The culturally and contextually sensitive assessment of mental health using a structured diagnostic interview (MINI Kid) for Syrian refugee children and adolescents in Lebanon: Challenges and solutions.

Autor: Kyrillos V; Médecins du Monde, Lebanon., Bosqui T; 112382American University of Beirut., Moghames P; Médecins du Monde, Lebanon., Chehade N; Médecins du Monde, Lebanon., Saad S; Médecins du Monde, Lebanon., Abdul Rahman D; Médecins du Monde, Lebanon., Karam E; Institute for Development, Research, Advocacy and Applied Care., Karam G; Institute for Development, Research, Advocacy and Applied Care., Saab D; Institute for Development, Research, Advocacy and Applied Care., Pluess M; 46175Queen Mary University of London., McEwen FS; 46175Queen Mary University of London.
Jazyk: angličtina
Zdroj: Transcultural psychiatry [Transcult Psychiatry] 2023 Feb; Vol. 60 (1), pp. 125-141. Date of Electronic Publication: 2022 Jul 12.
DOI: 10.1177/13634615221105114
Abstrakt: Elevated rates of mental health difficulties are frequently reported in conflict-affected and displaced populations. Even with advances in improving the validity and reliability of measures, our knowledge of the performance of assessment tools is often limited by a lack of contextualization to specific populations and socio-political settings. This reflective article aimed to review challenges and share lessons learned from the process of administering and supervising a structured clinical interview. We administered the MINI International Neuropsychiatric Interview for Children and Adolescents (MINI Kid) and used the Clinical Global Impression (CGI) severity scale with N  = 119 Syrian refugee children (aged 8-17) resident in ITSs in Lebanon. Qualitative data were derived from supervision process notes on challenges that arose during assessments, analyzed for thematic content. Five themes were identified: (1) practical and logistical challenges (changeable nature of daily life, competing demands, access to phones, temporary locations, limited referral options); (2) validity (lack of privacy, trust, perceptions of mental health, stigma, false positive answers); (3) cultural norms and meaning (impact of different meanings on answers); (4) contextual norms (reactive and adaptive emotional and behavioral responses to contextual stress); and (5) co-morbidity and formulation (interconnected and complex presentations). The findings suggest that while structured assessments have major advantages, cultural and contextual sensitivity during assessments, addressing practical barriers to improving accessibility, and consideration for inter-connected formulations are essential to help inform prevalence rates, treatment plans, and public health strategies.
Databáze: MEDLINE