In their cluster randomised controlled trial of guided self-help to reduce psychological distress in female Sudanese refugees in The Lancet Global Health, Wietse A Tol and colleagues have taken global mental health to a new and hopeful place. The intervention of guided self-help was delivered in exacting conditions in a refugee settlement to women who had high exposure to trauma, and where mental health specialists are scarce. No psychiatric diagnosis was required to receive the intervention, and women did not need to disclose exposure to sensitive traumatic experiences. The only inclusion criterion was that women reported at least moderate levels of psychological distress. The premise of the intervention was that existing coping strategies could be helpfully and appropriately supported to alleviate symptoms of mental ill health. The findings indicate that this was a successful approach, with women in the intervention group having reduced levels of distress, fewer symptoms of depression and post-traumatic stress, improvement in functioning, and improvement in overall wellbeing. In summary, guided self-help is a low-intensity psychosocial intervention that minimises risk of stigma, focuses on positive mental health, and is effective. The question now is how can this promising and potentially scalable intervention be transitioned to make real-world impact? We discuss four considerations for scale-up.

中文翻译：

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引导式自助减轻心理困扰：扩大规模的潜力是什么？

在《柳叶刀全球卫生》杂志中进行的有针对性的自助服务以减轻苏丹女难民心理困扰的随机对照试验，Wietse A Tol及其同事将全球心理健康推向了新的希望之地。在难民定居点的严格条件下，有针对性的自助干预措施是向遭受高创伤且精神病专家匮乏的妇女提供的。接受干预无需任何精神病学诊断，并且妇女无需透露暴露于敏感的创伤经历中。唯一的纳入标准是妇女报告的心理困扰至少处于中等水平。干预的前提是现有的应对策略可以得到帮助和适当的支持，以减轻精神疾病的症状。调查结果表明，这是一种成功的方法，干预组中的妇女苦恼程度有所降低，抑郁症和创伤后应激症状减少，功能改善，整体健康状况得到改善。总之，引导式自助是一种低强度的社会心理干预措施，可以最大程度地减少污名化的风险，专注于积极的心理健康，并且有效。现在的问题是，该有前途且具有潜在可扩展性的干预措施如何过渡以产生现实影响？我们讨论了扩大规模的四个注意事项。