The idea behind CMH is to promote mental health through services available to everyone, regardless of their financial status or location. Often, community-based health programs can use government funding streams to provide services to these patients at little to no cost. One aspect of a community-based mental health approach is providing mobile and crisis response teams. “Historically mental health care has been synonymous with institutionalization. The transition from institutional care to community-based care is driven by a growing understanding of the negative impact of long-term institutionalization, advances in treatments, and recognition of the human rights and dignity of individuals with mental disorders.
One qualitative study mentioned that cognitive and physical health conditions might impact individuals’ ability to function in their daily lives during and after homelessness (48). In addition, six quantitative papers (37–42), one mixed-method paper (43), and two qualitative papers (44, 45) report on (F)ACT. Of these, we found two reviews (32, 33), one RCT with positive results (35), and one RCT without significant results (36). We found mainly empirical studies about the implementation and efficacy of (F)ACT and collaboration with (F)ACT teams. In addition, two papers with a qualitative design emphasize adding an occupational therapist to a multidisciplinary team (44, 50). Five papers recommend close involvement within different disciplines in multidisciplinary teams.
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To ensure cultural and contextual relevance, self-developed tools tailored to the specific populations and settings of the initiatives were also included. This is also a high-level approach but is distinguished from collaboration as community leadership in 1 additional aspect. At this level, community members are partners with external professionals or researchers in shaping or delivering the initiative. However, the community members have minimal influence, and final decisions about the design and implementation of the initiative sit with external professionals or researchers. Considering the heterogeneity in reporting of included studies (eg, methodology and context), a narrative approach was used to synthesise the data.
Community-Based Mental Health Services in India: Current Status and Roadmap for the Future
Kermode et al51 emphasised the importance of addressing gender and power imbalances within Allegany County Sheriff’s Office Resources communities and strengthening health systems to support these efforts. The supportive and non-threatening environment of a temple, even in the absence of specific healing rituals, played a significant role in reducing clinical symptoms.62 VHWs in the Friendship Bench programme advocated for the need for implementation near their homes, and to be provided with bicycles to ease transport difficulties.52 Employing community-acceptable terms, such as ‘distress’ and ‘well-being’ instead of ‘depression’ and ‘anxiety’, also facilitated greater acceptance of programmes.50 Engaging local community people as partners in programme development35,46,57 and conducting active consultations at the programme’s inception35,57 were found to be crucial in promoting cultural safety and community acceptance. Four studies detailed the linguistic and cultural challenges and necessary adaptations required for implementing initiatives in diverse settings.39,43,54,63
- ICBs are central to the ambition of delivering neighbourhood health, as the strategic commissioner of neighbourhood health providers, with the freedom to commission wider neighbourhood health services to complement the core neighbourhood delivery.
- The District Mental Health Program (DMHP) forms the core of the mental health services available at community level.
- For example, the Basic Needs’ Mental Health and Development Programme55 involved community volunteers and lay health workers to enhance the effectiveness of the programme.
- Finally, all study designs were included, and we also included papers about interventions related to collaboration.
- In comparison, our review emphasised the importance of accessible psychiatrists, either on-site or those committed to regular site visits despite distance, to support PHC staff and facilitate meaningful collaboration.
To make neighbourhood working successful, there must be a clear and coherent relationship between a supportive infrastructure (integrated care systems), frontline care (team-based care) and communities. These are set out as the foundations of enabling neighbourhood health and neighbourhood working to thrive alongside a focus on leadership, public service reform and improvement support. Neighbourhood working is not just about the location of services but improving the population’s health. While welcome, the 10 Year Health Plan’s vision for a neighbourhood health service is not a radical new blueprint for health and care. This ensures that there is equitable access where needed, preventing gaps in service provision while working at a footprint that responds to and works with communities, fostering familiarity and strong relationships between public services and communities. But these services are under immense pressure to meet the demands of an ageing and increasingly sicker population, and lack the capacity to lead this shift without further support.
