Effective mental health interventions to reduce hospital readmission rates: a systematic review

BACKGROUND Digital mental health interventions are increasingly prevalent in the current context of rapidly evolving technology, and research indicates that they yield effectiveness outcomes comparable to in-person treatment. Integrating professionals (i.e. psychologists, physicians) into digital mental health interventions has been common, and the inclusion of guidance within programs can increase adherence to interventions. However, employing professionals to enhance mental health programs may undermine the scalability of digital interventions. Therefore, delegating guidance tasks to paraprofessionals (peer supporters, technicians, lay counsellors, or other non-clinicians) can help reduce costs and increase accessibility. OBJECTIVE This systematic review and meta-analysis evaluates the effectiveness, adherence, and other process outcomes of non-clinician guided digital mental health interventions. METHODS Four databases (MEDLINE, EMBASE, CINAHL, and PSYCInfo) were searched for randomized controlled trials published between 2010 and 2020 examining digital mental health interventions. Three journals focused on digital intervention were also hand searched and grey literature was searched using ProQuest and the Cochrane Central Register of Control Trials (CENTRAL). Two researchers independently assessed risk of bias using the Cochrane Risk of Bias Tool 2. Data were collected on effectiveness, adherence, and other process outcomes, and meta-analyses were conducted for effectiveness and adherence outcomes. Non-clinician guided interventions were compared with treatment as usual, clinician-guided interventions, and unguided interventions. RESULTS Thirteen studies qualified for inclusion. Results indicate that non-clinician guided interventions yielded higher post-treatment effectiveness outcomes when compared to conditions involving control programs (e.g. online psychoeducation, monitored attention control) or waitlist controls (k=7, Hedges g=-0.73 (95% CI -1.08 to -0.38)). There are significant differences between non-clinician guided interventions and unguided interventions as well (k=6, Hedges g=-0.17 (95% CI -0.23 to -0.11)). In addition, non-clinician guided interventions did not differ in effectiveness from clinician-guided interventions (k=3, Hedges g=0.08 (95% CI -0.01 to 0.17)). These results suggest that guided digital mental health interventions are helpful to improve mental health outcomes regardless of the qualification, and that the presence of a non-clinician guide improves effectiveness outcomes more than no guidance. Non-clinician guided interventions did not yield significantly different effects on adherence outcomes when compared with unguided interventions (k=3, OR 1.58 (95% CI 0.51 to 4.92)), although a general trend of improved adherence was observed within non-clinician guided interventions. CONCLUSIONS Integrating paraprofessionals and non-clinicians appear to improve outcomes of digital mental health interventions, and may also enhance adherence outcomes (though the trend was nonsignificant). Further research should focus on the specific types of tasks these paraprofessionals can successfully provide (i.e. psychosocial support, therapeutic alliance, technical augmentation) and their associated outcomes. CLINICALTRIAL The protocol is preregistered on PROSPERO (CRD42020191226).

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Systematic Review and Critique of Methods for Economic Evaluation of Digital Mental Health Interventions

Applied Health Economics and Health Policy ◽

10.1007/s40258-020-00607-3 ◽

2020 ◽

Vol 19 (1) ◽

pp. 17-27 ◽

Cited By ~ 1

Author(s):

Dina Jankovic ◽

Laura Bojke ◽

David Marshall ◽

Pedro Saramago Goncalves ◽

Rachel Churchill ◽

...

Keyword(s):

Mental Health ◽

Systematic Review ◽

Economic Evaluation ◽

Health Interventions ◽

Mental Health Interventions

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Economic evaluations of mental health interventions: A systematic review of interventions with work-focused components

Safety Science ◽

10.1016/j.ssci.2020.104982 ◽

2020 ◽

Vol 132 ◽

pp. 104982

Author(s):

Aurélie Gaillard ◽

Hélène Sultan-Taïeb ◽

Chantal Sylvain ◽

Marie-José Durand

Keyword(s):

Mental Health ◽

Systematic Review ◽

Health Interventions ◽

Economic Evaluations ◽

Mental Health Interventions

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What works where? A systematic review of child and adolescent mental health interventions for low and middle income countries

Social Psychiatry and Psychiatric Epidemiology ◽

10.1007/s00127-012-0566-x ◽

2012 ◽

Vol 48 (4) ◽

pp. 595-611 ◽

Cited By ~ 51

Author(s):

Henrikje Klasen ◽

Anne-Claire Crombag

Keyword(s):

Mental Health ◽

Systematic Review ◽

Adolescent Mental Health ◽

Child And Adolescent ◽

Health Interventions ◽

Middle Income ◽

Middle Income Countries ◽

What Works ◽

Mental Health Interventions ◽

Low And Middle Income

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Effectiveness of current policing-related mental health interventions: A systematic review

Criminal Behaviour and Mental Health ◽

10.1002/cbm.2058 ◽

2017 ◽

Vol 28 (2) ◽

pp. 108-119 ◽

Cited By ~ 12

Author(s):

Eddie Kane ◽

Emily Evans ◽

Farhad Shokraneh

Keyword(s):

Mental Health ◽

Systematic Review ◽

Health Interventions ◽

Mental Health Interventions

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The need for accessible mental health interventions for young adults in the COVID-19 pandemic: A student psychologists’ perspective and rapid systematic review

10.31234/osf.io/fw78q ◽

2021 ◽

Author(s):

Dilan Hulaj ◽

Sophie Antesberger ◽

Tabea Blum ◽

Raffaela Böswald ◽

Hannah M. Brandl ◽

...

Keyword(s):

Mental Health ◽

Systematic Review ◽

Young Adults ◽

General Population ◽

Mental Health Problems ◽

Severe Disease ◽

Health Interventions ◽

Medium Effect ◽

Web Based ◽

Mental Health Interventions

Importance: Although young adults are on average less affected by the physical consequences of COVID-19 infections, showing less severe disease progression and lower mortality risk, they suffer strongly from the mental health impact of the pandemic.Objective: We, a group of psychology students experiencing these impacts, aim to provide an overview of the existing literature on prevention and intervention efforts to effectively reduce the development of, or suffering from, mental health problems in young adults (18-35) during the COVID-19 pandemic.Evidence Review: A rapid systematic review was conducted to identify studies focusing on the implementation of mental health interventions for young adults of the general population during the COVID-19 pandemic. Literature was searched with Pubmed and Web of Science on June 17, 2021. The quality of each study was assessed by two reviewers with the Standard Quality Assessment Criteria for Evaluating Primary Research Papers.Findings: Of N = 76 records initially screened, eight studies met the inclusion criteria. Six applied web-based interventions, of which four were randomized controlled trials. Interventions were based on Cognitive Behavioral Therapy approaches (n = 5), mindfulness practices, logo-autobiography, and synergistic thinking methods. The interventions varied in length from single sessions to multiple sessions over a period of up to 10 weeks. All interventions were effective in reducing depression and anxiety symptoms, as well as stress with small to medium effect sizes and a symptom reduction up to 78.9%. With only three studies being of high quality, the overall quality was low.Conclusions and Relevance: Research on mental health interventions for young adults in the general population during the pandemic is sparse. However, all interventions resulted in symptoms reductions and thus have been shown to be effective ways of counteracting the potential development of mental disorders during times of uncertainty, with high levels of stress, such as during a pandemic. Therefore, we propose a concept for an innovative and cost-effective web-based platform to structure and raise awareness for existing measures.

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