A Services Approach to Preventive Mental Health for Adolescent Refugees

描述(由申请人提供)：对难民青少年的研究表明，精神疾病和其他负面行为后果的发生率较高。较少考虑的是，重新安置的情况可能非常适合青少年的精神障碍预防服务，因为他们的家庭和社会环境中有保护资源。这项针对处境危险的难民青少年的为期五年的研究使用人种学来发展关于防止心理健康问题的家庭和生态资源的背景知识，并利用这些知识来制定适合不同文化和不同服务环境的预防干预措施。它以家庭生态发展理论、复原力、创伤和移民理论以及服务方法为指导。这项研究的具体目的是：1)随着时间的推移，审查来自两个文化群体的高危难民青少年的经历，以确定可通过预防服务加强的家庭和生态保护资源的特征；2)利用家庭和生态保护资源的背景知识，为高危难民青少年制定预防干预措施，以适应不同的文化背景和服务环境。这项研究的第一个目的是通过多地点、跨文化、前瞻性的人种学研究来解决。样本是来自过去两年内抵达的两个不同难民群体的80名高危难民青少年(12岁至17岁)、他们的家人和服务提供者。调查人员将对以下人员进行后续面谈和跟踪实地观察：1)40名利比里亚人；2)40名索马里班图人。研究的第二个具体目标是：1)设计潜在有效和可推广的预防干预措施；2)通过焦点小组检查预防干预措施的可接受性和可行性；3)初步测试预防干预措施的可接受性和可行性。

DESCRIPTION (provided by applicant): Studies of refugee adolescents have demonstrated elevated rates of mental illness and other negative behavioral outcomes. Less often considered is that the circumstances of resettlement may be well suited for mental disorder prevention services amongst adolescents given the protective resources that lie in their family and social environments. This five-year study of at-risk refugee adolescents uses ethnography to develop contextual knowledge on family and ecological resources that protect against mental health problems, and uses that knowledge to develop a prevention intervention which is adaptable for different cultures and different service settings. It is guided by family-ecodevelopmental theory, theories of resilience, trauma, and migration, and a services approach. The specific aims of this study are: 1) To examine over time the experiences of at-risk refugee adolescents from two cultural groups, so as to characterize the family and ecological protective resources that may be enhanced by preventive services; 2) To use the contextual knowledge of family and ecological protective resources to develop a preventive intervention for at-risk refugee adolescents that is tailored to fit different cultural contexts and service settings. The first aim of this research is addressed through a multi-site, cross-cultural, prospective ethnographic study. The sample is 80 at-risk refugee adolescents (ages 12 to 17), their families, and service providers from two distinct refugee populations that arrived within the past two years. The investigators will conduct follow-along interviews and shadowing field observations with: 1) 40 Liberians; 2) 40 Somali Bantus. The second specific aim of the study is addressed through: 1) Designing a potentially effective and generalizable prevention intervention; 2) Examining through focus groups the acceptability and feasibility of the preventive intervention; 3) Pilot testing the acceptability and feasibility of the preventive intervention.