Baldwin Helen, Greenburgh Anna, Weir Hannah, Asif Zara, Laporte Dionne, Bertram Mark, Crawford Achille, Duberry Gabrielle, Lauter Shoshana, Lloyd-Evans Brynmor, Lovelock Cassandra, Das-Munshi Jayati, Morgan Craig
ESRC Centre for Society and Mental Health (CSMH), King's College London, London, UK.
Population Health Improvement United Kingdom (PHI-UK), London, UK.
Psychol Med. 2025 Jul 28;55:e217. doi: 10.1017/S0033291725101128.
People who experience mental ill-health are typically more disadvantaged across a range of social and economic domains compared with the general population. This disadvantage is further heightened for people from marginalised communities. Social and economic adversities can limit both the access to, and effectiveness of, interventions for mental ill-health; however, these challenges are often overlooked by mental health services. Therefore, adequate support for social needs is urgently required, particularly for those from marginalised and vulnerable groups. We conducted a PRISMA-compliant systematic review of three academic databases to identify social and/or economic interventions which were adapted or developed bespoke for people from marginalised or minoritised communities living with mental ill-health. All records were screened blind by two reviewers; quality appraisal was conducted with the Kmet tool. Seventy-eight papers were included, deriving mostly from high-income countries. The identified interventions targeted nine sociodemographic or socioeconomic groups including: people experiencing homelessness or unstable housing ( = 50), people with an offending history ( = 9), mothers ( = 6), people experiencing economic disadvantage ( = 3), older adults ( = 3), caregivers ( = 2), minority ethnic groups ( = 2), women with experience of intimate partner violence ( = 1), and people with comorbid intellectual disabilities ( = 1). All identified interventions demonstrated feasibility, acceptability, or effectiveness on at least one social and/or economic outcome measure, suggesting that targeted intervention can help to address social and economic needs and reduce systemic inequalities in mental health care. However, the evidence base is still sparse, and further replication is warranted to inform commissioners and policy makers.
与普通人群相比,患有精神疾病的人在一系列社会和经济领域通常处于更为不利的地位。对于来自边缘化社区的人来说,这种不利状况更加突出。社会和经济逆境会限制获得精神疾病干预措施的机会以及干预措施的效果;然而,这些挑战往往被心理健康服务所忽视。因此,迫切需要对社会需求提供充分支持,特别是对那些来自边缘化和弱势群体的人。我们对三个学术数据库进行了一项符合PRISMA标准的系统综述,以确定为患有精神疾病的边缘化或少数族裔社区人群量身定制或专门开发的社会和/或经济干预措施。所有记录由两名评审员进行盲审;使用Kmet工具进行质量评估。纳入了78篇论文,大部分来自高收入国家。确定的干预措施针对九个社会人口统计学或社会经济群体,包括:无家可归或住房不稳定的人(n = 50)、有犯罪史的人(n = 9)、母亲(n = 6)、经济处于不利地位的人(n = 3)、老年人(n = 3)、照顾者(n = 2)、少数族裔群体(n = 2)、有亲密伴侣暴力经历的女性(n = 1)以及患有智力残疾合并症的人(n = 1)。所有确定的干预措施在至少一项社会和/或经济结果指标上都显示出可行性、可接受性或有效性,这表明有针对性的干预措施有助于满足社会和经济需求,并减少精神卫生保健中的系统性不平等。然而,证据基础仍然薄弱,有必要进一步进行重复研究,为专员和政策制定者提供参考。