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Innovations in community-based mental health care: an overview of meta-analyses

Carra, Giuseppe; Bartoli, Francesco; Capogrosso, Chiara A; Cioni, Riccardo M; Moretti, Federico; Piacenti, Susanna; Riboldi, Ilaria; ... Bebbington, Paul E; + view all (2022) Innovations in community-based mental health care: an overview of meta-analyses. International Review of Psychiatry , 34 (7-8) pp. 770-782. 10.1080/09540261.2022.2113043. Green open access

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Abstract

In the last four decades, mental health services for people with Severe Mental Illness (SMI) have seen asylums replaced by a balanced model of Community Mental Healthcare (CMH). Innovative approaches and strategies in the field of CMH have been extensively researched. However, this research has been hampered by issues limiting their capacity to inform clinicians and policymakers. We conducted an overview of meta-analyses of the effectiveness of innovative CMH models focussing on clinical and psychosocial outcomes in comparisons with standard care in adults with SMI. Based on the 12 eligible studies, we appraised, synthesised and graded the resulting evidence. There was moderate quality evidence that case management, Early Intervention Services (EIS) and caregiver-directed interventions were superior to standard care in reducing hospital admission. In relation to psychosocial outcomes, EIS showed high quality evidence of a small effect on global functioning. There was moderate quality evidence for a similar effect of Intensive Case Management, and for a large effect of family intervention. For quality of life, both EIS and self-management education had a small effect, with moderate quality. The level of research about effective CMH models is therefore substantial. However, several gaps related to innovative CMH not yet covered in meta‐analytic synthesis, need to be filled.

Type: Article
Title: Innovations in community-based mental health care: an overview of meta-analyses
Location: England
Open access status: An open access version is available from UCL Discovery
DOI: 10.1080/09540261.2022.2113043
Publisher version: https://doi.org/10.1080/09540261.2022.2113043
Language: English
Additional information: This version is the author accepted manuscript. For information on re-use, please refer to the publisher’s terms and conditions.
Keywords: Community mental health; innovation; meta-analyses overview; severe mental illness
UCL classification: UCL
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > Division of Psychiatry
URI: https://discovery.ucl.ac.uk/id/eprint/10174582
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