The culturally and contextually sensitive assessment of mental health using a structured diagnostic interview (MINI Kid) for Syrian refugee children and adolescents in Lebanon: Challenges and solutions

Elevated rates of mental health difficulties are frequently reported in conflict-affected and displaced populations. Even with advances in improving the validity and reliability of measures, our knowledge of the performance of assessment tools is often limited by a lack of contextualisation to specific populations and socio-political settings.

This article reviews the challenges and shares lessons learned from the process of administering and supervising a structured clinical interview – the MINI International Neuropsychiatric Interview for Children and Adolescents. Five themes were identified:

1. practical and logistical challenges (changeable nature of daily life, competing demands, access to phones, temporary locations, limited referral options)
2. validity (lack of privacy, trust, perceptions of mental health, stigma, false positive answers)
3. cultural norms and meaning (impact of different meanings on answers)
4. contextual norms (reactive and adaptive emotional and behavioral responses to contextual stress);
5. co-morbidity and formulation (interconnected and complex presentations).

The findings suggest that while structured assessments have major advantages, cultural and contextual sensitivity during assessments are essential to help inform prevalence rates, treatment plans, and public health strategies.