# Psychosocial problems, daily functioning and help-seeking behaviour of international migrant workers in the Netherlands: A qualitative study to inform the adaptation of a scalable stepped-care intervention

## TL;DR

This study explores the challenges and help-seeking behaviors of international migrant workers in the Netherlands to adapt a mental health intervention for their specific needs.

## Contribution

The study provides a culturally adapted, scalable psychological intervention tailored to the unique context of international migrant workers in the Netherlands.

## Key findings

- International migrant workers face work, housing, and healthcare access issues, exacerbated by the pandemic.
- Stigma and fear of job loss hinder help-seeking behaviors among migrant workers.
- The intervention was adapted to be context-specific and offered remotely to better serve Polish migrant workers in the Netherlands.

## Abstract

International migrant workers (IMWs) may face insecure work and housing, limited access to healthcare and increased risk of psychological problems. Two scalable, evidence-based interventions to support individuals experiencing psychological distress are Doing What Matters in Times of Stress (DWM) and Problem Management Plus (PM+). This study aimed to explore IMWs’ problems, daily functioning and help-seeking behaviour, to inform cultural adaptation of the DWM/PM+ stepped-care intervention in the Netherlands. Following the Design, Implementation, Monitoring, and Evaluation (DIME) model, we conducted various qualitative interviews and a focus group discussion with IMWs (n = 30) and professionals (n = 18). Data were analysed thematically, and findings informed adaptations. Participants described problems related to work, housing, administration, finances, healthcare access and the COVID-19 pandemic. Daily routines focused on practical needs. Help-seeking was hindered by stigma, fear of job loss, low trust and reliance on informal or cross-border healthcare. Based on these results, the intervention was adapted to the needs of Polish IMWs in the Netherlands, regarding content and examples, which were tailored to their context; the intervention was offered remotely and collaboration with employers was avoided. These findings highlight the structural vulnerabilities of IMWs and demonstrate how qualitative insights can guide the cultural adaptation of a psychological intervention.