Community Interventions to Promote Mental Health and Social Equity
Open accessAbstract
PURPOSE OF REVIEW: We review recent community interventions to promote mental health and social equity. We define community interventions as those that involve multi-sector partnerships, emphasize community members as integral to the intervention, and/or deliver services in community settings. We examine literature in seven topic areas: collaborative care, early psychosis, school-based interventions, homelessness, criminal justice, global mental health, and mental health promotion/prevention. We adapt the social-ecological model for health promotion and provide a framework for understanding the actions of community interventions. RECENT FINDINGS: There are recent examples of effective interventions in each topic area. The majority of interventions focus on individual, family/interpersonal, and program/institutional social-ecological levels, with few intervening on whole communities or involving multiple non-healthcare sectors. Findings from many studies reinforce the interplay among mental health, interpersonal relationships, and social determinants of health. There is evidence for the effectiveness of community interventions for improving mental health and some social outcomes across social-ecological levels. Studies indicate the importance of ongoing resources and training to maintain long-term outcomes, explicit attention to ethics and processes to foster equitable partnerships, and policy reform to support sustainable healthcare-community collaborations.
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Written from the paper’s full text.
TL;DR
This review synthesizes recent community interventions across seven topic areas and finds evidence for improving mental health and some social outcomes at multiple social-ecological levels. It emphasizes the need for sustained resources and training, equitable community partnerships, and policy reform to support long-term healthcare-community collaborations.
Key findings
- Multi-sector collaborative care: In Community Partners in Care (CPIC), 95 programs across five sectors served a predominantly under-resourced racial/ethnic minority sample (n = 1018; 46% African American, 41% Latino, 74% below federal poverty level); at 6 months, Community Engagement and Planning vs. Resources for Services improved health-related quality of life, increased physical activity, reduced homelessness risk factors, and reduced behavioral health hospitalizations, though main effects diminished over time.
- Early psychosis and justice interventions: The Danish OPUS trial showed significant 2-year benefits for assertive early intervention, but most differences dissipated at 10-year follow-up; Forensic Assertive Community Treatment (n = 35 vs. 35) produced fewer convictions (0.4 ± 0.7 vs. 0.9 ± 1.3, p = .023), fewer days in jail (21.5 ± 25.9 vs. 43.5 ± 59.2, p = .025), and more outpatient mental health treatment days (305.5 ± 92.1 vs. 169.4 ± 139.6, p < .001).
- Housing, global mental health, and prevention: In At Home/Chez Moi (n = 950), Housing First participants entered housing faster (73 vs. 220 days) and retained housing longer (281 vs. 115 days); in Goa, India, the lay-counselor-delivered Healthy Activity Program (n = 495) reduced depression severity, suicidal ideation, disability, days out of work, and intimate partner violence; a South African parenting program (n = 115 dyads) reduced child abuse from 63.0% to 29.5% (p < .001).
- School and community-level prevention: In the FRIENDS trial (41 schools, n = 1343), health-led FRIENDS was more effective than school-led FRIENDS or PSHE for anxiety outcomes, with no effects on math, reading, or writing test scores; Communities That Care (24 communities, n > 14,000) showed reduced substance use, delinquency, and violence at eighth grade, with some effects persisting to age 21 (n = 4002; e.g., increased lifetime abstinence from alcohol, tobacco, and marijuana use, ARR 1.49, 95% CI 1.03, 2.16).
Methods
- Narrative review, not a comprehensive systematic review, focusing on interventions published in peer-reviewed medical journals from 2015 to 2018, with additional studies identified through reference mining and expert recommendations.
- Seven topic areas were selected: multi-sector collaborative care, early psychosis, school-based interventions, homelessness, criminal justice, global mental health, and mental health promotion/prevention; studies were selected for design, outcomes, and/or impact.
- Community interventions were defined as those involving multi-sector partnerships, including community members as integral to the intervention, and/or delivering services in community settings; the review adapts the social-ecological model for health promotion.
Limitations
- Stated: The review highlights major developments and trends rather than providing a comprehensive systematic review, and it excludes substance use interventions, which the authors say warrant a separate review.
- Stated/evident: Most reviewed interventions focused on individual, family/interpersonal, and program/institutional social-ecological levels, with few intervening on whole communities or involving multiple non-healthcare sectors.
- Evident from the text: Several beneficial effects diminished over time (e.g., CPIC, OPUS), some interventions had negative or unexpected results (e.g., London early intervention service referral study; expedited Medicaid enrollment associated with greater jail/prison days), and the authors note the importance of ongoing resources, training, and policy reform to sustain outcomes.
Model-written summary. Check it against the paper before relying on it.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
0 of 66 cited sources checked · 0 supported · 0 flagged
- Findingcitation
Adapted ACT teams for early psychosis and justice-involved populations are effective community interventions.
“International lay health worker interventions, a parenting intervention to reduce child abuse, a whole-school cognitive behavioral therapy prevention program, adapted ACT teams for early psychosis and justice-involved populations, Housing First services, and multi-sector collaborative care and prevention services are examples of effective community interventions.”
Quote in the paperSubstantial claim - Findingown data
Most interventions reviewed here included one non-healthcare sector collaborator as opposed to collaborating with communities more broadly.
“Most interventions reviewed here included one non-healthcare sector collaborator as opposed to collaborating with communities more broadly.”
Quote in the paperNot a substantial claim- Rests on an assumption: The studies selected for this review are representative of recent community interventions in the seven topic areas.
- Findingown data
We found only a small number of studies that intervened at the level of whole communities.
“We found only a small number of studies that intervened at the level of whole communities.”
Quote in the paperNot a substantial claim- Rests on an assumption: The studies selected for this review are representative of recent community interventions in the seven topic areas.
- Findingcitation
Other studies acted at the community level by directly providing or influencing resources on a large scale, through cash/food transfers or land revitalization efforts.
“Other studies acted at the community level by directly providing or influencing resources on a large scale, through cash/food transfers or land revitalization efforts”
Quote in the paperNot a substantial claim - Findingnone given
Housing First services are effective community interventions.
“International lay health worker interventions, a parenting intervention to reduce child abuse, a whole-school cognitive behavioral therapy prevention program, adapted ACT teams for early psychosis and justice-involved populations, Housing First services, and multi-sector collaborative care and prevention services are examples of effective community interventions.”
Quote in the paperSubstantial claim
- Findingcitation
A parenting intervention to reduce child abuse is an effective community intervention.
“International lay health worker interventions, a parenting intervention to reduce child abuse, a whole-school cognitive behavioral therapy prevention program, adapted ACT teams for early psychosis and justice-involved populations, Housing First services, and multi-sector collaborative care and prevention services are examples of effective community interventions.”
Quote in the paperSubstantial claim - Findingnone given
A whole-school cognitive behavioral therapy prevention program is an effective community intervention.
“International lay health worker interventions, a parenting intervention to reduce child abuse, a whole-school cognitive behavioral therapy prevention program, adapted ACT teams for early psychosis and justice-involved populations, Housing First services, and multi-sector collaborative care and prevention services are examples of effective community interventions.”
Quote in the paperSubstantial claim - Findingnone given
A second group of interventions intervened at the interpersonal level (e.g., parent and family interventions).
“A second group of interventions intervened at the interpersonal level (e.g., parent and family interventions).”
Quote in the paperNot a substantial claim - Findingcitation
International lay health worker interventions are effective community interventions.
“International lay health worker interventions, a parenting intervention to reduce child abuse, a whole-school cognitive behavioral therapy prevention program, adapted ACT teams for early psychosis and justice-involved populations, Housing First services, and multi-sector collaborative care and prevention services are examples of effective community interventions.”
Quote in the paperSubstantial claim - Findingcitation
Multi-sector collaborative care and prevention services are effective community interventions.
“International lay health worker interventions, a parenting intervention to reduce child abuse, a whole-school cognitive behavioral therapy prevention program, adapted ACT teams for early psychosis and justice-involved populations, Housing First services, and multi-sector collaborative care and prevention services are examples of effective community interventions.”
Quote in the paperSubstantial claim - Findingown data
Most interventions reviewed promoted mental health at the individual level.
“We found that most interventions reviewed promoted mental health at the individual level.”
Quote in the paperNot a substantial claim- Rests on an assumption: The studies selected for this review are representative of recent community interventions in the seven topic areas.
- Findingcitation
A third group of interventions functioned at the organizational/institutional level by enhancing the processes by which non-healthcare programs serve those with mental illness.
“A third group of interventions functioned at the organizational/institutional level by enhancing the processes by which non-healthcare programs serve those with mental illness.”
Quote in the paperNot a substantial claim - Findingnone given
Many individual-level interventions also simultaneously acted at the organizational/institutional level.
“Many individual-level interventions also simultaneously acted at the organizational/institutional level.”
Quote in the paperNot a substantial claim - Findingcitation
Several successful school-based interventions operated at the organizational level.
“Several successful school-based interventions operated at the organizational level”
Quote in the paperNot a substantial claim - Premisecitation
In Hankerson et al., none of the participants who screened positive requested community mental health referrals, even though these were offered.
“none of the participants who screened positive requested community mental health referrals, even though these were offered”
Quote in the paperSubstantial claim0 of 1 sources checked- cites [38] Hankerson SH, Lee YA, Brawley DK, Braswell K, Wickramaratne PJ, Weissman MM. Screening for depression in African-American churches. Am J Prev Med. 2015;49:526–33. source
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- Interpretationnone given
There is evidence for the effectiveness of community interventions for improving mental health and some social outcomes across social-ecological levels.
“There is evidence for the effectiveness of community interventions for improving mental health and some social outcomes across social-ecological levels.”
Quote in the paperSubstantial claim - Premisecitation
CPIC was identified by a 2015 Cochrane review as the only high-quality study that specifically evaluated the added value of a community engagement and planning intervention over and above resource enhancement and community outreach.
“A 2015 Cochrane review identified CPIC as the only “high-quality study” that “specifically evaluated the added value of a community engagement and planning intervention (i.e. a coalition-led intervention) over and above resource enhancement and community outreach””
Quote in the paperNot a substantial claim0 of 1 sources checked- cites [2•]
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- Premisecitation
In CPIC, at 6-month follow-up, participants in CEP compared to RS had reduced homelessness risk factors.
“reduced homelessness risk factors”
Quote in the paperSubstantial claim0 of 1 sources checked- cites [18•]
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- Interpretationnone given
Studies indicate the importance of ongoing resources and training to maintain long-term outcomes.
“Studies indicate the importance of ongoing resources and training to maintain long-term outcomes”
- Also stated in: § Conclusions · hedged
“Studies indicate the importance of ongoing resources and training to maintain long-term outcomes and the need for policy reform to support healthcare-community partnerships.”
Quote in the paperSubstantial claim - Also stated in: § Conclusions · hedged
- Premisecitation
In CPIC, at 6-month follow-up, participants in CEP compared to RS had significantly improved health-related quality of life.
“At 6-month follow-up, participants in CEP (n = 514) compared to RS (n = 504) had significantly improved health-related quality of life”
Quote in the paperSubstantial claim0 of 1 sources checked- cites [18•]
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- Premisecitation
In CPIC, at 6-month follow-up, participants in CEP compared to RS had increased physical activity.
“increased physical activity”
Quote in the paperSubstantial claim0 of 1 sources checked- cites [18•]
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- Premisecitation
In CPIC, at 6-month follow-up, participants in CEP compared to RS had reduced behavioral health hospitalizations.
“reduced behavioral health hospitalizations”
Quote in the paperSubstantial claim0 of 1 sources checked- cites [18•]
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- Premisecitation
In the London EIS study, referred patients experienced significantly more contacts with intermediate healthcare/non-healthcare programs in their pathway to EIS treatment post-intervention (2.06 vs. 2.45 steps, p = 0.002).
“referred patients experienced significantly more contacts with intermediate healthcare/non-healthcare programs in their pathway to EIS treatment (2.06 vs. 2.45 steps, p = 0.002)”
Quote in the paperSubstantial claim0 of 1 sources checked- cites [51•]
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- Interpretationcitation
The Hankerson et al. findings demonstrate the importance of churches as sites for depression screening, counseling, and referral.
“demonstrating the importance of churches as sites for depression screening, counseling (i.e., Mental Health First Aid), and referral”
Quote in the paperSubstantial claim0 of 1 sources checked- cites [38, 39•]
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- Premisecitation
In Skryabina et al.'s RCT, health-led FRIENDS was more effective in decreasing social anxiety, generalized anxiety, and total Revised Children's Anxiety and Depression Scale scores compared to school-led FRIENDS and PSHE.
“Health-led FRIENDS was more effective in decreasing social anxiety, generalized anxiety, and total Revised Children’s Anxiety and Depression Scale scores as compared to school-led FRIENDS and PSHE.”
Quote in the paperSubstantial claim0 of 1 sources checked- cites [59] Skryabina E, Taylor G, Stallard P. Effect of a universal anxiety prevention programme (FRIENDS) on children’s academic performance: results from a randomised controlled trial. J Child Psychol Psychiatry. 2016;57:1297–307. source
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- Premisecitation
In the Danish OPUS trial, at 2 years, ACT-based assertive early intervention compared to services as usual decreased positive and negative psychotic symptoms.
“OPUS results at 2 years showed significant positive outcomes compared to services as usual: decreased positive and negative psychotic symptoms”
Quote in the paperSubstantial claim0 of 1 sources checked- cites [50] Secher RG, Hjorthøj CR, Austin SF, Thorup A, Jeppesen P, et al. Ten-year follow-up of the OPUS specialized early intervention trial for patients with a first episode of psychosis. Schizophr Bull. 2014;41:617–26. source
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- Premisecitation
In the London EIS study, there was no significant difference in duration of untreated psychosis pre- versus post-intervention (295 vs. 396 days, p = 0.715).
“there was no significant difference in duration of untreated psychosis (295 vs. 396 days, p = 0.715)”
Quote in the paperSubstantial claim0 of 1 sources checked- cites [51•]
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- Interpretationreasoning
This and other studies illustrate the importance of intervening at the levels of the classroom and whole school.
“This and other studies illustrate the importance of intervening at the levels of the classroom and whole school.”
Quote in the paperSubstantial claim - Premisecitation
School infrastructures allow for large-scale implementation of prevention interventions.
“School infrastructures also allow for large-scale implementation of prevention interventions”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites [54••]
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- Premisecitation
In Skryabina et al.'s RCT, there were no intervention effects on math, reading, or writing standardized assessment test scores.
“There were no intervention effects on math, reading, or writing standardized assessment test scores.”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites [59] Skryabina E, Taylor G, Stallard P. Effect of a universal anxiety prevention programme (FRIENDS) on children’s academic performance: results from a randomised controlled trial. J Child Psychol Psychiatry. 2016;57:1297–307. source
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- Premisecitation
In OPUS, at 2 years, ACT-based early intervention reduced family burden compared to services as usual.
“reduced family burden”
Quote in the paperSubstantial claim0 of 1 sources checked- cites [50] Secher RG, Hjorthøj CR, Austin SF, Thorup A, Jeppesen P, et al. Ten-year follow-up of the OPUS specialized early intervention trial for patients with a first episode of psychosis. Schizophr Bull. 2014;41:617–26. source
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- Premisecitation
In At Home/Chez Moi, participants in Housing First had significantly higher gains in community functioning and quality of life in the first year.
“They also had significantly higher gains in community functioning and quality of life in the first year.”
Quote in the paperSubstantial claim0 of 1 sources checked- cites [67••]
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- Premisecitation
In OPUS, at 2 years, ACT-based early intervention increased treatment satisfaction compared to services as usual.
“higher treatment satisfaction”
Quote in the paperSubstantial claim0 of 1 sources checked- cites [50] Secher RG, Hjorthøj CR, Austin SF, Thorup A, Jeppesen P, et al. Ten-year follow-up of the OPUS specialized early intervention trial for patients with a first episode of psychosis. Schizophr Bull. 2014;41:617–26. source
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- Premisecitation
In OPUS, at 2 years, ACT-based early intervention improved treatment adherence compared to services as usual.
“improved treatment adherence”
Quote in the paperSubstantial claim0 of 1 sources checked- cites [50] Secher RG, Hjorthøj CR, Austin SF, Thorup A, Jeppesen P, et al. Ten-year follow-up of the OPUS specialized early intervention trial for patients with a first episode of psychosis. Schizophr Bull. 2014;41:617–26. source
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- Premisecitation
Research shows that youth, especially under-resourced youth, are most likely to receive mental healthcare in schools, given barriers to obtaining community mental health services.
“Research shows that youth, especially under-resourced youth, are most likely to receive mental healthcare in schools, given barriers to obtaining community mental health services”
Quote in the paperSubstantial claim0 of 1 sources checked- cites [52••, 53]
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- Premisecitation
In the London Early Intervention Service study, attitudes toward EIS as a first referral destination improved from 37% pre- to 68% post-workshop.
“attitudes toward EIS as a first referral destination improved (37% pre- to 68% post-workshop)”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites [51•]
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- Premisecitation
In OPUS, at 2 years, ACT-based early intervention reduced substance use compared to services as usual.
“reduced substance use”
Quote in the paperSubstantial claim0 of 1 sources checked- cites [50] Secher RG, Hjorthøj CR, Austin SF, Thorup A, Jeppesen P, et al. Ten-year follow-up of the OPUS specialized early intervention trial for patients with a first episode of psychosis. Schizophr Bull. 2014;41:617–26. source
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- Premisecitation
In OPUS, at 2 years, ACT-based early intervention lowered antipsychotic medication dosage compared to services as usual.
“lower antipsychotic medication dosage”
Quote in the paperSubstantial claim0 of 1 sources checked- cites [50] Secher RG, Hjorthøj CR, Austin SF, Thorup A, Jeppesen P, et al. Ten-year follow-up of the OPUS specialized early intervention trial for patients with a first episode of psychosis. Schizophr Bull. 2014;41:617–26. source
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- Premisecitation
In OPUS, at 10-year follow-up, most outcome differences between ACT-based early intervention and services as usual had dissipated.
“At 10-year follow-up, however, most of these outcome differences had dissipated.”
Quote in the paperSubstantial claim0 of 1 sources checked- cites [50] Secher RG, Hjorthøj CR, Austin SF, Thorup A, Jeppesen P, et al. Ten-year follow-up of the OPUS specialized early intervention trial for patients with a first episode of psychosis. Schizophr Bull. 2014;41:617–26. source
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- Premisecitation
FACT enrollees had significantly fewer days in jail (21.5 ± 25.9 vs 43.5 ± 59.2, p = .025).
“days in jail (21.5 ± 25.9 vs 43.5 ± 59.2, p = .025)”
Quote in the paperSubstantial claim0 of 1 sources checked- cites [77] Lamberti JS, Weisman RL, Cerulli C, Williams GC, Jacobowitz DB, Mueser KT, et al. A randomized controlled trial of the Rochester forensic assertive community treatment model. Psychiatr Serv. 2017;68:1016–24. source
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In Monroe County, New York, FACT enrollees compared to usual treatment had significantly fewer convictions (0.4 ± 0.7 vs 0.9 ± 1.3, p = .023).
“FACT enrollees had significantly fewer convictions (0.4 ± 0.7 vs 0.9 ± 1.3, p = .023)”
Quote in the paperSubstantial claim0 of 1 sources checked- cites [77] Lamberti JS, Weisman RL, Cerulli C, Williams GC, Jacobowitz DB, Mueser KT, et al. A randomized controlled trial of the Rochester forensic assertive community treatment model. Psychiatr Serv. 2017;68:1016–24. source
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- Premisecitation
In Shinn et al., youth in both usual care and family-adapted critical time intervention exhibited reductions in psychosocial and mental health symptoms over time.
“Youth in both groups exhibited reductions in psychosocial and mental health symptoms over time.”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites [69] Shinn M, Samuels J, Fischer SN, Thompkins A, Fowler PJ. Longitudinal impact of a family critical time intervention on children in high-risk families experiencing homelessness: a randomized trial. Am J Community Psychol. 2015;56:205–16. source
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- Premisecitation
Nath found that for every month of attendance at a drop-in center, children used 4.6% fewer substances.
“used 4.6% fewer substances”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites [68] Nath R. The Impact of Drop-In Centres on the Health of Street Children in New Delhi, India [dissertation]. 2016. source
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Nath found that for every month of attendance at a drop-in center, children experienced 2.1% fewer ill health outcomes per month.
“for every month of attendance at a drop-in center, children experienced 2.1% fewer ill health outcomes per month”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites [68] Nath R. The Impact of Drop-In Centres on the Health of Street Children in New Delhi, India [dissertation]. 2016. source
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- Premisecitation
FACT enrollees had more days in outpatient mental health treatment (305.5 ± 92.1 versus 169.4 ± 139.6, p < .001).
“more days in outpatient mental health treatment (305.5 ± 92.1 versus 169.4 ± 139.6, p < .001)”
Quote in the paperSubstantial claim0 of 1 sources checked- cites [77] Lamberti JS, Weisman RL, Cerulli C, Williams GC, Jacobowitz DB, Mueser KT, et al. A randomized controlled trial of the Rochester forensic assertive community treatment model. Psychiatr Serv. 2017;68:1016–24. source
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- Premisecitation
In Shinn et al., children ages 6-10 and 11-16 receiving the family-adapted critical time intervention compared to usual care were less likely at 24-month follow-up to self-report school troubles.
“Children ages 6–10 and 11–16 receiving the intervention compared to usual care were less likely at 24-month follow-up to self-report school troubles”
Quote in the paperSubstantial claim0 of 1 sources checked- cites [69] Shinn M, Samuels J, Fischer SN, Thompkins A, Fowler PJ. Longitudinal impact of a family critical time intervention on children in high-risk families experiencing homelessness: a randomized trial. Am J Community Psychol. 2015;56:205–16. source
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LHW interventions increase the supply of services in under-resourced areas by enlarging the workforce of culturally appropriate providers.
“LHW interventions increase the supply of services in under-resourced areas by enlarging the workforce of culturally appropriate providers.”
Quote in the paperSubstantial claim0 of 1 sources checked- cites [85•]
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- Premisecitation
Emergency room use increased in the intervention group compared to services as usual (55% vs. 35%, p < .01).
“emergency room use (55% vs. 35%, p < .01)”
Quote in the paperSubstantial claim0 of 2 sources checked- cites [79] Grabert BK, Gertner AK, Domino ME, Cuddeback GS, Morrissey JP. Expedited Medicaid enrollment, service use, and recidivism at 36 months among released prisoners with severe mental illness. Psychiatr Serv. 2017;68:1079–82. source
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- cites [80] Morrissey JP, Domino ME, Cuddeback GS. Expedited Medicaid enrollment, mental health service use, and criminal recidivism among released prisoners with severe mental illness. Psychiatr Serv. 2016;67:842–9. source
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- Premisecitation
Community mental health use increased in the intervention group compared to services as usual (69% vs. 37%, p < .01).
“Community mental health (69% vs. 37%, p < .01)”
Quote in the paperSubstantial claim0 of 2 sources checked- cites [79] Grabert BK, Gertner AK, Domino ME, Cuddeback GS, Morrissey JP. Expedited Medicaid enrollment, service use, and recidivism at 36 months among released prisoners with severe mental illness. Psychiatr Serv. 2017;68:1079–82. source
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- cites [80] Morrissey JP, Domino ME, Cuddeback GS. Expedited Medicaid enrollment, mental health service use, and criminal recidivism among released prisoners with severe mental illness. Psychiatr Serv. 2016;67:842–9. source
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- Premisecitation
Outpatient primary care use increased in the intervention group compared to services as usual (64% vs. 42%, p < .01).
“outpatient primary care (64% vs. 42%, p < .01)”
Quote in the paperSubstantial claim0 of 2 sources checked- cites [79] Grabert BK, Gertner AK, Domino ME, Cuddeback GS, Morrissey JP. Expedited Medicaid enrollment, service use, and recidivism at 36 months among released prisoners with severe mental illness. Psychiatr Serv. 2017;68:1079–82. source
Not checked in the free run.
- cites [80] Morrissey JP, Domino ME, Cuddeback GS. Expedited Medicaid enrollment, mental health service use, and criminal recidivism among released prisoners with severe mental illness. Psychiatr Serv. 2016;67:842–9. source
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- Premisecitation
Many CTC results persisted to grades 10-12, despite few CTC programs focused on these grade levels.
“Many of these results persisted to grades 10–12, despite few CTC programs focused on these grade levels.”
Quote in the paperSubstantial claim0 of 1 sources checked- cites [103•]
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- Interpretationcitation
The community interventions reviewed highlight the successes and promise of these interventions to promote mental health and broader outcomes at all social-ecological levels.
“The community interventions above (Appendix A), drawn from a larger selection (Appendix B), highlight the successes and promise of these interventions to promote mental health and broader outcomes at all social-ecological levels”
Quote in the paperSubstantial claim- Rests on an assumption: The studies selected for this review are representative of recent community interventions in the seven topic areas.
- Premisecitation
In male participants, CTC versus control communities showed increased likelihood of sustained abstinence from tobacco, marijuana, and inhalant use.
“In male participants, CTC versus control communities also showed increased likelihood of sustained abstinence from tobacco, marijuana, and inhalant use.”
Quote in the paperSubstantial claim0 of 1 sources checked- cites [103•]
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- Premisecitation
In Ecuador, reductions in the prevalence of any physical/sexual violence were greater for women with low baseline ratings of household decision-making power.
“with even greater reductions in the prevalence of any physical/sexual violence for women with low baseline ratings of household decision-making power”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites [106•]
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- Interpretationcitation
These studies highlight the importance of addressing social inequities to achieve mental health gains in under-resourced communities.
“These studies highlight the importance of addressing social inequities to achieve mental health gains in under-resourced communities”
Quote in the paperSubstantial claim0 of 1 sources checked- cites [107•, 110•]
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- Premisecitation
In the Ecuador neighborhood cluster RCT, pooled results from all treatment arms showed the intervention significantly decreased the probability of controlling behaviors and physical and/or sexual violence by 6 to 7 percentage points compared to controls.
“Pooled results from all treatment arms showed the intervention significantly decreased the probability of controlling behaviors and physical and/or sexual violence by 6 to 7 percentage points compared to controls”
Quote in the paperSubstantial claim0 of 1 sources checked- cites [106•, 109]
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- May combine two claims. 27
- The quote only partly states this claim. 1
- Classified as probably not a substantial claim. 8
May combine two claims. The quote only partly states this claim.
Findingnone givenThere are recent examples of effective community interventions in each of seven topic areas: collaborative care, early psychosis, school-based interventions, homelessness, criminal justice, global mental health, and mental health promotion/prevention.
“There are recent examples of effective interventions in each topic area.”
Quote in the paperNot a substantial claim- Rests on an assumption: The studies selected for this review are representative of recent community interventions in the seven topic areas.
May combine two claims.
Findingnone givenThe majority of community interventions focus on individual, family/interpersonal, and program/institutional social-ecological levels, with few intervening on whole communities or involving multiple non-healthcare sectors.
“The majority of interventions focus on individual, family/interpersonal, and program/institutional social-ecological levels, with few intervening on whole communities or involving multiple non-healthcare sectors.”
Quote in the paperSubstantial claim- Rests on an assumption: The studies selected for this review are representative of recent community interventions in the seven topic areas.
May combine two claims.
FindingcitationThere is evidence for the effectiveness of community interventions in multiple topic areas and acting at all social-ecological levels.
“There is evidence for the effectiveness of community interventions in multiple topic areas and acting at all social-ecological levels.”
Quote in the paperSubstantial claimClassified as probably not a substantial claim.
Findingnone givenStudies indicate the need for policy reform to support healthcare-community partnerships.
“Studies indicate the importance of ongoing resources and training to maintain long-term outcomes and the need for policy reform to support healthcare-community partnerships.”
Quote in the paperSubstantial claim- Rests on an assumption: Community-based organizations, social services, and healthcare agencies have different funding streams and incentives.
Probably not a substantial claim: may not pass S3 (load-bearing), S4 (based).
Interpretationnone givenFindings from many studies reinforce the interplay among mental health, interpersonal relationships, and social determinants of health.
“Findings from many studies reinforce the interplay among mental health, interpersonal relationships, and social determinants of health.”
Quote in the paperNot a substantial claimProbably not a substantial claim: may not pass S4 (based). May combine two claims.
Interpretationnone givenMulti-sector and community-based mental healthcare approaches can help address health and social inequities by promoting social well-being and addressing structural determinants of mental health.
“Multi-sector and community-based mental healthcare approaches can help address health and social inequities by promoting social well-being and addressing structural determinants of mental health”
Quote in the paperNot a substantial claimClassified as probably not a substantial claim.
Interpretationnone givenStudies indicate the importance of explicit attention to ethics and processes to foster equitable partnerships.
“explicit attention to ethics and processes to foster equitable partnerships”
Quote in the paperSubstantial claimClassified as probably not a substantial claim.
Interpretationnone givenStudies indicate the importance of policy reform to support sustainable healthcare-community collaborations.
“policy reform to support sustainable healthcare-community collaborations”
Quote in the paperSubstantial claimMay combine two claims.
PremisecitationIn CPIC, sub-group analyses and follow-up studies at 12 and 36 months support some significant beneficial effects of CEP over RS, with main effects seen predominantly during the first 6 months post-intervention and diminishing over time.
“Sub-group analyses and follow-up studies at 12 and 36 months support some significant beneficial effects of CEP over RS, with main effects seen predominantly during the first 6 months post-intervention and diminishing over time”
Quote in the paperSubstantial claim0 of 1 sources checked- cites [25, 27–34, 35•]
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May combine two claims.
PremisecitationIn Hankerson et al., 19.7% of 122 community members screened at three predominantly African American Christian mega churches reported moderate depression (PHQ-9 ≥ 10), which the authors noted is higher than is seen in African American community samples.
“19.7% of those screened reported moderate depression (PHQ-9 ≥ 10), in which the authors noted is higher than is seen in African American community samples”
Quote in the paperSubstantial claim0 of 1 sources checked- cites [38] Hankerson SH, Lee YA, Brawley DK, Braswell K, Wickramaratne PJ, Weissman MM. Screening for depression in African-American churches. Am J Prev Med. 2015;49:526–33. source
Not checked in the free run.
Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.
PremisecitationA 2015 Cochrane review described three assumptions that underlie community interventions: awareness of multiple forces at all social-ecological levels, investment in community participation, and prioritization of community mental health and social outcomes.
“A 2015 Cochrane review described three assumptions that underlie community interventions”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites [2•]
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May combine two claims.
InterpretationreasoningBoth CPIC and the London EIS study suggest the importance of resources to sustain lasting change.
“Similar to CPIC, both of these studies suggest the importance of resources to sustain lasting change.”
Quote in the paperNot a substantial claimMay combine two claims.
PremisecitationHousing First yields quicker and more sustained housing retention compared to continuum housing approaches.
“Studies have demonstrated that Housing First yields quicker and more sustained housing retention compared to continuum housing approaches”
Quote in the paperSubstantial claim0 of 1 sources checked- cites [66••]
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May combine two claims.
PremisecitationIn the Canadian At Home/Chez Moi RCT, participants in Housing First compared with usual care more quickly entered housing (within 73 vs. 220 days), retained housing for longer durations (281 vs. 115 days), and rated the quality of their housing more positively at 2-year follow-up.
“participants in Housing First, compared with usual care, more quickly entered housing (within 73 vs. 220 days), retained housing for longer durations (281 vs. 115 days), and rated the quality of their housing more positively at 2-year follow-up”
Quote in the paperSubstantial claim0 of 1 sources checked- cites [67••]
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May combine two claims.
PremisecitationIn the Head Start REDI RCT, children in the intervention versus control group were significantly more likely to follow optimal developmental trajectories in social behavior, aggressive-oppositional behavior, learning engagement, attention problems, student-teacher closeness, and peer rejection.
“Children in the Head Start REDI intervention vs. control group were significantly more likely to follow optimal developmental trajectories in social behavior, aggressive-oppositional behavior, learning engagement, attention problems, student-teacher closeness, and peer rejection.”
Quote in the paperSubstantial claim0 of 1 sources checked- cites [60] Nix RL, Bierman KL, Heinrichs BS, Gest SD, Welsh JA, Domitrovich CE. The randomized controlled trial of head start REDI: sustained effects on developmental trajectories of social–emotional functioning. J Consult Clin Psychol. 2016;84:310–22. source
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May combine two claims.
PremisecitationIn CTC versus control communities, results showed improved individual outcomes at eighth grade: reduced substance use, delinquency, and violence; later initiation of alcohol use, tobacco use, and delinquency; and lower prevalence of risky behaviors.
“In CTC versus control communities, results showed improved individual outcomes at eighth grade: reduced substance use, delinquency, and violence; later initiation of alcohol use, tobacco use, and delinquency; and lower prevalence of risky behaviors”
Quote in the paperSubstantial claim0 of 1 sources checked- cites [103•]
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May combine two claims.
PremisecitationBarnett et al.'s 2018 review of lay health worker interventions describes that LHWs elevate demand for services by increasing awareness of services and mental health literacy and by reducing stigma and barriers to care.
“Barnett et al. in their 2018 review of LHW interventions describe that LHWs elevate demand for services by increasing awareness of services and mental health literacy and by reducing stigma and barriers to care”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites [85•]
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May combine two claims.
PremisecitationIn the South Africa child abuse prevention study, there were significant improvements in social outcomes: reduced child abuse (63.0% to 29.5%, p < .001), reduced adolescent delinquency/aggressive behavior, reduced witnessed violence by adolescents, improved positive and involved parenting, and improved social support.
“The study yielded significant improvements in social outcomes: reduced child abuse (63.0% to 29.5%, p < .001), reduced adolescent delinquency/aggressive behavior, reduced witnessed violence by adolescents, improved positive and involved parenting (adolescent and caregiver self-report), and improved social support (adolescent and caregiver self-report).”
Quote in the paperSubstantial claim0 of 1 sources checked- cites [92••]
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May combine two claims.
PremisecitationIn the South Africa study, there were significant improvements in mental health outcomes: decreased caregiver substance use, reduced adolescent and caregiver depression, and reduced parenting stress.
“The study also demonstrated significantly improved mental health outcomes, specifically decreased caregiver substance use, reduced adolescent and caregiver depression, and reduced parenting stress.”
Quote in the paperSubstantial claim0 of 1 sources checked- cites [92••]
Not checked in the free run.
May combine two claims.
PremisecitationCilliers et al. found that truth and reconciliation commissions yielded improvements in societal healing but worsened individuals' health (worsened psychological health, depression, anxiety, and PTSD).
“They found that TRCs yielded improvements in societal healing, but worsened individuals’ health (worsened psychological health, depression, anxiety, and PTSD).”
Quote in the paperSubstantial claim0 of 1 sources checked- cites [94] Cilliers J, Dube O, Siddiqi B. Reconciling after civil conflict increases social capital but decreases individual well-being. Science. 2016;352:787–94. source
Not checked in the free run.
May combine two claims.
PremisecitationIn Washington State, 12 months post-implementation, 81% of the expedited Medicaid group and 43% of the services as usual group were enrolled in Medicaid (p < .01).
“Twelve months post-implementation, 81% of the expedited group and 43% of the services as usual group were enrolled in Medicaid, (p < .01).”
Quote in the paperSubstantial claim0 of 2 sources checked- cites [79] Grabert BK, Gertner AK, Domino ME, Cuddeback GS, Morrissey JP. Expedited Medicaid enrollment, service use, and recidivism at 36 months among released prisoners with severe mental illness. Psychiatr Serv. 2017;68:1079–82. source
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- cites [80] Morrissey JP, Domino ME, Cuddeback GS. Expedited Medicaid enrollment, mental health service use, and criminal recidivism among released prisoners with severe mental illness. Psychiatr Serv. 2016;67:842–9. source
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May combine two claims.
PremisecitationUnexpectedly, a significantly greater proportion of the intervention versus comparison group spent any days in jail (43 vs. 34%, p < .01) and state prison (56% vs. 46%, p < .01), with no significant difference in the proportion with any arrests (59% vs. 54%).
“Unexpectedly, there was a significantly greater proportion of those in the intervention versus comparison group that spent any days in jail (43 vs. 34%, p < .01) and state prison (56% vs. 46%, p < .01), with no significant difference in the proportion with any arrests (59% vs. 54%) at follow-up.”
Quote in the paperSubstantial claim0 of 2 sources checked- cites [79] Grabert BK, Gertner AK, Domino ME, Cuddeback GS, Morrissey JP. Expedited Medicaid enrollment, service use, and recidivism at 36 months among released prisoners with severe mental illness. Psychiatr Serv. 2017;68:1079–82. source
Not checked in the free run.
- cites [80] Morrissey JP, Domino ME, Cuddeback GS. Expedited Medicaid enrollment, mental health service use, and criminal recidivism among released prisoners with severe mental illness. Psychiatr Serv. 2016;67:842–9. source
Not checked in the free run.
May combine two claims.
PremisecitationNearly 40% of jail and prison inmates self-report a history of mental illness, and this prevalence is higher among those with more arrests and time served in a correctional facility.
“Nearly 40% of jail and prison inmates self-report a history of mental illness, and this prevalence is higher among those with more arrests and time served in a correctional facility”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites [75] Bronson J, Berzofsky M. Indicators of mental health problems reported by prisoners and jail inmates, 2011–2012, 1–17. Washington, DC: US Department of Justice; 2017.
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May combine two claims.
PremisecitationIn Patel et al.'s RCT, at 3 months, HAP participants demonstrated significantly reduced depression symptom severity, suicidal ideation, disability, days out of work, and intimate partner violence and significantly higher rates of depression remission and improved behavioral activation compared to the EUC group.
“At 3 months, HAP participants demonstrated significantly reduced depression symptom severity, suicidal ideation, disability, days out of work, and intimate partner violence and significantly higher rates of depression remission and improved behavioral activation compared to the EUC group.”
Quote in the paperSubstantial claim0 of 1 sources checked- cites [91•]
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May combine two claims.
PremisecitationQualitative interviews indicated that improved family well-being, reduced marital stress and conflict, and women's increased freedom of movement and decision-making power contributed to the decrease in violence.
“Qualitative interviews with participants indicated that improved family well-being, reduced marital stress and conflict, and women’s increased freedom of movement and decision-making power contributed to the decrease in violence.”
Quote in the paperSubstantial claim0 of 1 sources checked- cites [106•]
Not checked in the free run.
Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.
PremisecitationThrive NYC is an example of large-scale action to promote mental health at the civic level, with a budget of $850 million and 54 initiatives across all public agencies and departments, with special emphases on community partnerships and prevention.
“Thrive NYC is an example of large-scale action to promote mental health at the civic level, with a budget of $850 million and 54 initiatives across all public agencies and departments, with special emphases on community partnerships and prevention”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites [131, 132•]
Not checked in the free run.
Probably not a substantial claim: may not pass S2 (checkable), S3 (load-bearing).
PremisecitationThe expertise of community leaders and other stakeholders can be integrated equitably with that of researchers with trust, respect, and two-way knowledge exchange.
“The expertise of community leaders and other stakeholders can be integrated equitably with that of researchers with trust, respect, and two-way knowledge exchange [134, 135].”
Quote in the paperNot a substantial claim0 of 2 sources checked- cites [134] Bromley E, Figueroa C, Castillo EG, Kadkhoda F, Chung B, Miranda J, et al. Community partnering for behavioral health equity: public agency and community leaders’ views of its promise and challenge. Ethn Dis. 2018;28:397–406. source
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- cites [135] Jones L, Wells K. Strategies for academic and clinician engagement in community-participatory partnered research. JAMA. 2007;297:407–10. source
Not checked in the free run.
May combine two claims.
PremisecitationSimilar studies in Kenya's cash transfer program for at-risk youth and a cluster RCT of greening urban vacant land both showed significant improvements in depression outcomes compared to control communities.
“Similar studies include a large cluster RCT of cash transfers in Kenya’s program for at-risk youth and a cluster RCT of greening urban vacant land; both showed significant improvements in depression outcomes compared to control communities.”
Quote in the paperSubstantial claim0 of 1 sources checked- cites [107•, 110•]
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PremisecitationBy age 21, CTC versus control communities showed increased likelihood of lifetime abstinence from alcohol, tobacco, and marijuana use (ARR 1.49; 95% CI 1.03, 2.16), increased abstinence from antisocial behavior (ARR 1.18, 95% CI 1.02, 1.37), and decreased lifetime incidence of violence (ARR 0.89, 95% CI 0.79, 0.99).
“By age 21, CTC vs. control communities showed increased likelihood of lifetime abstinence from alcohol, tobacco, and marijuana use (ARR 1.49; 95% CI 1.03, 2.16), increased abstinence from antisocial behavior (ARR 1.18, 95% CI 1.02, 1.37), and decreased lifetime incidence of violence (ARR 0.89, 95% CI 0.79, 0.99).”
Quote in the paperSubstantial claim0 of 1 sources checked- cites [103•]
Not checked in the free run.
May combine two claims.
InterpretationcitationLay health worker interventions extend access and increase acceptability of mental health services by leveraging trusted relationships.
“LHW interventions extend access and increase acceptability of mental health services by leveraging trusted relationships.”
Quote in the paperNot a substantial claimMay combine two claims.
PremisecitationFewer CTC results persisted to age 19 (greater lifetime abstinence from antisocial behavior; greater lifetime abstinence from drug use and violence in male but not female participants).
“Fewer results (greater lifetime abstinence from antisocial behavior; greater lifetime abstinence from drug use and violence in male but not female participants) persisted to age 19”
Quote in the paperSubstantial claim0 of 1 sources checked- cites [103•, 104]
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InterpretationcitationPolicies as varied as mental health insurance parity, assisted outpatient treatment statutes, quality metrics for social determinants of health, value-based payment reforms, and the integration of funds and services for health and social care have the potential to improve access to treatment and improve outcomes.
“Policies as varied as mental health insurance parity, assisted outpatient treatment statutes, quality metrics for social determinants of health, value-based payment reforms, and the integration of funds and services for health and social care have the potential to improve access to treatment and improve outcomes”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites [114–117, 118•, 119–121]
Not checked in the free run.
The paper relies on this without support.
The studies selected for this review are representative of recent community interventions in the seven topic areas.
“We highlight major developments and trends, rather than providing a comprehensive systematic review.”
The paper relies on this without support.
Community-based organizations, social services, and healthcare agencies have different funding streams and incentives.
“Community-based organizations, social services, and healthcare agencies also have different funding streams and incentives.”
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
Some health and social domains such as education, housing, nutrition, and healthcare have pervasive influence on low income settings, while lack of supportive environments and community networks may have more detrimental effects in urban areas with high population density or ethnic minorities.
“some health and social domains such as education, housing, nutrition, and healthcare, have pervasive influence on low income settings, while lack of supportive environments and community networks may have more detrimental effects in urban areas with high population density or ethnic minorities [50, 51]”
From Prevention and early intervention in youth mental health: is it time for a multidisciplinary and trans-diagnostic model for care? (2020) · cites this paper as [50]
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Self-citationSUICIDAL IDEATION AND SUICIDE ATTEMPTS IN A SAMPLE OF HOMELESS PEOPLE WITH MENTAL ILLNESS
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- Authors
- Castillo, E. G., Ijadi-Maghsoodi, R., Shadravan, S., Moore, E., Mensah, M. O., Docherty, M., Aguilera Nunez, M. G., Barcelo, N., Goodsmith, N., Halpin, L. E., Morton, I., Mango, J., Montero, A. E., Rahmanian Koushkaki, S., Bromley, E., Chung, B., Jones, F., Gabrielian, S., Gelberg, L., Greenberg, J. M., Kalofonos, I., Kataoka, S. H., Miranda, J., Pincus, H. A., Zima, B. T., & Wells, K. B.
- Affiliations
- University of California, Los Angeles (US)
- New York State Psychiatric Institute (US)
- RAND Corporation (US)
- Healthy African American Families II (US)
- Corresponding author
- Castillo, Enrico G.
- ORCID
- Venue
- Current Psychiatry Reports
- Published
- 2019-03-29
- Volume
- 21
- Issue
- 5
- Pages
- 35-35
- ISSN
- 1523-3812 (ISSN-L)
- 1535-1645
- PMC
- PMC6440941
- OpenAlex
- W2927051625
- Semantic Scholar
- 3313f94a641d7640ed5b621180384888e4509dba
- Cited by
- 387
- References
- 119
- Citations by year
- 2026: 53 · 2025: 105 · 2024: 64 · 2023: 61 · 2022: 42 · 2021: 25 · 2020: 18 · 2019: 19
- FWCI
- 4.78
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- Locations
- Current Psychiatry Reports (publishedVersion, cc-by)
- Europe PMC (PubMed Central) (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- eScholarship (California Digital Library) (submittedVersion, cc-by)
- eScholarship (California Digital Library) (submittedVersion)
- Funders
- National Institute on Drug Abuse (K12DA000357)
- National Institute on Minority Health and Health Disparities (R01MD007721)
- Topics
- Health Sciences › Health Professions › General Health Professions › Community Health and Development
- Social Sciences › Psychology › Social Psychology › Mental Health Treatment and Access
- Social Sciences › Psychology › Clinical Psychology › Psychiatric care and mental health services
- Keywords
- community-based intervention, mental health promotion, social equity, socio-ecological model, intersectoral collaboration, collaborative care, early psychosis, school-based intervention, homelessness, criminal justice, global mental health, social determinants of health, interpersonal relationships, community-based services
- MeSH terms
- Community Medicine, Health Promotion, Humans, Mental Health, Psychotic Disorders, Schools, Social Environment
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
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