Publications by authors named "Daniela Fuhr"

Background: Despite the significant burden of alcohol use disorders (AUD), there is a large treatment gap, especially in settings and populations affected by armed conflict. A key barrier to care is the lack of contextually relevant interventions and adequately skilled human resources to deliver them. This paper describes the systematic development of the CHANGE intervention, a potentially scalable psychological intervention for people with co-existing AUD and psychological distress in conflict-affected populations, delivered by non-specialist workers (NSWs).

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Non-specialist mental health interventions serve as a potential solution to reduce the mental healthcare gap in low- and middle-income countries, such as Sri Lanka. However, contextual factors often influence their effective implementation, reflecting a research-to-practice gap. This study, using a qualitative, participatory approach with local mental health workers (n = 9) and potential service users (n = 11), identifies anticipated barriers and facilitators to implementing these interventions while also exploring alternative strategies for reducing the mental healthcare gap in this context.

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Article Synopsis
  • - The study evaluates a care program (DWM and PM+) for healthcare workers in Spain who are experiencing psychological distress, focusing on the context, implementation outcomes, and mechanisms of action.
  • - Mixed methods were used for data collection, including quantitative data from a randomized control trial and qualitative insights from interviews and focus groups, revealing both barriers (like stigma) and enabling factors (like flexibility in interventions).
  • - Results indicate that the program was feasible with good participant acceptance, and it highlights the need for increased mental health awareness and support to improve future implementations in similar settings.
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Article Synopsis
  • The COVID-19 pandemic led to studies on how it affected people's mental health, with mixed results; some felt worse, while others stayed stable.
  • The study focused on 135,445 people in Germany to see how age and past mental health issues affected depression and anxiety during the early pandemic.
  • Results showed people with past mental health problems felt the same after the pandemic began, but younger folks without those issues felt worse, highlighting the need for better support strategies.
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Unlabelled: PURPOSE  : To assess gender differences in COVID-19 related changes in home and work responsibilities longitudinally, and determine whether these differences, together with other potential risk and protective factors, are associated with depression, anxiety, and post-traumatic stress disorder (PTSD) symptomatology.

Method: Symptoms of depression, anxiety, and PTSD were measured using an online survey instrument, between May 2020 and April 2021, in four waves completed at 3-monthly intervals. Analyses were based on data from the COvid MEntal healTh (COMET) survey which investigated the mental health effects of the COVID-19 outbreak spanning 13 countries on five continents in N = 7,909 participants.

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Background: Syrian refugees have a high burden of mental health symptoms and face challenges in accessing mental health and psychosocial support (MHPSS). This study assesses health system responsiveness (HSR) to the MHPSS needs of Syrian refugees, comparing countries in Europe and the Middle East to inform recommendations for strengthening MHPSS systems.

Methods: A mixed-methods rapid appraisal methodology guided by an adapted WHO Health System Framework was used to assess HSR in eight countries (Egypt, Germany, Jordan, Lebanon, Netherlands, Sweden, Switzerland, and Türkiye).

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Our aim was to examine mental health needs and access to mental healthcare services among Syrian refugees in the city of Leipzig, Germany. We conducted a cross-sectional survey with Syrian refugee adults in Leipzig, Germany in 2021/2022. Outcomes included PTSD (PCL-5), depression (PHQ-9), anxiety (GAD-7) and somatic symptom (SSS-8).

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Background: The war in South Sudan has displaced more than four million people, with Uganda hosting the largest number of South Sudanese refugees. Research in Uganda has shown elevated levels of alcohol misuse and psychological distress among these refugees. The World Health Organization (WHO) has developed a trans-diagnostic scalable psychological intervention called Problem Management Plus (PM +) to reduce psychological distress among populations exposed to adversities.

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Digital Mental Health Technologies (DMHTs) have the potential to close treatment gaps in settings where mental healthcare is scarce or even inaccessible. For this, DMHTs need to be affordable, evidence-based, justice-oriented, user-friendly, and embedded in a functioning digital infrastructure. This viewpoint discusses areas crucial for future developments of DMHTs.

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[Digital technologies to improve mental health].

Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz

March 2024

The burden of mental diseases is enormous and constantly growing worldwide. The resulting increase in demand for psychosocial help is also having a negative impact on waiting times for psychotherapy in Germany. Digital interventions for mental health, such as interventions delivered through or with the help of a website (e.

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In conflict-affected settings, prevalence of alcohol use disorders (AUDs) can be high. However, limited practical information exists on AUD management in low-income settings. Using a theory of change (ToC) approach, we aimed to identify pathways influencing the implementation and maintenance of a new transdiagnostic psychological intervention ("CHANGE"), targeting both psychological distress and AUDs in humanitarian settings.

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There has been an increase in the evaluation and implementation of non-specialist delivered psychological interventions to address unmet mental health needs in humanitarian emergencies. While randomized controlled trials (RCTs) provide important evidence about intervention impact, complementary qualitative process evaluations are essential to understand key implementation processes and inform future scaling up of the intervention. This study was conducted as part of an RCT of the Early Adolescents Skills for Emotions (EASE) psychological intervention for young adolescents with elevated psychological distress (predominantly with a Syrian refugee background) in Lebanon.

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Background: Higher social support protects people from developing mental disorders. Limited evidence is available on the mechanism through which social support plays this protective role.

Objective: To investigate the stress-buffering process of social support on depressive symptoms using a novel longitudinal dynamic symptom network approach.

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Background: Mothers with perinatal depression can show different symptom trajectories and may spontaneously remit from depression, however, the latter is poorly understood. This is the first study which sought to investigate predictors of spontaneous remission and longer-term recovery among untreated women with perinatal depression.

Methods: We analysed data from two randomised controlled trials in women with perinatal depression in India and Pakistan.

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Introduction: South Africa lacks services to detect and address alcohol use during pregnancy, particularly outside of health-care facilities. This study aimed to explore pregnant women and healthcare providers' perceptions of the acceptability, feasibility and appeal of a community-based counselling programme for pregnant women with alcohol problems.

Methods: Twenty-eight in-depth interviews with pregnant women who drink, Community Health Workers (CHWs) and antenatal service providers were conducted.

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Background: To examine changes in COVID-19 stressors and symptoms of mental disorders in the Republic of Georgia.

Methods: A longitudinal design was used. Following on from our study of May-June 2020, this follow-up study in January-March 2021 was conducted at: (i)an individual level with the same respondents involved in the May-June 2020 study (repeat responders/cohort); and (ii) at a population-wide level, using non-probabilistic sampling.

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Background: Refugees are at an increased risk of developing symptoms of mental disorders but face various structural and socio-cultural barriers to accessing mental health care. The SPIRIT project (Scaling-up Psychological Interventions in Refugees In SwiTzerland) seeks to promote the resilience of refugees and improve their access to mental health care. For this purpose, Problem Management Plus (PM+), an evidence-based low-intensity psychological intervention delivered by trained non-specialist "helpers", is being scaled-up in Switzerland.

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Background: There are one billion migrants globally, of whom 82 million are forced migrants. Pregnant migrants face pre-migration stressors such as conflict, transit stressors including poverty, and post-migration stressors including navigating the immigration system; these stressors can make them vulnerable to mental illness. We aimed to assess the global prevalence of and risk factors for perinatal mental health disorders or substance use among women who are migrants.

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Article Synopsis
  • Many refugees have mental health problems, but it can be hard for them to get help in richer countries.
  • A study was done to see if a program called Problem Management Plus (PM+) could help Syrian refugees in the Netherlands feel better.
  • The results showed that those who used PM+ felt less depressed, anxious, and had fewer PTSD symptoms compared to those who didn’t use it, meaning PM+ is a helpful tool for their mental health.
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Training nonspecialists in providing evidence-based psychological interventions (i.e. task-sharing) can effectively increase community access to psychological support.

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Backgrounds: Individuals with chronic medical conditions are considered highly exposed to COVID-19 pandemic stress, but emerging evidence is demonstrating that resilience is common even among them. We aimed at identifying sustained resilient outcomes and their predictors in chronically ill people during the first year of the pandemic.

Methods: This international 4-wave 1-year longitudinal online survey included items on socio-demographic characteristics, economic and living situation, lifestyle and habits, pandemic-related issues, and history of mental disorders.

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Issues: Despite the large number of effective psychological interventions for alcohol use disorders (AUD), there is still a lack of clarity concerning the strategies that make these interventions effective.

Approach: The overall goal of this review was to identify, examine and synthesise the information about common strategies from evidence-based psychological interventions for AUDs by conducting a review of systematic reviews, that is, a meta-review. We isolated the relevant primary studies from eligible systematic reviews and extracted information about the interventions from these studies to understand the strategies used.

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Background: While employment programs were not created with the intent to improve common mental disorders (CMDs), they may have a positive impact on the prevalence, incidence, and severity of CMD by reducing poverty and increasing access to economic mobility.

Aim: To examine and synthesize the available quantitative evidence of the impact of employment programs on outcomes of CMD.

Methods: Embase, Econlit, Global Health, MEDLINE, APA PsychINFO, and Social Policy and Practice were searched for experimental and quasi-experimental studies which investigated the impact of employment programs on primary and secondary outcomes of a CMD.

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Background: Randomised controlled trials (RCTs) have been increasingly used to test the effectiveness of mental health and psychosocial support(MHPSS) interventions for populations affected by humanitarian crises. Process evaluations are often integrated within RCTs of psychological interventions to investigate the implementation of the intervention, the impact of context, and possible mechanisms of action. We aimed to explore limitations and strengths of how process evaluations are currently conceptualised and implemented within MHPSS RCTs specifically.

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