P47 A systematic scoping review of community-based interventions for the prevention of poor mental health in older adults

Abstract Background 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. Method 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. Results 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. Conclusions 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.

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The Effect of Neighborhood Experiences on Positive Mental Health Among Community-Dwelling Older Adults

Innovation in Aging ◽

10.1093/geroni/igaa057.1408 ◽

2020 ◽

Vol 4 (Supplement_1) ◽

pp. 436-436

Author(s):

Daniel R Y Gan ◽

Grand H-L Cheng ◽

Tze Pin Ng ◽

John Chye Fung ◽

Im Sik Cho

Keyword(s):

Mental Health ◽

Older Adults ◽

Path Analysis ◽

Linear Regression Analysis ◽

Psychosocial Health ◽

Positive Mental Health ◽

Community Dwelling ◽

Neighborhood Environment ◽

Community Based Interventions ◽

Psychosocial Wellbeing

Abstract Given reduced life spaces, the neighborhood often functions as a social venue for older adults. Yet how these everyday social spaces affect older adults’ psychosocial wellbeing remains largely unknown. Drawing on the GRP-CARE Survey data, this paper examined the relation between neighborhood experiences and positive mental health. Participants were 601 community-dwelling Singaporeans aged 50+ who lived in public housing neighborhoods. Neighborhood experiences were measured using the four-factorial, 16-item OpenX scale (Gan, Fung, Cho, 2019); positive mental health was measured using a six-factorial, 19-item scale (Vaingankar et al., 2011). Both scales have good psychometric properties and had been validated. Path analysis between relevant factors of both scales was conducted using Stata, within a theorized model of causation from neighborhood environment to social factors to psychosocial health. Age, education, ethnicity and sex were controlled for. Multiple linear regression analysis showed a strong, positive association between neighborhood experiences and mental health (p=0.000) even after controlling for personal traits (operationalized as depressive symptoms, GDS) in addition to sociodemographic variables. Path analysis showed that two distinct neighborhood health processes mediated this association. These were (1) the potential for a sense of community in the neighborhood improved emotional support, and (2) having better neighborly friendships improved interpersonal skills. These neighborhood health processes provide us with new lenses to understand older adults’ everyday experiences of their neighborhoods. Community-based interventions to improve older adults’ psychosocial wellbeing may be developed to facilitate these processes. Spatial and programmatic implications will be discussed in relation to age-friendly cities and communities (AFCC).

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Homeless on Main Street: Using Photovoice to Highlight Older Adults Among the Hidden Homeless

Innovation in Aging ◽

10.1093/geroni/igaa057.2583 ◽

2020 ◽

Vol 4 (Supplement_1) ◽

pp. 728-728

Author(s):

H Shellae Versey

Keyword(s):

Older Adults ◽

Rural Areas ◽

Meaning Making ◽

Small Towns ◽

Photo Elicitation ◽

Service Agency ◽

Structured Interviews ◽

Community Based Interventions ◽

Community Based ◽

Formerly Homeless

Abstract Homelessness is a reality for a growing number of Americans living in small towns and rural areas. However, unlike in cities, housing instability may be less visible. Using a photo-elicitation method (i.e., Photovoice), this study explores the meaning of place and obscured visibility to currently and formerly homeless older adults living in a small town in central Connecticut. Participants (N = 27) were recruited from a local service agency, given cameras and asked to photograph areas around town that were meaningful to them. Photographs were developed and followed by in-person, semi-structured interviews with participants in which photos and experiences during the project were discussed. Primary themes included belonging, generativity, social isolation, and place-making as meaning-making. The study culminated in a community photography exhibition in which photographs from the project were displayed in public spaces around town. Implications for community-based interventions to reach homeless groups in rural areas are discussed. Part of a symposium sponsored by the Qualitative Research Interest Group.

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Military spouses with deployed partners are at greater risk of poor perinatal mental health: a scoping review

Journal of the Royal Army Medical Corps ◽

10.1136/jramc-2018-001069 ◽

2019 ◽

Vol 165 (5) ◽

pp. 363-370 ◽

Cited By ~ 1

Author(s):

Lauren Rose Godier-McBard ◽

L Ibbitson ◽

C Hooks ◽

M Fossey

Keyword(s):

Mental Health ◽

Social Support ◽

Scoping Review ◽

Healthcare Providers ◽

Well Being ◽

Perinatal Period ◽

Poor Mental Health ◽

Adverse Outcomes ◽

Military Spouses ◽

Perinatal Mental Health

BackgroundPoor mental health in the perinatal period is associated with a number of adverse outcomes for the individual and the wider family. The unique circumstances in which military spouses/partners live may leave them particularly vulnerable to developing perinatal mental health (PMH) problems.MethodsA scoping review was carried out to review the literature pertaining to PMH in military spouses/partners using the methodology outlined by Arksey and O’Malley (2005). Databases searched included EBSCO, Gale Cengage Academic OneFile, ProQuest and SAGE.ResultsThirteen papers fulfilled the inclusion criteria, all from the USA, which looked a PMH or well-being in military spouses. There was a strong focus on spousal deployment as a risk factor for depressive symptoms and psychological stress during the perinatal period. Other risk factors included a lack of social/emotional support and increased family-related stressors. Interventions for pregnant military spouses included those that help them develop internal coping strategies and external social support.ConclusionsUS literature suggests that military spouses are particularly at risk of PMH problems during deployment of their serving partner and highlights the protective nature of social support during this time. Further consideration needs to be made to apply the findings to UK military spouses/partners due to differences in the structure and nature of the UK and US military and healthcare models. Further UK research is needed, which would provide military and healthcare providers with an understanding of the needs of this population allowing effective planning and strategies to be commissioned and implemented.

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Mental Health Outcomes of Peer-led Therapeutic Adventure for Military Veterans

Journal of Experiential Education ◽

10.1177/10538259211049535 ◽

2021 ◽

pp. 105382592110495

Author(s):

Joanna Ellen Bettmann ◽

Ileana Anderson ◽

Joe Makouske ◽

Adam Hanley

Keyword(s):

Mental Health ◽

Military Veterans ◽

Well Being ◽

Group Model ◽

Health Issues ◽

Post Traumatic Stress ◽

Community Based Interventions ◽

Community Based ◽

Post Traumatic ◽

Adventure Program

Background: Skepticism of therapy and stigma are significant barriers for veterans with mental health issues. Therapeutic adventure shows promise in addressing veterans’ mental health needs while circumventing the stigma many veterans face in initiating treatment. Purpose: Given the small group model of therapeutic adventure programs, such programs may be ideal to provide social support for veterans and reduce mental health symptomology. The present study investigated: can a brief peer-led therapeutic adventure program modify veterans’ mental health symptoms? Methodology/Approach: The study's sample included 56 participants attending one Sierra Club Military Outdoors trip lasting at least three days and two nights and involving camping. Participants completed study measurements assessing depression, anxiety, stress, Post-Traumatic Stress Disorder symptoms, substance misuse symptoms, and suicidality at pre-trip, post-trip, one-month post trip, six-months post trip, and 12-months post trip. Six-month and 12-month post-trip data was collected during the COVID-19 pandemic. Findings/Conclusions: Results indicated significant reduction in mental health symptomology from pre-trip to post-trip, but showed few longer-term changes in mental health symptomology. Implications: The present study's findings are consistent with research suggesting improvements in overall psychological well-being immediately following a nature-based intervention and suggest the need for on-going, community-based interventions to support optimally military veterans’ mental health.

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Health Care and Community-based Interventions for War-traumatized People in Croatia: Community-based Study of Service Use and Mental Health

Croatian Medical Journal ◽

10.3325/cmj.2008.4.483 ◽

2008 ◽

Vol 49 (4) ◽

pp. 483-490 ◽

Cited By ~ 8

Author(s):

Tanja Frančišković ◽

Zdravko Tovilović ◽

Zoran Šuković ◽

Aleksandra Stevanović ◽

Dean Ajduković ◽

...

Keyword(s):

Mental Health ◽

Health Care ◽

Service Use ◽

Community Based Interventions ◽

Community Based

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Community interventions for people with complex emotional needs that meet the criteria for ‘personality disorder’ diagnoses: a systematic review of economic evaluations

10.1101/2020.11.03.20225078 ◽

2020 ◽

Author(s):

Joe Botham ◽

Amy Clark ◽

Thomas Steare ◽

Ruth Stuart ◽

Sian Oram ◽

...

Keyword(s):

Mental Health ◽

Cost Effectiveness ◽

Personality Disorder ◽

Economic Evaluations ◽

Economic Evidence ◽

Emotional Needs ◽

Community Based Interventions ◽

Community Based ◽

Single Intervention ◽

The Cost

AbstractBackgroundDiagnoses of “personality disorder” are prevalent among people using community secondary mental health services. Whilst the effectiveness of a range of community-based treatments have been considered, as the NHS budget is finite, it is also important to consider the cost-effectiveness of those interventions.AimsTo assess the cost-effectiveness of primary or secondary care community-based interventions for people with complex emotional needs that meet criteria for a diagnosis of “personality disorder” to inform healthcare policy making.MethodSystematic review (PRESPORO #: CRD42020134068) of five databases, supplemented by reference list screening and citation tracking of included papers. We included economic evaluations of interventions for adults with complex emotional needs associated with a diagnosis of ‘personality disorder’ in community mental health settings published between before 18 September 2019. Study quality was assessed using the CHEERS statement. Narrative synthesis was used to summarise study findings.ResultsEighteen studies were included. The studies mainly evaluated psychotherapeutic interventions. Studies were also identified which evaluated altering the setting in which care was delivered and joint crisis plans. No strong economic evidence to support a single intervention or model of community-based care was identified.ConclusionThere is no robust economic evidence to support a single intervention or model of community-based care for people with complex emotional needs. The review identified the strongest evidence for Dialectical Behavioural Therapy with all three identified studies indicating the intervention is likely to be cost-effective in community settings compared to treatment as usual. Further research is needed to provide robust evidence on the cost-effectiveness of community-based interventions upon which decision makers can confidently base guidelines or allocate resources.

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Elements for developing community-based interventions for adults with fetal alcohol spectrum disorder: A scoping review

British Journal of Occupational Therapy ◽

10.1177/0308022618790206 ◽

2018 ◽

Vol 82 (4) ◽

pp. 201-212

Author(s):

Ryan Quan ◽

E Sharon Brintnell ◽

Ada WS Leung

Keyword(s):

Scoping Review ◽

Fetal Alcohol Spectrum Disorder ◽

Service Providers ◽

Spectrum Disorder ◽

Fetal Alcohol ◽

Community Based Interventions ◽

Community Based ◽

Daily Lives ◽

High Prevalence ◽

Fetal Alcohol Spectrum

Introduction Current literature about interventions for adults with fetal alcohol spectrum disorder (FASD) is limited, which is a concern, due to the high prevalence of FASD. FASD creates lifelong physical, mental, cognitive and behavioral deficits, which impacts many aspects of daily living. Community-based interventions are necessary to better support adults with FASD and provide them with the opportunity to achieve success in their daily lives and social participation. This scoping review aimed to identify elements for developing successful community-based interventions for these individuals. Method A search was conducted in the MEDLINE, PsycINFO, CINAHL, and EMBASE databases and supplementary gray literature was resourced. Articles were selected based on inclusion–exclusion criteria, and a thematic analysis was completed to identify and present relevant findings. Results Seven articles met selection criteria and were included in this review. Six emerging themes were identified: inclusion of a functional context, individualized support, education for service providers, structure and routine, utilizing a strengths-based approach, and environmental adaptations. These themes were used to present the findings related to the elements necessary for developing interventions for adults with FASD. Conclusion The results indicate that the identified elements may be necessary to develop successful interventions, especially community-based interventions, for adults with FASD.

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Psychological Science Into Practice During the COVID-19 Pandemic

European Psychologist ◽

10.1027/1016-9040/a000458 ◽

2021 ◽

Vol 26 (4) ◽

pp. 387-396

Author(s):

Eleni Karayianni ◽

Tom Van Daele ◽

Jasminka Despot-Lučanin ◽

Josip Lopižić ◽

Nicholas Carr

Keyword(s):

Public Health ◽

Mental Health ◽

Professional Growth ◽

European Federation ◽

Evidence Based ◽

Community Based Interventions ◽

Community Based ◽

The Public ◽

The Third ◽

Psychological Science

Abstract. The public health outbreak of the COVID-19 virus has hit all aspects of life as we know it. We found ourselves trying to solve several concurrent crises that have afflicted us. The European Federation of Psychologists’ Associations (EFPA) launched the Psychologists’ Support Hub to share resources among its members and beyond and promote the continuing adoption of psychological science to battle the pandemic. In the greater context of evidence-based practice (EBP), the best available evidence is what we turn to for help in our decision-making on how best to address different challenges. However, there are challenges in implementing EBP when the science is limited, and we are still expected to be effective and efficient as professionals. The article outlines the need for EBP during the pandemic. Three vignettes display how that can be done while identifying obstacles and recommending ways forward in the future. The first one relates to the development of e-mental health services in Belgium following the March 2020 lockdown. The second describes addressing the needs of older adults in Croatia when it was hit by two crises simultaneously – the March 2020 lockdown and a destructive earthquake. The third looks at how targeted community-based interventions in Norway directed at social change can positively impact times of crisis. Overall, the pandemic presents a unique opportunity for professional growth for researchers, trainers, practitioners, and policymakers alike. EFPA can play a pivotal role in EBP adoption.

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