ArticleBMC psychiatry2023
An online tiered screening procedure to identify mental health problems among refugees.
Article in BMC psychiatry, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers, 1 of them a synthesis that pooled it.
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Who cites it
7 citing papers in PubMed, 1 synthesis or guideline pooled it, 10 citations in OpenAlex.
- Insomnia and poor sleep quality in refugee and asylum-seeking populations: A systematic review and meta-analysis.PloS one · 2026Pooled it
- Differential contributions of PTSD symptom clusters and their associations with resilience in traumatized individuals with a refugee background.European journal of psychotraumatology · 2026Article
- Understanding Psychologists' Usage, Knowledge, and Attitudes Toward Digital Mental Health Solutions for Refugees and Migrants: Exploratory Cross-Sectional Survey in Sweden.JMIR human factors · 2026Article
- Digital mental health needs a purpose-driven approach.Nature human behaviour · 2026Review
- Online Tiered Screening for Mental Health Problems Among Refugees in Sweden: Validation Study.JMIR human factors · 2026Article
- "It's the modern way of doing things": a qualitative study of user-experience, acceptability, and content validity of a digital mental health screener for refugees.Frontiers in psychology · 2026Article
- Unrecognized grief - Prevalence and comorbidity of prolonged grief among refugees in Sweden.Journal of migration and health · 2024Article
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Authors and funding
8 authors at 4 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundMany refugees suffer from mental health problems due to stressful and traumatic events before, during, and after migration. However, refugees are facing a wide variety of barriers, limiting their access to mental health care. Internet-based tools, available in several languages, could be one way to increase the availability of mental health services for refugees. The present study aimed to develop and test a screening tool to screen for clinically relevant symptoms of psychiatric disorders common among refugees (i.e. Depression, Anxiety, Post-traumatic stress disorder, and Insomnia). We, designed, translated, and adapted an internet-based tiered screening procedure suitable for use with the largest refugee populations residing in Sweden. The tool aims to accurately identify symptoms of mental distress (Tier 1), differentiate between symptoms of specific psychiatric disorders (Tier 2), and assess symptom severity (Tier 3). We tested the overall efficiency of using a tiered screening procedure.
methodsSeven hundred fifty-seven refugees residing in Sweden, speaking any of the languages Arabic, Dari, Farsi, English, or Swedish, completed an online questionnaire following a three-tiered procedure with screening instruments for each tier. In this study, the Tier 3 scales were used as reference standards for clinically relevant symptoms, to evaluate screening efficiency in terms of accuracy and reduction of item burden in previous tiers.
resultsThe results show that the tiered procedure could reduce the item burden while maintaining high accuracy, with up to 86% correctly assessed symptoms and few false negatives with moderate symptoms and above (at most 9%), and very few with severe symptoms (at most 1.3%). DISCUSSION: This study generated an accurate screening tool that efficiently identifies clinically relevant symptoms of common psychiatric disorders among refugees. Using an adapted online tiered procedure to screen for multiple mental health issues among refugees has the potential to facilitate screening and increase access to mental health services for refugees. We discuss the utility of the screening tool and the necessity of further evaluation.
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