The Problem Management Plus psychosocial intervention for distressed and functionally impaired asylum seekers and refugees: the PROSPER feasibility RCT

Asylum seekers and refugees often experience emotional distress, but they may find it hard to get the health and social care they need. Problem Management Plus (PM+) is an intervention designed to help people that is delivered by others (known as lay therapists) in similar situations, and it has been shown to help distressed people living in difficult circumstances. The aim of the PROSPER study was to find out if it is possible to conduct a trial of PM+ for distressed asylum seekers and refugees in the UK.
Using evidence from published research and from conversations with local experts, we aimed to modify PM+ to meet the needs of distressed asylum seekers and refugees living in Merseyside. We also aimed to train people with experience of the asylum process to deliver PM+. We designed a small-scale preliminary trial (a pilot trial) of five 90-minute sessions of PM+, comparing individual and group
sessions with usual treatment. We set out to recruit 105 people to take part in this pilot trial. The main outcomes were symptoms of anxiety and depression, which were to be measured at 3 and 6 months after recruitment into the trial.
We found that PM+ could be modified to meet the needs of asylum seekers and refugees living in Merseyside. We successfully trained 12 people with lived experience of the asylum process as lay therapists to deliver PM+. However, the pilot trial was cut short by the COVID-19 pandemic and we were able to involve only 11 people in it. We gathered information on how to involve people in the
trial, on how PM+ was delivered, and on how acceptable the study measures were.
Although we were unable to complete the pilot trial as planned, our findings offer guidance for future studies into mental health care provided by lay therapists for distressed asylum seekers and refugees.