Community interventions for improving adult mental health: mapping local policy and practice in England.
Community interventions for improving adult mental health: mapping local policy and practice in England.
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DOI：
10.1186/s12889-021-11741-5
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发表时间：
2021-09-16
影响因子：
4.5
通讯作者：
Oliver EJ
中科院分区：
文献类型：
--
作者：
Duncan F;Baskin C;McGrath M;Coker JF;Lee C;Dykxhoorn J;Adams EA;Gnani S;Lafortune L;Kirkbride JB;Kaner E;Jones O;Samuel G;Walters K;Osborn D;Oliver EJ
公共心理健康的目的是在人口层面上改善福祉和预防心理健康状况不佳。这是一项全球性挑战，也是英国优先采取行动的领域。社区在提供PMH干预措施方面发挥着重要作用。然而，基于社区的PMH干预措施的证据基础有限，这意味着将服务提供与需求进行比较具有挑战性。没有这一点，就会妨碍有效和公平地提供服务。在这里，我们试图绘制目前在英格兰提供的以社区为基础的改善心理健康和福祉的干预措施的范围，以告知政策和服务干预的优先领域。我们采用了一种既定的绘图方法，将服务提供情况与人口和贫困统计数据进行比较。根据不同的人口统计、心理健康需求和更广泛的挑战情况（即高度贫困），选择了英格兰的五个地方当局地区。基于社区的干预措施是通过以下方式确定的：1)基于桌面的研究；2)建立的专业网络；3)参与当地心理健康促进和预防的个人连锁转诊抽样；4)同行研究人员的见解。我们纳入了2019年7月至2020年5月期间针对成年居民的所有基于社区的非临床干预措施。在五个领域确定了407项干预措施，涉及PMH的16个风险/保护因素。针对社会孤立和孤独的干预措施最为普遍，最常见的是通过社会活动和/或交友服务。最常见的目标人群是老年人和少数民族背景的人。侧重于更广泛的结构和环境决定因素的干预措施并不常见。有一些证据表明，服务提供是根据当地需求量身定制的，尽管这并不一致，这意味着一些风险群体，如少数民族背景的男性或LGBTQ+人群被遗漏了。干预措施没有得到一致的评估。有证据表明对国家和地方优先次序的部分反应。提供的条款主要针对解决PMH的社会和个人决定因素，这表明需要更多的整合，以使更广泛的服务提供者和决策者参与PMH战略和社区一级的交付。急需解决缺乏对改善PMH服务的全面评估的问题，以确定其在所服务的社区中的有效性程度。在线版本包含补充材料，可在10.1186/s12889-021-11741-5获得。
Public mental health (PMH) aims to improve wellbeing and prevent poor mental health at the population level. It is a global challenge and a UK priority area for action. Communities play an important role in the provision of PMH interventions. However, the evidence base concerning community-based PMH interventions is limited, meaning it is challenging to compare service provision to need. Without this, the efficient and equitable provision of services is hindered. Here, we sought to map the current range of community-based interventions for improving mental health and wellbeing currently provided in England to inform priority areas for policy and service intervention. We adopted an established mapping exercise methodology, comparing service provision with demographic and deprivation statistics. Five local authority areas of England were selected based on differing demographics, mental health needs and wider challenging circumstances (i.e. high deprivation). Community-based interventions were identified through: 1) desk-based research 2) established professional networks 3) chain-referral sampling of individuals involved in local mental health promotion and prevention and 4) peer researchers’ insight. We included all community-based, non-clinical interventions aimed at adult residents operating between July 2019 and May 2020. 407 interventions were identified across the five areas addressing 16 risk/protective factors for PMH. Interventions for social isolation and loneliness were most prevalent, most commonly through social activities and/or befriending services. The most common subpopulations targeted were older adults and people from minority ethnic backgrounds. Interventions focusing on broader structural and environmental determinants were uncommon. There was some evidence of service provision being tailored to local need, though this was inconsistent, meaning some at-risk groups such as men or LGBTQ+ people from minority ethnic backgrounds were missed. Interventions were not consistently evaluated. There was evidence of partial responsiveness to national and local prioritising. Provision was geared mainly towards addressing social and individual determinants of PMH, suggesting more integration is needed to engage wider service providers and policy-makers in PMH strategy and delivery at the community level. The lack of comprehensive evaluation of services to improve PMH needs to be urgently addressed to determine the extent of their effectiveness in communities they serve. The online version contains supplementary material available at 10.1186/s12889-021-11741-5.
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影响因子：
6.3
作者：
Dijkstra-Kersten, Sandra M. A.;Biesheuvel-Leliefeld, Karolien E. M.;van Marwijk, Harm W. J.
通讯作者：
van Marwijk, Harm W. J.
影响因子：
5.2
作者：
Hodgson, Kate J.;Shelton, Katherine H.;van den Bree, Marianne B. M.
通讯作者：
van den Bree, Marianne B. M.
影响因子：
5.5
作者：
Jones, Andrew D.
通讯作者：
Jones, Andrew D.
影响因子：
64.3
作者：
Kandola, Aaron;Lewis, Gemma;Hayes, Joseph F.
通讯作者：
Hayes, Joseph F.
影响因子：
5.1
作者：
Kelly, Danielle;Steiner, Artur;Baker, Rachel
通讯作者：
Baker, Rachel