Interventions to increase help-seeking for mental health care in low- and middle-income countries: A systematic review.
Interventions to increase help-seeking for mental health care in low- and middle-income countries: A systematic review.
复制标题
DOI：
10.1371/journal.pgph.0002302
复制
发表时间：
2023
期刊：
影响因子：
--
通讯作者：
中科院分区：
文献类型：
--
作者：
心理健康问题是全世界发病率的一个重要和日益增长的原因。尽管有循证干预措施，但大多数有精神健康问题的人仍然得不到治疗。这种治疗差距在低收入和中等收入国家尤其大，这是由于供应方和需求方的障碍。本系统综述的目的是识别和综合有关干预措施的证据，以改善中低收入国家心理健康问题的求助。该方案已事先注册（注册号：CRD 42021255635）。我们使用基于三个概念的术语搜索了八个数据库：“心理健康/疾病”和“寻求帮助”和“LMIC”;包括所有年龄组和心理健康问题。42篇论文合格并纳入本综述。根据求助过程中的步骤，干预内容分为三类：（1）提高普通人群的心理健康意识（例如，印刷或视听材料的分发），（2）识别有精神健康问题的个人（例如，社区一级的筛查或检测），以及（3）促进需要精神卫生保健的人寻求帮助（例如，发送提醒）。大多数干预措施（80%）包括上述类别的组合。大多数研究报告了积极的结果，但关于有效性的结果好坏参半，有一个明显的趋势，即有利于干预措施的组成部分来自一个以上的类别。在42项研究中，有10项（24%）对求助的干预产生了统计学上的显著影响;所有研究都针对上述类别的组合（即，提高认识、查明和促进寻求帮助）。只有6项研究（14%）关注儿童和青少年。由于在中低收入国家进行的稳健研究数量有限，以及研究设计、结果和所用组成部分的异质性，无法就个别策略或干预措施内容的影响得出明确结论。
Mental health problems are a significant and growing cause of morbidity worldwide. Despite the availability of evidence-based interventions, most people experiencing mental health problems remain untreated. This treatment gap is particularly large in low- and middle-income countries (LMIC) and is due to both supply-side and demand-side barriers. The aim of this systematic review is to identify and synthesise the evidence on interventions to improve help-seeking for mental health problems in LMICs. The protocol was registered a priori (Registration number: CRD42021255635). We searched eight databases using terms based on three concepts: ‘mental health/illness’ AND ‘help-seeking’ AND ‘LMICs’; and included all age groups and mental health problems. Forty-two papers were eligible and included in this review. Intervention components were grouped into three categories following the steps in the help-seeking process: (1) raising mental health awareness among the general population (e.g., distribution of printed or audio-visual materials), (2) identification of individuals experiencing mental health problems (e.g., community-level screening or detection), and (3) promoting help-seeking among people in need of mental health care (e.g., sending reminders). The majority of interventions (80%) included components in a combination of the aforementioned categories. Most studies report positive outcomes, yet results on the effectiveness is mixed, with a clear trend in favour of interventions with components from more than one category. Ten out of 42 studies (24%) yielded a statistically significant effect of the intervention on help-seeking; and all targeted a combination of the aforementioned categories (i.e., raising awareness, identification and help-seeking promotion). Only six studies (14%) focused on children and adolescents. Due to the limited number of robust studies done in LMICs and the heterogeneity of study designs, outcomes and components used, no definite conclusions can be drawn with regards to the effects of individual strategies or content of the interventions.