International Journal of Environmental Research and Public Health
Volume 15, Issue 6, 2018

The role of communities in mental health care in low-and middle-income countries: A meta-review of components and competencies (Review) (Open Access)

Kohrt B.A.* , Asher L. , Bhardwaj A. , Fazel M. , Jordans M.J.D. , Mutamba B.B. , Nadkarni A. , Pedersen G.A. , Singla D.R. , Patel V.
  • a Division of Global Mental Health, Department of Psychiatry and Behavioral Sciences, The George Washington University, Washington, DC 20037, United States
  • b Division of Epidemiology and Public Health, University of NottinghamNG7 2RD, United Kingdom
  • c Division of Global Mental Health, Department of Psychiatry and Behavioral Sciences, The George Washington University, Washington, DC 20037, United States
  • d Department of Psychiatry, University of Oxford, Warneford LaneOX1 2JD, United Kingdom
  • e Center for Global Mental Health, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, SE5 8AF, United Kingdom, War Child, Research and Development, Amsterdam, 1098 LE, Netherlands
  • f Butabika National Mental Hospital, 2 Kirombe-Butabika Road, P.O. Box 7017, Kampala, Uganda, YouBelong, P.O. Box 36510, Kampala, Uganda
  • g Center for Global Mental Health, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, SE5 8AF, United Kingdom, Sangath, Socorro, Porvorim, Goa 403501, India
  • h Division of Global Mental Health, Department of Psychiatry and Behavioral Sciences, The George Washington University, Washington, DC 20037, United States
  • i Department of Psychiatry, Sinai Health System, University of Toronto, Toronto, ON M5G 1X5, Canada
  • j Sangath, Socorro, Porvorim, Goa 403501, India, Department of Global Health and Social Medicine, Harvard Medical School, Harvard University, Boston, MA 02115, United States, Harvard T. H. Chan School of Public Health, Harvard University, Boston, MA 02115, United States

Abstract

Community-based mental health services are emphasized in the World Health Organization’s Mental Health Action Plan, the World Bank’s Disease Control Priorities, 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. © 2018 by the authors. Licensee MDPI, Basel, Switzerland.

Author Keywords

Mental disorders Global health Meta-review Paraprofessionals Psychological treatments low-and middle-income countries Community

Index Keywords

home mental health service psychoeducation community care developing country clinical effectiveness mental health Developing Countries human middle income country economic aspect Clinical Competence mental health care psychotherapy local participation Humans family psychology health services research Review refugee camp developing world school health services Community Mental Health Services health care utilization awareness health care access global health low income country low income population skill rehabilitation care primary health care
Link
https://www.scopus.com/inward/record.uri?eid=2-s2.0-85048666392&doi=10.3390%2fijerph15061279&partnerID=40&md5=428a53c98a5241556919f67ca4d71467
DOI: 10.3390/ijerph15061279
ISSN: 16617827
Cited by: 12
Original Language: English