Novel Models for Delivering Mental Health Services and Reducing the Burdens of Mental Illness

Abstract

Most individuals in both developing and developed countries who experience mental illness do not receive psychological services. The dominant model of delivering services used in developed countries (individual therapy by a highly trained mental health professional) can provide effective (i.e., evidence-based) treatments but is greatly limited as a means of reaching the large swath of individuals in need. We highlight several models outside the mental health professions (e.g., public health, medicine, business) that are more affordable and accessible and can be scaled up to reach many individuals in need. These models include task shifting, disruptive innovations, interventions in everyday settings, best-buy interventions, lifestyle changes, and social media. We convey their key characteristics and how they have been or can be applied to mental health. We end by discussing challenges in applying the models, critical issues on which effective treatment delivery depends, and paths to make progress.

Reducing Distress in Mothers of Children With Autism and Other Disabilities: A Randomized Trial

“…This approach meets urgent calls to improve global mental health by training nonspecialists to address unmet mental health needs. 46,47 These same calls also highlight needs to integrate mental health screening or services into primary health care settings. Although pediatricians are uniquely well positioned to screen mothers of patients with disabilities, multiple challenges remain in doing so.…”

Modificación de Sesgos Cognitivos (MSC) en depresión: Una revisión crítica de nuevos procedimientos para el cambio de sesgos cognitivos

“…Parte de este esfuerzo debe provenir de usar méto-dos de intervención a través de Internet, smartphones, etc. (Kazdin y Rabbitt, 2013), junto con la necesaria mejora de los tratamientos ya existentes. Los procedimientos de MSC pueden integrarse bien en esta dirección.…”

From Efficacy to Global Impact: Lessons Learned About What Not to Do in Translating Our Research to Reach

“…Kazdin and colleagues (Kazdin, 2016;Kazdin & Blase, 2011;Kazdin & Rabbitt, 2013) have also observed that we collectively need to address another critical gap. They note that our field's emphasis on treatment, particularly one-on-one psychotherapy delivered by expert (i.e., master's or doctoral) providers, creates a treatment-gap-or a discrepancy between those who could benefit from services and those who receive them.…”

“…But, as noted by Patel (2014), we already know enough to make a meaningful global difference if we expend more resources in other directions. Sample recommendations proposed to increase our impact include an increased focus on prevention and public health approaches, the use of strategic research to change public policy, and utilization of scalable strategies to increase the reach of what we currently have (Brownell & Roberto, 2015;Fairburn & Patel, 2014;Fairburn & Wilson, 2013;Kazdin & Blase, 2011;Kazdin & Rabbitt, 2013;Lyon & Koerner, 2016;Patel, 2014;Patel, Chowdhary, Rahman, & Verdeli, 2011;Zandberg & Wilson, 2013). Scalability refers to the degree to which interventions can be scaled-up to reach large populations without significant loss of effectiveness.…”