Gender-Sensitive Peer Counselling Groups in Times of Conflict Reflections on a Self-Help Support Group in Berlin

  • Jinan Abi Jumaa Charité – Universitätsmedizin Berlin, Germany
  • Andreas Heinz Charité – Universitätsmedizin Berlin, Germany
Keywords: refugees, mental health, public health, peer support, self-help interventions, culture accessibility, self-management, stepped care collaborative model

Abstract

The arrival of stark number of forcibly displaced refugees in Germany since 2015 has led
to increased challenges in the mental health care system. The system was overburdened, and
therefore innovative approaches to health care for refugees were necessary in order to gain
knowledge about their expansion and admission to regular care. To increase knowledge of refugees
regarding mental health services and to provide practical support, a manual for peer-to-peer
counseling was developed at Charité University Medical Center Berlin and refugees were trained as
peer counsellors. This paper aims to give an overview of previous peer support interventions
published in literature and to also point out to the preliminary results from the intervention
conducted at the Charité. Good practices and recommendations for peer interventions are provided.
Qualitative interviews were conducted with the group participants, and results show that peer groups
helped refugees in sharing experiences, in giving ideas for possible solutions, in building
social/friendship networks, and in providing a safe place for discussions. The results of our study
suggest that integrating gender-sensitive peer support approaches in the mental health services for
refugees may benefit the public health by reducing both need and demand for these services.

References

Abi Jumaa, J., Kluge, U., Weigold, S., Heinz, E., & Mehran, N. (2019). Peer-to-Peer-Selbsthilfe-Interventionen

für Geflüchtete-eine Pilotstudie Peer-to-Peer Self-help Interventions for Refugees: A Pilot Study. Fortschritte

Der Neurologie Psychiatrie, 88(02), 89– 94. https://doi.org/10.1055/a-1011-4232

Ayoughi, S., Missmahl, I., Weierstall, R., & Elbert, T. (2012). Provision of mental health services in resourcepoor settings: A randomised trial comparing counselling with routine medical treatment in North Afghanistan

(Mazar-e-Sharif). BMC Psychiatry, 12(1), 14. https://doi.org/10.1186/1471-244X-12-14

Bajbouj, M., Alabdullah, J., Ahmad, S., Schidem, S., Zellmann, H., Schneider, F., & Heuser, I. (2018).

Psychosocial care of refugees in Germany: Insights from the emergency relief and development aid. In

Nervenarzt (Vol. 89, Issue 1). Springer Verlag. https://doi.org/10.1007/s00115-017-0326-y

Behnia, B. (2003). Refugees’ convoy of social support: Community peer groups and mental health services.

International Journal of Mental Health, 32(4), 6–19. https://doi.org/10.1080/00207411.2003.11449595

Behnia, B. (2007). An exploratory study of befriending programs with refugees: The perspective of volunteer

organizations. Journal of Immigrant and Refugee Studies, 5(3), 1–19. https://doi.org/10.1300/J500v05n03_01

Berger, R., Pat-Horenczyk, R., & Gelkopf, M. (2007). School-based intervention for prevention and treatment of

elementary-students’ terror-related distress in Israel: A quasi-randomized controlled trial. Journal of Traumatic

Stress, 20(4), 541–551. https://doi.org/10.1002/jts.20225

Block, A. M., Aizenman, L., Saad, A., Harrison, S., Sloan, A., Vecchio, S., & Wilson, V. (2018). Peer Support

Groups: Evaluating a Culturally Grounded, Strengths-Based Approach for Work With Refugees. Advances in

Social Work, 18(3), 930–948. https://doi.org/10.18060/21634

Böge, K., Karnouk, C., Hahn, E., Schneider, F., Habel, U., Banaschewski, T., Meyer-Lindenberg, A., Salize, H.

J., Kamp-Becker, I., Padberg, F., Hasan, A., Falkai, P., Rapp, M. A., Plener, P. L., Stamm, T., Elnahrawy, N.,

Lieb, K., Heinz, A., & Bajbouj, M. (2019). Mental health in refugees and asylum seekers (MEHIRA): study

design and methodology of a prospective multicentre randomized controlled trail investigating the effects of a

stepped and collaborative care model. European Archives of Psychiatry and Clinical Neuroscience, 270(1), 95–

https://doi.org/10.1007/s00406-019-00991-5

Bozorgmehr, K., & Razum, O. (2015). Effect of restricting access to health care on health expenditures among

asylum-seekers and refugees: A quasi-experimental study in Germany, 1994-2013. PLoS ONE, 10(7).

https://doi.org/10.1371/journal.pone.0131483

Chinman, M., George, P., Dougherty, R. H., Daniels, A. S., Ghose, S. S., Swift, A., & Delphin-Rittmon, M. E.

(2014). Peer Support Services for Individuals With Serious Mental Illnesses: Assessing the Evidence.

Psychiatric Services, 65(4), 429–441. https://doi.org/10.1176/appi.ps.201300244

Chuah, F. L. H., Tan, S. T., Yeo, J., & Legido-Quigley, H. (2018). The health needs and access barriers among

refugees and asylum-seekers in Malaysia: A qualitative study. International Journal for Equity in Health, 17(1),

https://doi.org/10.1186/s12939-018-0833-x

Cofrancisco, K. (2016). Cities and refugees: The German experience.

https://www.brookings.edu/research/cities-and-refugees-the-german-experience/

Demir, S. (2015). Beratung nach Flucht und Migration. Ein Handbuch zur psychologischen Erstbetreuung von

Geflüchteten (R. Mewes & H. Reich (Eds.)). WeltTrends.

Dennis, C. L. (2003a). Peer support within a health care context: A concept analysis. International Journal of

Nursing Studies. https://doi.org/10.1016/S0020-7489(02)00092-5

Dennis, C. L. (2003b). Peer support within a health care context: A concept analysis. International Journal of

Nursing Studies, 40(3), 321–332. https://doi.org/10.1016/S0020-7489(02)00092-5

Flegg, M., Gordon-Walker, M., & Maguire, S. (2015). Peer-to-peer mental health: a community evaluation case

study. Journal of Mental Health Training, Education and Practice, 10(5), 282–293.

https://doi.org/10.1108/JMHTEP-04-2015-0019

Golchert, J., Roehr, S., Berg, F., Grochtdreis, T., Hoffmann, R., Jung, F., Nagl, M., Plexnies, A., Renner, A.,

König, H. H., Kersting, A., & Riedel-Heller, S. G. (2019). HELP@APP: Development and evaluation of a selfhelp app for traumatized Syrian refugees in Germany- A study protocol of a randomized controlled trial. BMC

Psychiatry, 19(1), 1–12. https://doi.org/10.1186/s12888-019-2110-y

Hsieh, H. F., & Shannon, S. E. (2005). Three approaches to qualitative content analysis. Qualitative Health

Research, 15(9), 1277–1288. https://doi.org/10.1177/1049732305276687

Im, H., & Rosenberg, R. (2016). Building Social Capital Through a Peer-Led Community Health Workshop: A

Pilot with the Bhutanese Refugee Community. Journal of Community Health, 41(3), 509–517.

https://doi.org/10.1007/s10900-015-0124-z

Inter-Agency Standing Committee (IASC). (2007). Iasc Guidelines on Mental Health and Psychosocial support

in Emergency settings. http://www.humanitarianinfo.org/iasc/content/products

Kleinman, A., & Benson, P. (2006). Anthropology in the Clinic: The Problem of Cultural Competency and How

to Fix It. PLoS Medicine, 3(10), e294. https://doi.org/10.1371/journal.pmed.0030294

Kluge, U. (2020). Mental Health in Times of Increasing Flight and Migration - A German Perspective. In Health

in Diversity – Diversity in Health (pp. 13–23). Springer Fachmedien Wiesbaden. https://doi.org/10.1007/978-3-

-29177-8_2

Laban, C. J., Gernaat, H. B. P. E., Komproe, I. H., Schreuders, B. A., & De Jong, J. T. V. M. (2004). Impact of a

Long Asylum Procedure on the Prevalence of Psychiatric Disorders in Iraqi Asylum Seekers in The

Netherlands. https://doi.org/10.1097/01.nmd.0000146739.26187.15

Lakey, B., & Cohen, S. (2000). Social Support Theory and Measurement.

https://doi.org/10.1093/med:psych/9780195126709.003.0002

Lawn, S., Smith, A., & Hunter, K. (2008). Mental health peer support for hospital avoidance and early

discharge: An Australian example of consumer driven and operated service. Journal of Mental Health, 17(5),

–508. https://doi.org/10.1080/09638230701530242

Stewart, M., Simich, L., Beiser, M., Makumbe, K., Makwarimba, E., & Shizha, E. (2011). Impacts of a social

support intervention for Somali and Sudanese refugees in Canada. Ethnicity and Inequalities in Health and

Social Care, 4(4), 186–199. https://doi.org/10.1108/17570981111250840

Stewart, M., Simich, L., Shizha, E., Makumbe, K., & Makwarimba, E. (2012). Supporting African refugees in

Canada: Insights from a support intervention. Health and Social Care in the Community, 20(5), 516–527.

https://doi.org/10.1111/j.1365-2524.2012.01069.x

Tol, W. A., Leku, M. R., Lakin, D. P., Carswell, K., Augustinavicius, J., Adaku, A., Au, T. M., Brown, F. L.,

Bryant, R. A., Garcia-Moreno, C., Musci, R. J., Ventevogel, P., White, R. G., & van Ommeren, M. (2020).

Guided self-help to reduce psychological distress in South Sudanese female refugees in Uganda: a cluster

randomised trial. The Lancet Global Health, 8(2), e254–e263. https://doi.org/10.1016/S2214-109X(19)30504-2

Trilesnik, B., Altunoz, U., Wesolowski, J., Eckhoff, L., Ozkan, I., Loos, K., Penteker, G., & Graef-Calliess, I. T.

(2019). Implementing a Need-Adapted Stepped-Care Model for Mental Health of Refugees: Preliminary Data of

the State-Funded Project “RefuKey.” Frontiers in Psychiatry, 10(SEP), 688.

https://doi.org/10.3389/fpsyt.2019.00688

Webel, A. R., Okonsky, J., Trompeta, J., & Holzerner, W. L. (2010). A systematic review of the effectiveness of

peer-based interventions on health-related behaviors in adults. American Journal of Public Health, 100(2), 247–

https://doi.org/10.2105/AJPH.2008.149419

Wöller, W. (2016). Trauma-informierte Peer-Beratung in der Versorgung von Flüchtlingen mit

Traumafolgestörungen. PPmP Psychotherapie Psychosomatik Medizinische Psychologie, 66(9–10), 349–355.

https://doi.org/10.1055/s-0042-114992

Wollersheim, D., Koh, L., Walker, R., & Liamputtong, P. (2017). (PDF) Happy, just talking, talking, talking:

Community strengthening through mobile phone based peer support among refugee women in Melbourne,

Australia. The Journal of Community Informatics.

https://www.researchgate.net/publication/316452114_Happy_just_talking_talking_talking_Community_strengt

hening_through_mobile_phone_based_peer_support_among_refugee_women_in_Melbourne_Australia

World Health Organisation. (2015). WHO global strategy on people-centred and integrated health services

Interim Report.

https://apps.who.int/iris/bitstream/handle/10665/155002/WHO_HIS_SDS_2015.6_eng.pdf?sequence=1

World Health Organization. (2004). Prevention of Mental Disorders.

https://apps.who.int/iris/bitstream/handle/10665/43027/924159215X_eng.pdf?sequence=1&isAllowed=y

World Health Organization. (2018). Mental health promotion and mental health care in refugees and migrants.

http://www.euro.who.int/__data/assets/pdf_file/0004/386563/mental-health-eng.pdf?ua=1

World Health Organization. (2020). Refugee and migrant health. WHO; World Health Organization.

https://www.who.int/migrants/en/

Zellmann, H. (2017). Low-threshold psychosocial support for refugees and asylum seekers – a project guide.

https://www.gewaltschutz-gu.de/e5119/e5660/final-version-project-guide-msf-germany.pdf

Published
2020-07-30
How to Cite
Jumaa, J. A., & Heinz, A. (2020). Gender-Sensitive Peer Counselling Groups in Times of Conflict Reflections on a Self-Help Support Group in Berlin. Proceedings of the International Conference on Future of Women, 3(1), 12-24. https://doi.org/10.17501/26028646.2020.3102