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

Brandon A. Kohrt, Laura Asher, Anvita Bhardwaj, Mina Fazel, Mark J. D. Jordans, Byamah B. Mutamba, Abhijit Nadkarni, Gloria A. Pedersen, Daisy R. Singla and Vikram Patel
Additional contact information
Brandon A. Kohrt: Division of Global Mental Health, Department of Psychiatry and Behavioral Sciences, The George Washington University, Washington, DC 20037, USA
Laura Asher: Division of Epidemiology and Public Health, University of Nottingham, NG7 2RD, UK
Anvita Bhardwaj: Division of Global Mental Health, Department of Psychiatry and Behavioral Sciences, The George Washington University, Washington, DC 20037, USA
Mina Fazel: Department of Psychiatry, University of Oxford, Warneford Lane, OX1 2JD, UK
Mark J. D. Jordans: Center for Global Mental Health, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London SE5 8AF, UK
Byamah B. Mutamba: Butabika National Mental Hospital, 2 Kirombe-Butabika Road, P.O. Box 7017 Kampala, Uganda
Abhijit Nadkarni: Center for Global Mental Health, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London SE5 8AF, UK
Gloria A. Pedersen: Division of Global Mental Health, Department of Psychiatry and Behavioral Sciences, The George Washington University, Washington, DC 20037, USA
Daisy R. Singla: Department of Psychiatry, Sinai Health System & University of Toronto, Toronto, ON M5G 1X5, Canada
Vikram Patel: Sangath, Socorro, Porvorim, Goa 403501, India

IJERPH, 2018, vol. 15, issue 6, 1-31

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.

Keywords: community; global health; low- and middle-income countries; mental disorders; meta-review; paraprofessionals; psychological treatments (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2018
References: View references in EconPapers View complete reference list from CitEc
Citations: View citations in EconPapers (5)

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