Serving the underserved: A holistic and low-threshold approach to promote quality of life among refugees in Switzerland

Author(s) : Rilana Tanja Stöckli

Source : https://boristheses.unibe.ch/6640/

Abstract:

Refugees face complex mental health challenges shaped by pre-migration trauma, post-migration stressors, and significant barriers to accessing care. Despite the high prevalence of psychological distress, culturally sensitive and accessible mental health support remains limited. While face-to-face therapy is vital, alternative approaches, such as digital mental health interventions, offer promising solutions to overcome structural and socio-cultural barriers. This dissertation aims to advance the understanding and development of holistic, scalable, and culturally sensitive mental healthcare for refugees in Switzerland. It introduces a multi-levelled framework for mental health support and describes the development, cultural adaptation, and evaluation of two digital mental health interventions: the Sui SRK app, a holistic psychosocial support tool to enhance quality of life for Arabic-speaking refugees, and a grief support app specifically for Syrian refugees. Findings from the participatory cultural adaptation process of the Sui SRK and the grief app provide valuable insights into refugees’ needs, preferred formats and key cultural and contextual considerations for user-centred app development. Results from a mixed-methods randomised controlled trial of the Sui SRK app indicate high user satisfaction but no significant improvements in quality of life or mental health outcomes, highlighting the challenges of digital intervention efficacy. Based on these findings, the dissertation discusses the need for interdisciplinary integration, examines the potential mechanisms of change and iterative cultural adaptation, and outlines the strengths and limitations. It then offers recommendations for future research on digital mental health interventions for refugees. Finally, it concludes with reflections on the broader implications for refugee mental healthcare in Switzerland and the potential for scaling culturally sensitive digital interventions within existing support systems.