The world has more people fleeing war, violence, and persecution than ever before, and mental health problems for those fleeing is widespread. Research shows that refugees and migrants do not get access to the help they need due to barriers linked to language, stigma around mental illness, lack of access to effective tools for assessment and treatment, and aggravating circumstances within the healthcare system.
The SAHA-project
The SAHA (Arabic for “health”) research project started in 2018 as a collaboration between Linköping University, Karolinska Institutet, Mid Sweden University, Stockholm University, and Trinity College Dublin, with funding from the Swedish Research Council and FORTE. The project aimed to develop and evaluate digital interventions for the assessment and treatment of refugees and migrants who speak Arabic or Dari/Farsi, with a focus on children, adolescents, and young adults, as well as to investigate opportunities and obstacles for making the interventions available in regular healthcare. An important part of the project has been the cultural adaptation of treatment materials into Arabic and Dari/Farsi. The project was formally completed in 2025, but the collaboration between the Universities has continued.
Digital screening och assessment
In this mixed methods project, we developed and evaluated an adaptive digital screening tool, the i-TAP, designed to identify depression, anxiety, PTSD, and insomnia among individuals with a refugee background. The i-TAP (internet-based tiered assessment procedure) has been evaluated in Arabic, Dari, Farsi, Swedish and English. Three studies were conducted with the respective purposes to: 1) psychometrically develop the i-TAP, 2) evaluate its criterion validity, and 3) evaluate the content validity and acceptability of the i-TAP. The findings from these studies indicate that the i-TAP is a valid, efficient, acceptable, and feasible screening tool for common psychiatric disorders among individuals with a refugee background. The digital, adaptive, multi-symptom, and multi-language format would be beneficial to combine with tailored interventions, and could facilitate early assessment and improve access to mental health services for this population.
Culturally adapted internet-based treatment
Raha is a culturally adapted internet-based cognitive behavioral therapy intervention targeting Arabic and Dari/Farsi-speaking youth and young adults with migration and refuge experiences suffering from mild to moderate mental health problems. The cultural adaptation was influenced by the Ecological Validity framework and followed the Reporting of Cultural Adaptation in Psychological Trials (RECAPT) criteria.
A first pilot study in Dari/Farsi was conducted in 2021 and the results were published in Internet Interventions the following year. The manuscript for a second pilot study in Dari/Farsi, with adjustments in content and structure based on lessons learned from the first pilot study on the target group is in preparation.
The results of the first pilot study targeting Arabic-speaking refugees has been published in JMIR Formative Research and the results of a randomized clinical trial was published in the Journal of Behavioral and Cognitive Therapy in 2026. The conceptualization of mental distress among Arabic-speaking refugee youth and young adults will be communicated in another manuscript.
Results from the pilot studies and randomized trials show that culturally adapted guided ICBT is potentially effective in the treatment of common mental health problems for both Arabic and Dari/Farsi speaking migrants and refugees.
iComet in Arabic and Farsi/Dari
The parenting program iComet, with a focus on strengthening positive relationships, communication and conflict management, has been translated from Swedish into Arabic and Farsi/Dari. To focus has been on providing support for parents with an immigrant background, with children aged 3-11 years. Pilot studies are being conducted on both language versions where participants complete the modules with the support of a family guide and participate in subsequent interviews about the program. Two interview studues (Masters’ theses) have been completed so far with Farsi-speaking and Arabic-speaking participants, respectively, focusing on program acceptance and cultural adaptation.
Stakeholder analysis and networking activities
A national online survey conducted within the project examined Swedish psychologists’ use of digital solutions for migrants and refugees with mental health problems. The results indicate limited use of such solutions, low levels of knowledge about digital assessment and treatment, and a general view that digital interventions should be adapted to the needs of migrants and refugees and primarily offered within primary care. Using thematic analysis and implementation frameworks, the research team has also analyzed psychologists’ experiences of barriers and facilitators for implementing digital interventions in Swedish healthcare.
The findings have been disseminated through several scientific conferences, and one article has been published in JMIR Human Factors. An additional scientific manuscript is currently in preparation. Beyond academic publications, the project has contributed to national and international dialogue on digital mental health for refugees and migrants through participation in professional networks and stakeholder forums. This includes presentations at the 2nd Nordic MHPSS Conference, the MHPSS Momentum Conference, the Swedish Ministry for Foreign Affairs’ stakeholder network for global health, and an online webinar arranged by the eMental Health International Collaborative (eMHIC).
