Public mental health and wellbeing interventions delivered by allied health professionals (AHPs): mapping the evidence and identification of gaps. A systematic review

IF 1.6 Q3 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Journal of Public Mental Health Pub Date : 2023-09-20 DOI:10.1108/jpmh-04-2023-0033
Sarah Wigham, Eileen Kaner, Jane Bourne, Kanar Ahmed, Simon Hackett
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A narrative synthesis and the Effective Public Health Practice Project appraisal tool were used to evaluate the evidence. Findings A total of 45-articles were included in the review describing AHP-delivered interventions addressing social disadvantage, trauma, bullying, loneliness, work-related stress, transitional stress, intersectionality, pain and bereavement. No articles were identified evaluating interventions delivered by operating department practitioners or orthoptists. A conceptual map was developed summarising the stressors, and a typology of public mental health interventions defined including: place-based interventions, discrete/one-off interventions, multi-component lifestyle and social connector interventions and interventions targeting groups at risk of mental health conditions. Research limitations/implications Many mental health conditions begin in childhood, and a strength of the review is the life course perspective. A further strength is compiling a compendium of public mental health outcome measures used by AHPs to inform future research. The authors excluded many articles focussed on clinical interventions/populations, which did not meet review inclusion criteria. While playing a key role in delivering public mental health interventions, clinical psychologists are not defined as AHPs and were excluded from the review, and this may be construed a limitation. Given heterogeneity of study designs and interventions evaluated numerical analyses of pooled findings was not appropriate. Practical implications The review highlights the breadth of community stressors on which AHPs can intervene and contribute in public mental health contexts, stressors which correspond to those identified in UK Government guidance as currently important and relevant to address. The findings can inform developing community public mental health pathways that align with the UK National Health Service (NHS) Long Term Plan, on prevention and early intervention to protect community mental health and well-being. Further can inform the NHS strategic direction for AHPs including informing ways of increasing utilisation of core AHP skills to optimise contributions in public mental health agendas. Social implications It is surprising there were not more AHP delivered evaluations of interventions for other stressors important to address in public mental health settings, for example gambling, domestic violence or that used digital technology, and these are areas for future research. Future research should identify the most active/effective dimensions of multi-component interventions which could be informed by frameworks to guide complex intervention development. The relative paucity of research identified, highlights the predominant focus of research to date on interventions for clinical mental health conditions and populations. The lack of preventative approaches is evident, and an important area for future research to align with UK health and social care priorities. Originality/value The review highlights AHP-delivered interventions impacting diverse community stressors across the life course. 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Abstract

Purpose Mental well-being is associated with positive outcomes throughout the life course. This study aims to examine interventions delivered by allied health professionals (AHPs) to alleviate community stressors adversely impacting public mental health and well-being. Design/methodology/approach Review inclusion criteria comprised experimental and qualitative process evaluations of public mental health interventions delivered by AHPs. Electronic searches in Cinahl, Embase, Medline, PsycINFO and the Cochrane Library, were combined with grey literature searches of National Institute for Health and Care Excellence public health guidance. A narrative synthesis and the Effective Public Health Practice Project appraisal tool were used to evaluate the evidence. Findings A total of 45-articles were included in the review describing AHP-delivered interventions addressing social disadvantage, trauma, bullying, loneliness, work-related stress, transitional stress, intersectionality, pain and bereavement. No articles were identified evaluating interventions delivered by operating department practitioners or orthoptists. A conceptual map was developed summarising the stressors, and a typology of public mental health interventions defined including: place-based interventions, discrete/one-off interventions, multi-component lifestyle and social connector interventions and interventions targeting groups at risk of mental health conditions. Research limitations/implications Many mental health conditions begin in childhood, and a strength of the review is the life course perspective. A further strength is compiling a compendium of public mental health outcome measures used by AHPs to inform future research. The authors excluded many articles focussed on clinical interventions/populations, which did not meet review inclusion criteria. While playing a key role in delivering public mental health interventions, clinical psychologists are not defined as AHPs and were excluded from the review, and this may be construed a limitation. Given heterogeneity of study designs and interventions evaluated numerical analyses of pooled findings was not appropriate. Practical implications The review highlights the breadth of community stressors on which AHPs can intervene and contribute in public mental health contexts, stressors which correspond to those identified in UK Government guidance as currently important and relevant to address. The findings can inform developing community public mental health pathways that align with the UK National Health Service (NHS) Long Term Plan, on prevention and early intervention to protect community mental health and well-being. Further can inform the NHS strategic direction for AHPs including informing ways of increasing utilisation of core AHP skills to optimise contributions in public mental health agendas. Social implications It is surprising there were not more AHP delivered evaluations of interventions for other stressors important to address in public mental health settings, for example gambling, domestic violence or that used digital technology, and these are areas for future research. Future research should identify the most active/effective dimensions of multi-component interventions which could be informed by frameworks to guide complex intervention development. The relative paucity of research identified, highlights the predominant focus of research to date on interventions for clinical mental health conditions and populations. The lack of preventative approaches is evident, and an important area for future research to align with UK health and social care priorities. Originality/value The review highlights AHP-delivered interventions impacting diverse community stressors across the life course. The findings can inform developing public mental health pathways aligned with government health service priorities to protect mental health and well-being, prioritise prevention and early intervention and increase utilisation of AHP skills across public mental health settings.
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联合卫生专业人员提供的公共精神卫生和福祉干预措施:绘制证据并查明差距。系统回顾
心理健康与生命历程中的积极结果有关。本研究旨在探讨联合卫生专业人员(AHPs)提供的干预措施,以减轻对公众心理健康和福祉产生不利影响的社区压力源。设计/方法/方法审查纳入标准包括对ahp提供的公共精神卫生干预措施的实验和定性过程评估。在Cinahl、Embase、Medline、PsycINFO和Cochrane图书馆中进行电子检索,并结合国家健康与护理卓越研究所公共卫生指导的灰色文献检索。采用叙事综合和有效公共卫生实践项目评估工具对证据进行评估。研究结果共纳入了45篇文章,描述了层次分析法提供的干预措施,涉及社会劣势、创伤、欺凌、孤独、工作压力、过渡压力、交叉性、痛苦和丧亲之痛。没有文章被确定评估手术部门从业人员或骨科医生提供的干预措施。制定了一个概述压力源的概念图,并确定了公共精神卫生干预措施的类型,包括:基于地点的干预措施、离散/一次性干预措施、多组分生活方式和社会联系干预措施以及针对有精神健康状况风险群体的干预措施。研究局限/启示许多心理健康状况始于童年,该综述的一个优势是生命历程视角。另一个优势是编制了一份由ahp使用的公共心理健康结果衡量标准纲要,为今后的研究提供信息。作者排除了许多不符合纳入标准的关于临床干预/人群的文章。虽然临床心理学家在提供公共心理健康干预方面发挥着关键作用,但他们没有被定义为ahp,因此被排除在审查之外,这可能被解释为一种限制。考虑到研究设计和干预措施的异质性,综合结果的数值分析评估是不合适的。该审查强调了社区压力源的广度,AHPs可以在公共精神卫生背景下对其进行干预和贡献,这些压力源与联合王国政府指导中确定的当前重要和相关的压力源相对应。这些发现可以为制定符合英国国家卫生服务(NHS)长期计划的社区公共心理健康途径提供信息,以预防和早期干预来保护社区心理健康和福祉。此外,还可以为AHP的NHS战略方向提供信息,包括告知如何增加AHP核心技能的利用,以优化对公共精神卫生议程的贡献。令人惊讶的是,没有更多的AHP提供对其他压力源的干预措施的评估,这些压力源在公共心理健康环境中很重要,例如赌博、家庭暴力或使用数字技术,这些都是未来研究的领域。未来的研究应该确定多成分干预措施最积极/有效的维度,这些维度可以通过框架来指导复杂干预措施的发展。所确定的研究相对较少,突出了迄今为止研究的主要重点是临床心理健康状况和人群的干预措施。预防方法的缺乏是显而易见的,这是未来研究与英国健康和社会保健优先事项保持一致的重要领域。该综述强调了ahp提供的干预措施在整个生命过程中影响各种社区压力源。研究结果可以为制定与政府卫生服务优先事项一致的公共精神卫生途径提供信息,以保护精神健康和福祉,优先考虑预防和早期干预,并在公共精神卫生机构中增加AHP技能的利用。
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来源期刊
Journal of Public Mental Health
Journal of Public Mental Health PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH-
CiteScore
2.40
自引率
7.10%
发文量
32
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