International Journal of Emergency Mental Health and Human Resilience
Open Access

Mental health, Mental health intervention, Community networks, Social problems, Community interventions, Community-based interventions.

Families, places of employment, institutions, schools, social services, and communities all have the capacity to support health. The World Health Organization stated that “state of complete physical, mental, and social well-being and not only the absence of disease or infirmity” was the definition of health in 1948. By enhancing social well-being and addressing structural determinants of mental health, multisector and community-based mental healthcare initiatives can assist alleviate health and social disparities (public policies and other upstream forces that influence the social determinants of mental health).

Three underlying presumptions underlie community interventions, according to a 2015 Cochrane review. The first is an understanding of the various dynamics that operate at all social-ecological levels (i.e., personal, interpersonal, institutional, community, and policy) and either support or hinder mental health. The second is spending money on community involvement to supply resources and inform actions while acknowledging knowledge outside the healthcare system. Prioritizing community mental health and social outcomes is the third (Barnes et al. 2008).

The recent advancements in community interventions to support mental health are the main focus of this review. Instead of offering a thorough, systematic review, we focus on the most significant events and trends. According to our review, community interventions include those that entail cross-sector collaboration, engage community members (such lay health workers) as active participants, and/or involve providing services in neighbourhood settings (e.g., schools, homes). We include both studies that cover a wider variety of outcomes, such as knowledge about mental health, quality of life, and social well-being, as well as interventions that are centred on traditional mental health outcomes (such as depression remission). We omit drug use interventions because they need to be reviewed separately (Ell et al 2009).

Multi-Sector Collaborative Care: The Chronic Care Model (CCM) of managing chronic diseases has historical roots in collaborative care approaches for mental health. In order to boost the capacity of healthcare settings to improve outcomes for people with chronic illnesses, the CCM envisaged a combination of health system reforms and community-based resources. Several studies on collaborative care, frequently for depression, have concentrated on adding various levels of mental health services to primary care settings. Other target demographics (like children) and environments (like obstetrics/gynecology practises, mental health clinics) can be modified. Studies have recognised the significance of community groups and social services, particularly when inequities play a significant influence in outcomes and call for interventions outside of the healthcare system, such as for communities with little resources and after natural disasters (Laxman et al. 2008).

Early Intervention Services for Psychosis: The RAISE Early Treatment Program/NAVIGATE and OnTrackNY are only two examples of the numerous and expanding body of research on integrated specialist care programmes for patients with early psychosis. Many early psychosis interventions summarised in a 2014 review by Nordentoft et al. adapted Assertive Community Treatment (ACT), an evidence-based service delivery paradigm that places an emphasis on outreach-based services, to our community intervention approach (Lund et al. 2010).

The 10-year follow-up results of the Danish OPUS study, a two-site RCT of a 2-year ACT-based aggressive early intervention, were published by Secher et al. A multidisciplinary team (10:1 patient-to-staff ratio, including a psychiatrist, psychologist, nurses, social workers, a vocational therapist, and a physiotherapist) provided services in the patients' homes, other community settings, or a clinic, depending on their preferences. It was believed that providing them with intensive care at this crucially early stage would have a lasting impact by teaching them how to control their psychotic diseases. When compared to services as usual, OPUS results at two years showed a number of significant advantages, including decreased positive and negative psychotic symptoms, decreased substance use, improved treatment adherence, lower dosages of antipsychotic medications, higher treatment satisfaction, and lessened family burden.

School-Based Interventions: Given the difficulties to receiving community mental health treatments, research demonstrates that kids, particularly those with limited resources, are most likely to receive mental healthcare in schools. The infrastructure of schools also enables the widespread application of preventative strategies. Nonetheless, experts advise taking into account policies, school culture and environment, and leadership structure while conducting interventions because of the variety of elements involved. With the special restrictions of the Family Educational Rights and Privacy Act and HIPAA, researchers may find it chalenging to gather academic results. Additionally, creating academic-community collaborations may take years in order to implement lasting interventions in schools that are truly responsive to kids' needs (Thase 2007).

There is proof that community interventions are effective across a wide range of social and ecological scales. Effective community interventions include parenting programmes to prevent child abuse, whole-school cognitive behavioural therapy prevention programmes, adapted ACT teams for populations with early psychosis and a history of involvement with the justice system, Housing First services, and multisector collaborative care and prevention services. Research show the significance of continued resources, training, and policy reform to improve healthcare-community collaborations and long-term outcomes.

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