Community-based models of care facilitating the recovery of people living with persistent and complex mental health needs: a systematic review and narrative synthesis

Frontiers in Psychiatry

Psychiatry

Hamilton Kennedy¹  Bridget Hamilton¹  Justine Fletcher²  Helen Killaspy³  Carol Harvey⁴  Priscilla Ennals⁵  Catherine Brasier⁶  Tessa-May Zirnsak⁶  Lisa Brophy⁶  Peter McKenzie⁷ 

[1]Centre for Mental Health Nursing, Department of Nursing, The University of Melbourne, Melbourne, VIC, Australia

[2]Centre for Mental Health, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, VIC, Australia

[3]Department of Epidemiology and Applied Clinical Research, Division of Psychiatry, University College London, London, United Kingdom

[4]Camden and Islington NHS Foundation Trust, London, United Kingdom

[5]Department of Psychiatry, University of Melbourne, Melbourne, VIC, Australia

[6]North West Area Mental Health, Division of Mental Health, Northern Health, Melbourne, VIC, Australia

[7]Neami National, Preston, VIC, Australia

[8]Social Work and Social Policy, Department of Community and Clinical Health, La Trobe University, Bundoora, VIC, Australia

[9]The Bouverie Centre, School of Psychology and Public Health, La Trobe University, Brunswick, VIC, Australia

关键词: recovery;    complex;    mental illness;    models of care;    community;   

DOI  :  10.3389/fpsyt.2023.1259944

 received in 2023-07-17, accepted in 2023-08-23,  发布年份 2023

来源: Frontiers

【 摘 要 】

ObjectiveThis study aims to assess the effectiveness of community-based models of care (MoCs) supporting the recovery of individuals who experience persistent and complex mental health needs.MethodWe conducted a systematic review and narrative synthesis of MoC studies reporting clinical, functional, or personal recovery from October 2016 to October 2021. Sources were Medline, EMBASE, PsycInfo, CINAHL, and Cochrane databases. Studies were grouped according to MoC features. The narrative synthesis was led by our researchers with lived experience.ResultsBeneficial MoCs ranged from well-established to novel and updated models and those explicitly addressing recovery goals and incorporating peer support: goal-focused; integrated community treatment; intensive case management; partners in recovery care coordination; rehabilitation and recovery-focused; social and community connection-focused; supported accommodation; and vocational support. None of our diverse group of MoCs supporting recovery warranted a rating of best practice. Established MoCs, such as intensive case management, are promising practices regarding clinical and functional recovery, with potential for enhancements to support personal recovery. Emerging practice models that support personal and functional recovery are those where consumer goals and priorities are central.ConclusionEvidence for established models of care shows that there is a need for inevitable evolution and adaptation. Considering the high importance of effective MoCs for people experiencing persistent and complex mental health needs, further attention to service innovation and research is required. Greater emphasis on the inclusion of lived and living experience in the design, delivery, implementation, and research of MoCs is needed, to enhance MOCs' relevance for achieving individual consumer recovery outcomes.

【 授权许可】

Unknown   
Copyright © 2023 Harvey, Zirnsak, Brasier, Ennals, Fletcher, Hamilton, Killaspy, McKenzie, Kennedy and Brophy.