Harvey Carol, Zirnsak Tessa-May, Brasier Catherine, Ennals Priscilla, Fletcher Justine, Hamilton Bridget, Killaspy Helen, McKenzie Peter, Kennedy Hamilton, Brophy Lisa
Department of Psychiatry, University of Melbourne, Melbourne, VIC, Australia.
North West Area Mental Health, Division of Mental Health, Northern Health, Melbourne, VIC, Australia.
Front Psychiatry. 2023 Sep 14;14:1259944. doi: 10.3389/fpsyt.2023.1259944. eCollection 2023.
This study aims to assess the effectiveness of community-based models of care (MoCs) supporting the recovery of individuals who experience persistent and complex mental health needs.
We conducted a systematic review and narrative synthesis of MoC studies reporting clinical, functional, or personal recovery from October 2016 to October 2021. Sources were Medline, EMBASE, PsycInfo, CINAHL, and Cochrane databases. Studies were grouped according to MoC features. The narrative synthesis was led by our researchers with lived experience.
Beneficial MoCs ranged from well-established to novel and updated models and those explicitly addressing recovery goals and incorporating peer support: ; ; ; ; ; ; ; and . None of our diverse group of MoCs supporting recovery warranted a rating of best practice. Established MoCs, such as , are promising practices regarding clinical and functional recovery, with potential for enhancements to support personal recovery. Emerging practice models that support personal and functional recovery are those where consumer goals and priorities are central.
Evidence for established models of care shows that there is a need for inevitable evolution and adaptation. Considering the high importance of effective MoCs for people experiencing persistent and complex mental health needs, further attention to service innovation and research is required. Greater emphasis on the inclusion of lived and living experience in the design, delivery, implementation, and research of MoCs is needed, to enhance MOCs' relevance for achieving individual consumer recovery outcomes.
本研究旨在评估基于社区的照护模式（MoC）对有持续且复杂心理健康需求者康复的有效性。
我们对2016年10月至2021年10月期间报告临床、功能或个人康复情况的MoC研究进行了系统评价和叙述性综合分析。资料来源为Medline、EMBASE、PsycInfo、CINAHL和Cochrane数据库。研究根据MoC特征进行分组。叙述性综合分析由有实际经验的研究人员主导。
有益的MoC涵盖了成熟的、新颖的和更新的模式，以及那些明确针对康复目标并纳入同伴支持的模式：;;;;;;;;。我们这组支持康复的多样化MoC中，没有一个被评为最佳实践。成熟的MoC，如，在临床和功能康复方面是有前景的做法，有进一步改进以支持个人康复的潜力。支持个人和功能康复的新兴实践模式是以消费者目标和优先事项为核心的模式。
现有照护模式的证据表明，不可避免地需要进行演变和调整。鉴于有效的MoC对有持续且复杂心理健康需求者至关重要，需要进一步关注服务创新和研究。需要更加强调在MoC的设计、提供、实施和研究中纳入实际和现有的经验，以提高MoC与实现个体消费者康复结果的相关性。
