Maddock Alan, Blair Carolyn, Ean Nil, Best Paul
School of Social Sciences, Education and Social Work, Queen's University Belfast, Northern Ireland, Belfast, UK.
Department of Psychology, Royal University of Phnom Penh, Phnom Penh, Cambodia.
Int J Ment Health Syst. 2021 Jun 5;15(1):56. doi: 10.1186/s13033-021-00482-y.
Mental health issues and disorders are major public health challenges, particularly in low- and middle-income countries in Southeast Asia, where chronic shortages in mental health services and human resources exist. The development of effective and accessible mental health systems in Southeast Asia will require evidence based psychological and social interventions. This systematic review provides a narrative synthesis of the evidence on the effectiveness of such interventions for mental health issues and disorders in Southeast Asia.
A comprehensive literature search of 7 electronic databases (PsycINFO, Medline (Ovid), Cochrane library, EMBASE, SCOPUS, APA PsycArticles, and Social Care Online) was undertaken.
Thirty two studies employing RCT designs to evaluate the effectiveness of a range of psychological and social mental health interventions on a number of different mental health outcomes were included in this review. The disparate intervention programmes reviewed were categorised as: lay delivered, yoga, aerobic and/or meditation based, cognitive behavioural therapy oriented, eye movement desensitization and reprocessing based (EMDR), health worker delivered, and hybrid programmes. The majority of the studies included in this review were of low to moderate quality due to the variability in the quality of the study design. The highest quality, and most promising evidence came from the evaluations of lay delivered interventions. This evidence demonstrates the feasibility and potential sustainability of implementing such interventions in resource constrained contexts.
The review findings indicate that a disparate array of mental health interventions can be implemented effectively in a range of Southeast Asian mental health and health settings. There is a clear need for significantly more research however, through higher quality and larger scale RCTs before it will be known more definitively, if these interventions are effective, and for whom they are most effective in different Southeast Asian contexts.
心理健康问题和障碍是重大的公共卫生挑战，尤其是在东南亚的低收入和中等收入国家，这些国家存在心理健康服务和人力资源长期短缺的问题。在东南亚建立有效且可及的心理健康系统将需要基于证据的心理和社会干预措施。本系统评价对东南亚此类干预措施在心理健康问题和障碍方面有效性的证据进行了叙述性综合分析。
对7个电子数据库（PsycINFO、Medline（Ovid）、Cochrane图书馆、EMBASE、SCOPUS、APA PsycArticles和Social Care Online）进行了全面的文献检索。
本评价纳入了32项采用随机对照试验（RCT）设计来评估一系列心理和社会心理健康干预措施对多种不同心理健康结局有效性的研究。所综述的不同干预项目分为：非专业人员实施的、瑜伽、有氧运动和/或冥想为基础的、认知行为疗法导向的、眼动脱敏再处理疗法（EMDR）为基础的、卫生工作者实施的以及混合项目。由于研究设计质量的差异，本评价纳入的大多数研究质量为低到中等。质量最高且最具前景的证据来自对非专业人员实施干预措施的评估。这一证据表明在资源受限的环境中实施此类干预措施的可行性和潜在可持续性。
综述结果表明，一系列不同的心理健康干预措施可在东南亚的一系列心理健康和卫生环境中有效实施。然而，显然需要通过更高质量和更大规模的随机对照试验进行更多研究，才能更确切地了解这些干预措施是否有效，以及在不同的东南亚背景下对哪些人最有效。
