Improving access to psychosocial interventions for common mental health problems in the United Kingdom: narrative review and development of a conceptual model for complex interventions
Open accessAbstract
BACKGROUND: In the United Kingdom and worldwide, there is significant policy interest in improving the quality of care for patients with mental health disorders and distress. Improving quality of care means addressing not only the effectiveness of interventions but also the issue of limited access to care. Research to date into improving access to mental health care has not been strongly rooted within a conceptual model, nor has it systematically identified the different elements of the patient journey from identification of illness to receipt of care. This paper set out to review core concepts underlying patient access to mental health care, synthesise these to develop a conceptual model of access, and consider the implications of the model for the development and evaluation of interventions for groups with poor access to mental health care such as older people and ethnic minorities. METHODS: Narrative review of the literature to identify concepts underlying patient access to mental health care, and synthesis into a conceptual model to support the delivery and evaluation of complex interventions to improve access to mental health care. RESULTS: The narrative review adopted a process model of access to care, incorporating interventions at three levels. The levels comprise (a) community engagement (b) addressing the quality of interactions in primary care and (c) the development and delivery of tailored psychosocial interventions. CONCLUSIONS: The model we propose can form the basis for the development and evaluation of complex interventions in access to mental health care. We highlight the key methodological challenges in evaluating the overall impact of access interventions, and assessing the relative contribution of the different elements of the model.
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The reviews emphasised both heterogeneity and commonalities in access issues within and across under-represented groups.
“The reviews [8,9] emphasised both heterogeneity and commonalities in access issues within and across under-represented groups.”
From Development and evaluation of culturally sensitive psychosocial interventions for under-served people in primary care (2014) · cites this paper as [8]
The Results sections on models and processes of access describe factors shared across groups and variation between patient groups. The paper also discusses distinct approaches for underserved groups, including older people and ethnic minorities. The passages do not clearly address heterogeneity within those groups, so that part of the claim is not established. (LLM, conf=0.79)
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- Authors
- Gask, L., Bower, P., Lamb, J., Burroughs, H., Chew-Graham, C., Edwards, S., Hibbert, D., Kovandžić, M., Lovell, K., Rogers, A., Waheed, W., Dowrick, C., & Group, A. R.
- Affiliations
- Manchester Academic Health Science Centre (GB)
- University of Liverpool (GB)
- Lancashire Care NHS Foundation Trust (GB)
- Corresponding author
- Gask, Linda
- ORCID
- Venue
- BMC Health Services Research
- Published
- 2012-08-13
- Volume
- 12
- Issue
- 1
- Pages
- 249-249
- ISSN
- 1472-6963 (ISSN-L)
- PMC
- PMC3515797
- OpenAlex
- W2059536672
- Cited by
- 61
- References
- 89
- Citations by year
- 2026: 2 · 2025: 7 · 2024: 7 · 2023: 2 · 2022: 4 · 2021: 2 · 2020: 4 · 2019: 5 · 2018: 4 · 2017: 4 · 2016: 5 · 2015: 4 · 2014: 6 · 2013: 2 · 2012: 2
- FWCI
- 0.63
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- BMC Health Services Research (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion)
- Research Explorer (The University of Manchester) (submittedVersion)
- Funders
- National Institute for Health and Care Research (RP-PG-0606-1071)
- Goddard Space Flight Center
- Programme Grants for Applied Research
- Topics
- Social Sciences › Psychology › Social Psychology › Mental Health Treatment and Access
- Social Sciences › Psychology › Clinical Psychology › Psychiatric care and mental health services
- Health Sciences › Health Professions › General Health Professions › Health Policy Implementation Science
- Keywords
- access to mental health care, psychosocial interventions, common mental disorders, complex interventions, patient journey, community participation, primary care, personalized interventions, older adults, ethnic minorities, intervention evaluation
- MeSH terms
- Mental Disorders, United Kingdom, Health Services Accessibility, Humans, Mental Health Services, Quality of Health Care, Models, Organizational, Quality Improvement
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