School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia.
Research and Training Centre for Community Development (RTCCD), Hanoi, Vietnam.
Int J Soc Psychiatry. 2020 May;66(3):232-239. doi: 10.1177/0020764019898234. Epub 2020 Jan 6.
There is a lack of an intervention model that empowers people with severe mental illness (SMI) and their families and addresses the mental health gap in low- and middle-income countries. There is a significant gap in care for people with SMI in rural Vietnam due to the low quality of care in the formal mental health system and the lack of access to an evidence-informed informal approach to care.
To assess acceptability, feasibility, preliminary evidence of impact and potential cost savings of a mental health support group intervention for people with SMI in the community.
The proof of concept used a pre-post design with qualitative assessment, impact evaluation and cost analysis.
A mental health support group intervention facilitated by Women's Union staff using a positive deviance approach was conducted among 68 people with SMI. Qualitative evaluation showed that the approach was highly acceptable and feasible. There was a significant improvement in personal functioning and a reduction in stigma and discrimination experienced by intervention participants. The intervention was found to reduce significantly the financial burden on the families having members with SMI.
The proof of concept of the mental health support group intervention delivered by informal community care providers for people with SMI provides promising evidence to address the mental health gap with high acceptability, feasibility and low-cost for low- and middle-income countries.
在中低收入国家，缺乏一种既能赋予严重精神疾病患者及其家属权力，又能解决精神卫生差距的干预模式。由于正规精神卫生系统的护理质量低下，以及缺乏循证的非正式护理途径，越南农村地区的精神疾病患者护理存在很大差距。
评估针对社区中严重精神疾病患者的心理健康支持小组干预措施的可接受性、可行性、初步效果证据和潜在成本节约。
概念验证采用了前后测设计，结合定性评估、效果评估和成本分析。
妇女联合会工作人员采用积极偏差方法实施了一项心理健康支持小组干预措施，共有 68 名严重精神疾病患者参与。定性评估表明，该方法具有高度的可接受性和可行性。干预组患者的个人功能显著改善，经历的污名化和歧视有所减少。研究发现，该干预措施显著减轻了有精神疾病患者的家庭的经济负担。
由非正式社区护理提供者为严重精神疾病患者提供的心理健康支持小组干预措施的概念验证，提供了有希望的证据，可以以高可接受性、可行性和低成本来解决中低收入国家的精神卫生差距问题。
