当前位置: X-MOL 学术Perspect. Psychol. Sci. › 论文详情
Our official English website, www.x-mol.net, welcomes your feedback! (Note: you will need to create a separate account there.)
A Community-Embedded Implementation Model for Mental-Health Interventions: Reaching the Hardest to Reach
Perspectives on Psychological Science ( IF 10.5 ) Pub Date : 2022-04-29 , DOI: 10.1177/17456916211049362
Eve S Puffer 1, 2 , David Ayuku 3
Affiliation  

The mental-health-care treatment gap remains very large in low-resource communities, both within high-income countries and globally in low- and middle-income countries. Existing approaches for disseminating psychological interventions within health systems are not working well enough, and hard-to-reach, high-risk populations are often going unreached. Alternative implementation models are needed to expand access and to address the burden of mental-health disorders and risk factors at the family and community levels. In this article, we present empirically supported implementation strategies and propose an implementation model—the community-embedded model (CEM)—that integrates these approaches and situates them within social settings. Key elements of the model include (a) embedding in an existing, community-based social setting; (b) delivering prevention and treatment in tandem; (c) using multiproblem interventions; (d) delivering through lay providers within the social setting; and (e) facilitating relationships between community settings and external systems of care. We propose integrating these elements to maximize the benefits of each to improve clinical outcomes and sustainment of interventions. A case study illustrates the application of the CEM to the delivery of a family-based prevention and treatment intervention within the social setting of religious congregations in Kenya. The discussion highlights challenges and opportunities for applying the CEM across contexts and interventions.



中文翻译:

心理健康干预的社区嵌入式实施模式:达到最难达到的目标

在资源匮乏的社区,无论是在高收入国家还是在全球范围内的低收入和中等收入国家,精神卫生保健治疗的差距仍然很大。在卫生系统内传播心理干预的现有方法效果不佳,难以触及的高风险人群往往无法触及。需要替代实施模式来扩大访问范围并解决家庭和社区层面的精神健康障碍和风险因素的负担。在本文中,我们提出了经验支持的实施策略,并提出了一个实施模型——社区嵌入模型(CEM)——它整合了这些方法并将它们置于社会环境中。该模型的关键要素包括 (a) 嵌入现有的基于社区的社会环境中;(b) 预防和治疗同时进行;(c) 使用多问题干预措施;(d) 在社会环境中通过非专业人士提供服务;(e) 促进社区环境和外部护理系统之间的关系。我们建议整合这些要素,以最大限度地提高每个要素的益处,以改善临床结果和干预措施的持续性。一个案例研究说明了 CEM 在肯尼亚宗教会众的社会环境中应用于以家庭为基础的预防和治疗干预措施。讨论强调了跨环境和干预应用 CEM 的挑战和机遇。(e) 促进社区环境和外部护理系统之间的关系。我们建议整合这些要素,以最大限度地提高每个要素的益处,以改善临床结果和干预措施的持续性。一个案例研究说明了 CEM 在肯尼亚宗教会众的社会环境中应用于以家庭为基础的预防和治疗干预措施。讨论强调了跨环境和干预应用 CEM 的挑战和机遇。(e) 促进社区环境和外部护理系统之间的关系。我们建议整合这些要素,以最大限度地提高每个要素的益处,以改善临床结果和干预措施的持续性。一个案例研究说明了 CEM 在肯尼亚宗教会众的社会环境中应用于以家庭为基础的预防和治疗干预措施。讨论强调了跨环境和干预应用 CEM 的挑战和机遇。一个案例研究说明了 CEM 在肯尼亚宗教会众的社会环境中应用于以家庭为基础的预防和治疗干预措施。讨论强调了跨环境和干预应用 CEM 的挑战和机遇。一个案例研究说明了 CEM 在肯尼亚宗教会众的社会环境中应用于以家庭为基础的预防和治疗干预措施。讨论强调了跨环境和干预应用 CEM 的挑战和机遇。

更新日期:2022-04-29
down
wechat
bug