A new grant awarded to an international team of researchers, co-led by investigators in the University of Iowa College of Public Health, will study whether engaging young adults as community mental health workers in humanitarian settings helps not only to support those communities in crisis, but protects the well-being of the young workers as well.

The collaborative research team is co-led by Rima Afifi, UI professor of community and behavioral health and director of the UI Prevention Research Center for Rural Health. Other investigators include Grant Brown, UI assistant professor of biostatistics, as well as researchers from George Mason University, American University of Beirut, and Yale University. The research team is also partnering with the non-governmental organization Multi-Aid Projects (MAPs) that will guide field activities.

The project, funded by a three-year, $450,000 grant from the National Institute of Mental Health, is focused on Syrian young adults living in Lebanon, a nation that currently hosts about 1.5 million Syrians displaced by war in their home country.

Syrian young adults, aged 18-24 years, will be trained to provide mental health care to at-risk adults in their community. The young adults will implement a program called Problem Management Plus (PM+), a World Health Organization-backed initiative that equips non-professional lay community members with skills and tools to decrease mental distress in communities affected by adversity. In humanitarian settings worldwide, PM+ has been demonstrated to reduce common mental health problems, such as anxiety and depression, as well as other problems, such as stress, unemployment, and interpersonal conflict.

“Humanitarian crises increase mental health disorders,” says Afifi. “Yet, in humanitarian settings, human resources for health are often insufficient to meet needs. Understanding how young adults can support communities in the context of disasters is an important area of research.”

The overall goal of the new study is to evaluate whether being a young adult community mental health worker (CMHW) impacts the young adults’ well-being, coping, and stress levels. The research also aims to measure how and why the CMHW role may be a protective factor for these young adults.

“If engaged effectively, young adults are resources and agents of change in their communities,” notes team co-leader Rima Nakkash, associate professor of global and community health at George Mason University. “Involving young adults in work that impacts their communities has positive outcomes for their well-being, and that of their communities. But often young adults are marginalized, particularly in humanitarian settings.”

The research project will recruit Syrian refugee young adults (YA) into a three-arm randomized control trial. The researchers will gather data from participants using surveys, experience sampling, as well as biological samples to measure stress. The three arms include: An CMHW intervention group trained to implement PM+ with their communities, a tutor intervention group trained to provide educational support to children in grades 1-6 in their communities, and a control group. A Community Alliance Committee will support all phases of the research project.

“The Syrian refugee crises provides a relevant setting to implement this project,” says team member Lilian Ghandour, associate professor of epidemiology and applied biostatistics at American University of Beirut. “It is considered one of the worst humanitarian crises in recent history, with over 5 million Syrians having fled their country. In Lebanon, about 60% of Syrian refugees aged 15-24 years are not employed, not in school, and not attending any training. Although the study is based in Lebanon, the intervention and its findings will be equally relevant to emergency situations across the globe, including natural disasters, instances of community violence, and other crises.”

MAPs general director Dr. Fadi Al Halabi stated: “I believe that there is a pronounced need to empower young Syrian refugees to support their communities rather than just exploring their everyday hurdles in host countries. This project highlights the role of academia in promoting community-engaged research not only to enrich research findings but also to engage Syrian youth as active influencers and ambassadors of change”.

A project infographic and additional information about this research is available to view online.