Internet Explorer is no longer supported by Microsoft. To browse the NIHR site please use a modern, secure browser like Google Chrome, Mozilla Firefox, or Microsoft Edge.

Routes to Wellness: a person centred approach to research

routes to wellness participant drawing

Routes to Wellness is an NIHR-funded project which aims to co-design a peer support model for improving the mental health and wellbeing of refugees. The study is working collaboratively with refugees, researchers, and service providers to create a shared language about mental health, which will help refugees to identify health goals and access support.

Published: 16 January 2024

The study

The Routes to Wellness project emerged as a result of workshops which emphasised the critical need for mental health interventions in the refugee and asylum seeker community. Researchers Debra Westlake, Kristin Liabo, and Helen Lloyd from the NIHR Applied Research Collaboration South West Peninsula, met with refugees and service providers to co-design a study on the topic. 

The study uses qualitative methods such as interviews, observations, and focus groups with both refugees and professionals to identify key issues known as emotional ‘touchpoints’. These touchpoints are used to help shape the peer support model in collaboration with participants over a series of workshops. 

Prior to gaining  ethics approval for the study, the team focused on establishing human connections with refugees and asylum seekers, participating in community activities, and fostering casual conversations. By immersing themselves in activities with the group, the team were able to invest in building relationships with the refugees they met, establishing a level of trust. 

“We were lucky because normally a lot of researchers are restricted by time,” says Hoayda Darkal, a Research Fellow from the School of Psychology at the University of Plymouth,  “but because our ethics process took a little bit of time, we had this window to actually invest in building trust and a relationship. We weren’t just parachuting into their lives as researchers.” 

An inclusive approach

This investment in creating  strong relationships with the group proved invaluable, and the team allocated resources to maintain these connections throughout the project. This included having interpreters at each session to ensure participants were able to express themselves adequately, as well as regular communication via WhatsApp and email. 

As part of the study, the group held a series of workshops, aiming to get people together from different  services and backgrounds, with different languages and experiences. Participants were actively engaged in these workshops, and also helped in planning and facilitating a celebration event to mark the conclusion of the second phase of the study. 

“The number one mistake a lot of studies make is to categorise refugees as one community,” says Hoayda. “ We forget that they all come from different cultures from all around the world, with different life stories. We want to reflect that because that’s the essence of our project; the person-centred care, person-centred research approach.” 

Making a difference

The researchers on the study felt personally motivated to take a person-centred approach to their research. Wen-Yu Wu, also a Research Fellow from the School of Psychology,  had previous experience of working in research methodology prior to working on the project. “[in my previous role] It wasn’t a collaborative approach,” she said, “I’d still meet participants, but the process was not involved or shaped mutually.”

She quickly found that working closely with participants and using a co-production approach brought out key factors that may have been left out otherwise: “During the workshops there was a theme around asylum seekers being unable to work and how that impacts on their mental health. That was conveyed to us very strongly during the first two workshops and if we did it without these co-produced methods, I think that could’ve been left out. It’s very hard to talk about policy-level things when you talk about mental health on an individual interaction level.” 

Hoayda, who came to the UK from Syria to study, also believes co-production is vital in research: “I felt hurt that people and academics in research or literature often talk about refugees as participants, or numbers, as a phenomenon we’re studying. So when I came across this project, I was so excited that we were seeing the person as part of the project and as part of the solution.”

What’s next?

While the project’s main aim is to design a model for peer support workers, the group are finding that as the study progresses they are discovering new ways to support people. 

Following feedback received from the sessions, they are now exploring additional training modules covering trauma, person-centred practices, cultural humility, and cultural competency. 

“People are feeling more empowered and equipped to help others,” says Hoayda, “I think if these things help someone to feel confident applying for a job or something else, that’s a huge thing. It’s also important for services to be engaged in our workshops and hear people’s experiences and ways of thinking.” 

Nafisa, a Libyan refugee, has been a participant in the study since its inception. She initially found it difficult to open up to the group about her experiences, but now hopes to use her skills to help other people in the same situation. “I can say anything about my life, or what I used to do, or about my mental health, it’s a very good group,” she says, “I want to do more  projects in the future so I can help people if they need it when they come to the UK for the first time.”

Latest case studies