The Role of Communities in Mental Health Care in Low- and Middle-Income Countries: A Meta-Review of Components and Competencies.

Journal: International journal of environmental research and public health

Volume: 15

Issue: 6

Year of Publication: 2019

Affiliated Institutions:  Division of Global Mental Health, Department of Psychiatry and Behavioral Sciences, The George Washington University, Washington, DC , USA. bkohrt@gwu.edu. Division of Epidemiology and Public Health, University of Nottingham, NG RD, UK. laura.asher@nottingham.ac.uk. Division of Global Mental Health, Department of Psychiatry and Behavioral Sciences, The George Washington University, Washington, DC , USA. abhardwa@alumni.unc.edu. Department of Psychiatry, University of Oxford, Warneford Lane, OX JD, UK. mina.fazel@psych.ox.ac.uk. Center for Global Mental Health, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London SE AF, UK. mark.jordans@kcl.ac.uk. Butabika National Mental Hospital, Kirombe-Butabika Road, P.O. Box Kampala, Uganda. byamamutamba@yahoo.com. Center for Global Mental Health, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London SE AF, UK. abhijit.nadkarni@kcl.ac.uk. Division of Global Mental Health, Department of Psychiatry and Behavioral Sciences, The George Washington University, Washington, DC , USA. gapedersen@gwu.edu. Department of Psychiatry, Sinai Health System & University of Toronto, Toronto, ON MG X, Canada. daisy.singla@utoronto.ca. Sangath, Socorro, Porvorim, Goa , India. vikram_patel@hms.harvard.edu.

Abstract summary 

Community-based mental health services are emphasized in the World Health Organization’s , the World Bank’s , and the Action Plan of the World Psychiatric Association. There is increasing evidence for effectiveness of mental health interventions delivered by non-specialists in community platforms in low- and middle-income countries (LMIC). However, the role of community components has yet to be summarized. Our objective was to map community interventions in LMIC, identify competencies for community-based providers, and highlight research gaps. Using a review-of-reviews strategy, we identified 23 reviews for the narrative synthesis. Motivations to employ community components included greater accessibility and acceptability compared to healthcare facilities, greater clinical effectiveness through ongoing contact and use of trusted local providers, family involvement, and economic benefits. Locations included homes, schools, and refugee camps, as well as technology-aided delivery. Activities included awareness raising, psychoeducation, skills training, rehabilitation, and psychological treatments. There was substantial variation in the degree to which community components were integrated with primary care services. Addressing gaps in current practice will require assuring collaboration with service users, utilizing implementation science methods, creating tools to facilitate community services and evaluate competencies of providers, and developing standardized reporting for community-based programs.

Authors & Co-authors:  Kohrt Brandon A BA Asher Laura L Bhardwaj Anvita A Fazel Mina M Jordans Mark J D MJD Mutamba Byamah B BB Nadkarni Abhijit A Pedersen Gloria A GA Singla Daisy R DR Patel Vikram V

Study Outcome 

Source Link: Visit source

Statistics
Citations :  Allen J., Balfour R., Bell R., Marmot M. Social determinants of mental health. Int. Rev. Psychiatry. 2014;26:392–407. doi: 10.3109/09540261.2014.928270.
Authors :  10
Identifiers
Doi : 1279
SSN : 1660-4601
Study Population
Male,Female
Mesh Terms
Clinical Competence
Other Terms
community;global health;low- and middle-income countries;mental disorders;meta-review;paraprofessionals;psychological treatments
Study Design
Narrative Study,Cross Sectional Study
Study Approach
Country of Study
Publication Country
Switzerland