate how collaborative roundtable meetings function as an approach for cross-sectoral collaboration.

Expected Impact:
We expect the project to inform future decisions on whether or not collaborations between municipal jobcentres and psychiatric PTSD treatmens hold any value for both patients, clinicians and society. Furthermore, we expect the knowledge from the project will be apllied if and when formulation future collaborative initiatives.

    Research areas

  • Health Sciences - Transcultural Psychiatry, Randomized Controlled Clinical Trial, Psychosocial Interventions, Health Systems Research, Registerbased research, Recovery

ID: 59557933