From Experience to Support – PEIL-FORSK: Can People with Migration and Refugee Backgrounds Help Each Other Improve Mental Health?
Intro:
How can refugees access mental health support that is both relevant and available? In Bergen and Fredrikstad, a new program is being tested where people with migration experience help others in similar situations. The initiative is accompanied by research aimed at understanding how the program works in a Norwegian context.
Refugees Helping Refugees: PM+ Strengthens Mental Health and Eases Pressure on Services
Norway has received a record number of refugees in recent years, which has increased the strain on its healthcare system. To meet the mental health needs of newly arrived refugees, the municipalities of Bergen and Fredrikstad are piloting the Problem Management Plus (PM+) program, developed by the World Health Organization (WHO).
PM+ is based on simple techniques from cognitive behavioral therapy and is designed for people in crisis. What makes the program unique is that individuals with refugee and migration backgrounds are trained to support others with similar experiences—under close supervision from health professionals. This creates a space where helpers and participants meet as equals, and lived experience becomes a resource.
Demand has been high, and PM+ has also been tested in group format to reduce waiting lists in municipal services. Early experiences suggest that PM+ may help strengthen refugees’ mental health while also relieving pressure on the Norwegian healthcare system.
Research as a Foundation for Development
Research is an integral part of the project. Since March 2024, a PhD candidate has been evaluating how PM+ works in a Norwegian context—both to improve the program and to assess its suitability for the target groups. To date, approximately 50 refugees from various countries have initiated or completed the PM+ intervention, with assessments of their mental health and coping skills conducted both before and after the program. Interviews have also been carried out with helpers and their supervisors to better understand how the program can be further improved.
Data analysis is ongoing, and a scientific article is currently being drafted. Once results are available, they may provide valuable insight into whether and how PM+ works in a Norwegian setting, and whether the program has potential to be part of long-term strategies for addressing mental health challenges among refugees.
The Road Ahead
The project has already created ripple effects. Services such as Ny Sjanse (NAV) and Bergen Learning Centre have begun their own trials, and several municipalities near the pilot areas have shown interest. Some of the trained helpers have secured permanent positions within the municipality—an important step from pilot to lasting service.
PM+ has been presented both nationally and internationally, including at the Alrek Health Days and other conferences. If implementation proves successful, PM+ could become a valuable tool for making health services more accessible and sustainable.
The project also aligns with national guidelines for mental health and substance use services for adults, as well as for work with refugees, family reunification cases, and asylum seekers. These guidelines emphasize the need for accessible, tailored, and evidence-based services—something PM+ may contribute to, if further evaluation shows promising results.
På grunn av demografiske endringer og budsjettutfordringer er det behov for nye løsninger i dagens velferds-og omsorgstjenester. Forskning viser at flyktninger med psykososiale vansker kan få god hjelp av ufaglærte hjelpere med lik kulturell bakgrunn. Senter for Migrasjonshelse (SEMI) har erfart at rollen som ufaglært hjelper er givende for hjelperne, og treffer klientenes behov. Rollen kan imidlertid være belastende over tid. Hjelpere og ansatte ved SEMI har derfor opplevd et behov for å sikre at hjelperne får den nødvendige struktur og oppfølging de trenger. Gjennom intervensjonen Program Management+ (PM+) utviklet av Verdens helseorganisasjon brukes kompetansen til ufaglærte hjelpere med fluktbakgrunn til å hjelpe andre flyktninger under veiledning av faglærte veiledere. Program management plus (PM+) er en manualbasert seks ukers lav-terskel intervensjon som har som mål å øke klienters problemløsningsevne og autonomi og foregår over en avgrenset tidsperiode. SEMI gjennomførte, med assistanse fra UiB, i 2021-22 et pilotprosjekt for å tilpasse og implementere PM+ i norsk kontekst med fokus på den Østafrikanske flyktninggruppe, med støtte fra Inkluderings- og Mangfoldsdirektoratet (IMDi). Erfaring fra pilot prosjekt var positiv. Neste steg var å skalere til andre kommuner med annerledes organisering og det ble inngått samarbeid med Fredrikstad kommune. Gjennom forskningssamarbeid med UiB, tar prosjektet sikte på å undersøke gjennomførbarhet, nytte og gevinster av PM+ som en lavintensitets, skalerbar psykologisk intervensjon for ulike grupper av flyktninger i norsk kontekst. Ulike faggrupper og flyktninger i kommunene skal delta i prosjektet. Prosjektet skal registrere gjennomførbarhetsrate og effekter på klientenes psykososiale fungering ved bruk av standardiserte spørreskjema. Gjennom fokusgruppeintervjuer og individuelle intervjuer vil vi for hvert halvår over to år kartlegge hvilken effekt PM+ har på hjelpernes identitet, livsmestring og psykisk helse.
