Current insights of community mental healthcare for people with severe mental illness: A scoping review

Abstract

BackgroundFor the last four decades, there has been a shift in mental healthcare toward more rehabilitation and following a more humanistic and comprehensive vision on recovery for persons with severe mental illness (SMI). Consequently, many community-based mental healthcare programs and services have been developed internationally. Currently, community mental healthcare is still under development, with a focus on further inclusion of persons with enduring mental health problems. In this review, we aim to provide a comprehensive overview of existing and upcoming community mental healthcare approaches to discover the current vision on the ingredients of community mental healthcare.MethodsWe conducted a scoping review by systematically searching four databases, supplemented with the results of Research Rabbit, a hand-search in reference lists and 10 volumes of two leading journals. We included studies on adults with SMI focusing on stimulating independent living, integrated care, recovery, and social inclusion published in English between January 2011 and December 2022 in peer-reviewed journals.ResultsThe search resulted in 56 papers that met the inclusion criteria. Thematic analysis revealed ingredients in 12 areas: multidisciplinary teams; collaboration within and outside the organization; attention to several aspects of health; supporting full citizenship; attention to the recovery of daily life; collaboration with the social network; tailored support; well-trained staff; using digital technologies; housing and living environment; sustainable policies and funding; and reciprocity in relationships.ConclusionWe found 12 areas of ingredients, including some innovative topics about reciprocity and sustainable policies and funding. There is much attention to individual ingredients for good community-based mental healthcare, but very little is known about their integration and implementation in contemporary, fragmented mental healthcare services. For future studies, we recommend more empirical research on community mental healthcare, as well as further investigation(s) from the social service perspective, and solid research on general terminology about SMI and outpatient support.

Exploring key determinants of health among individuals with serious mental illness: Qualitative insights from a first episode psychosis cohort, 20 years postdiagnosis

“…Our ndings reveal that longstanding therapeutic relationships with a known and trusted therapist positively affected health, well-being, and recovery. Other studies have similarly found that a mutual relationship of trust is imperative for su cient mental healthcare (20,25,51).…”

“…Previous research has highlighted an inverse association between social network size, psychopathology, and illness symptoms in SMI (3). Social network size does not consistently correlate with reported loneliness, indicating that the quality of relationships may be more important than quantity (20). In addition, the frequency of interactions with friends positively predicts clinical recovery in psychosis over two years (69).…”

“…Stress can exacerbate mental illness symptoms and lead to sick leave or disability insurance. Workplace factors such as working conditions, night shifts, job strain, psychosocial stressors, and unemployment could cause mental health to deteriorate (20). It is common for individuals with SMIs to struggle to maintain employment (12,14).…”

Hospitalization Costs and Mental Health: Challenges and Solutions from Recent Research - A Narrative Review

“…Over the past 20 years, capacities for individuals with mental disabilities have steadily increased, particularly in the area of outpatient assisted living. However, this increase in housing assistance has not been matched by a corresponding rise in housing options for the most severely ill individuals [40][41][42]. This trend is concerning, especially given the widespread shortage of medical rehabilitation services for people with serious mental illnesses, particularly outpatient and mobile rehabilitation options.…”