Maximising meaningful and impactful mental-health research for Syrian refugees during Covid-19: Co-creation, local relevance and ethical practice. (English)

From the Field was implemented between April and September 2020, to explore the impact of Covid-19 on the lives and livelihoods of Syrians living in Lebanon, Iraqi Kurdistan, Jordan, Syria and Turkey, using bespoke remote ethnographic approaches. Local researchers helped to navigate Syrian idioms of distress, interrogating the applicability of the proposed standardised measures, providing qualitative feedback on their own experience of the research process, to enable the development of a co-create survey questionnaires that were deployed to 100 Syrian refugees in the region using accessible technologies. Data was collected on the mental health of respondents who were facing enormous pressures and diminishing support in their day-to-day lives, exploring the linkages between their psychological wellbeing and food security, a key concern of local populations. The disseminated surveys included the Short Warwick-Edinburgh Mental Well-Being Scale (Clarke, et al., 2011) and the Food Security Coping Strategies Index (Maxwell, Watkins, Wheeler & Collins, 2003) adapted for the context. The project was underpinned by the Global Research Ethics Toolkit (https://www.ethical-global-research.ed.ac.uk/) offering a flexible frame of reference to promote contextual ethical reflection and accountability. The study suggests that culturally attuned locally driven mental health research is essential to a accurate conceptualisation of mental health conditions, to understanding the prevalence of common mental health conditions and interpreting responses properly.

• Mental health research for displaced Syrians must ensure measures are fit-for-purpose in the sociocultural context in which they are used, and diagnostic tools and interventions should integrate an appreciation of the daily stressors people face.
• Invest in the capacity of local mental health researchers and support the development of systems so they can safely undertake research with those experiencing mental health distress.