A Community-Embedded Implementation Model for Mental-Health Interventions

Reaching the Hardest to Reach

Bibliographic Data

ID21786144
AuthorsEve S Puffer (0000-0003-2281-821X, Duke University, corresponding author), David Ayuku (0000-0001-7401-1165, Moi University)
Year2022
Volume17
Issue5
Pages1276-1290
Publication date2022-09-01
Open AccessYes
TypeARTICLE
VenuePerspectives on Psychological Science (JOURNAL)
Journal identifiersISSN: 1745-6916 • E-ISSN: 1745-6924
PublisherSAGE Publications (PUBLISHER • US)
DOI10.1177/17456916211049362
PMID35486821
OpenAlexW4225146226
LanguageEN
Citations received5
References cited65

The mental-health-care treatment gap remains very large in low-resource communities, both within high-income countries and globally in low- and middle-income countries. Existing approaches for disseminating psychological interventions within health systems are not working well enough, and hard-to-reach, high-risk populations are often going unreached. Alternative implementation models are needed to expand access and to address the burden of mental-health disorders and risk factors at the family and community levels. In this article, we present empirically supported implementation strategies and propose an implementation model—the community-embedded model (CEM)—that integrates these approaches and situates them within social settings. Key elements of the model include (a) embedding in an existing, community-based social setting; (b) delivering prevention and treatment in tandem; (c) using multiproblem interventions; (d) delivering through lay providers within the social setting; and (e) facilitating relationships between community settings and external systems of care. We propose integrating these elements to maximize the benefits of each to improve clinical outcomes and sustainment of interventions. A case study illustrates the application of the CEM to the delivery of a family-based prevention and treatment intervention within the social setting of religious congregations in Kenya. The discussion highlights challenges and opportunities for applying the CEM across contexts and interventions

Mental health · Political science · Psychiatry · Psychological intervention · Public relations · Community Health and Development · Health Policy Implementation Science · Mental Health Treatment and Access · Psychology

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