Uptake of Mental Health Support by Ukrainian Refugees in Germany

Joint work with Alexandra Avdeenko (World Bank), Luc Behaghel (Paris School of Economics, INRAE), Esther Duflo (Massachussets Institute of Technology), Yagan Hazard (Collegio Alberto), Alexander Moldavski (ZI Mannheim), and Nicolas Rüsch (Ulm University).

We document a significant gap between the prevalence of mental health disorders and the receipt of mental health care among refugees, even though free, high-quality care is available.

We developed a comprehensive campaign and conducted two randomized controlled trials (RCTs) to determine effective strategies for capturing attention, conveying information, and debunking stigma. The campaign promoted a mental health hotline, established as part of the project, offering mental health orientation in the refugees' native language. We experimentally varied the message format and messenger (a simple text, a video featuring a relatable peer, or a video with celebrities), the inclusion of explicit prompts for peer-to-peer information sharing, and the option to receive a callback instead of initiating contact with the hotline.

The celebrity video did not result in higher uptake than the simple information text, while the patient video did. Offering the option to receive a callback did not facilitate uptake. Explicit prompts to share the videos with peers backfired, as refugees were less likely to share when encouraged to do so and exhibited reduced activity on the bot. Overall, peer-to-peer sharing was minimal. We identify a general trade-off between outreach and engagement: compared to selective recruitment, broader outreach on the web and social media attracted more refugees but resulted in fewer calls to the hotline.

The interventions and experiment are carried out in partnership with established institutions in Germany. Extensions to other countries may be possible at a later date.