The Effectiveness of Community-Based Care in Managing the Care of Individuals with Severe Mental Health Needs

This research investigates the effectiveness of community-based care in managing the care of individuals with severe mental health needs. It includes PICO framework, search strategy, research method, results of search strategy, summary and synthesis of paper and issue of implication.

IMPLEMENTING BEST PRACTICE

TABLE OF CONTENTS
INTRODUCTION...........................................................................................................................3
RESEARCH QUESTION................................................................................................................3
PICO framework..........................................................................................................................3
Rationale......................................................................................................................................3
RESEARCH METHODOLOGY.....................................................................................................4
Search strategy.............................................................................................................................4
Key search terms..........................................................................................................................4
Databases.....................................................................................................................................5
Boolean operators........................................................................................................................5
Inclusive and exclusive criteria....................................................................................................6
RESULTS OF THE SEARCH STRATEGY...................................................................................6
QUALITY APPRAISAL.................................................................................................................8
SUMMARY AND SYNTHESIS OF THE PAPERS......................................................................8
ISSUES OF IMPLEMENTATION...............................................................................................10
CONCLUSION..............................................................................................................................11
REFERENCES..............................................................................................................................12
APPENDIX 1.................................................................................................................................14
APPENDIX 2.................................................................................................................................17

INTRODUCTION
Currently in United Kingdom there are 1 out of 4 people that are experiencing mental
health problem, among with them 7.8% has been diagnosis. Depression, panic mental disorder
obsessive compulsive disorder disease, post-traumatic and stress disorder are some of the
specific mental health issues. Community based care is family of providers that offer necessary
support to people that are suffering from intellectual development disability. It is care services
for all the age of people that need health care assistance at home, thereby, physiotherapy,
rehabilitation and home support are different services provided to people living in the society.
This research will depict significant information related to “The effectiveness of community-
based care in managing the care of individuals with severe mental health needs”. It includes
PICO framework, search strategy, research method, results of search strategy, summary and
synthesis of paper and issue of implication.
RESEARCH QUESTION
PICO framework
Population: People that have severe mental health needs
Intervention: community-based care to several individuals with mental health needs.
Comparison: Nil
Outcome: effectiveness of community-based care on mental health of individual.
AIM
“To investigate on the effectiveness of various community-based care services in managing the
care of individuals with severe mental health needs.
OBJECTIVE
“ To improve patient experience by enhancing effectiveness within community based care in
managing the individuals with severe mental health need”.
Rationale
The study related to “effectiveness of community-based care in managing care of
individual that are suffering from mental health issue is important as there are limited literature
pertaining to the same. The statistic shows that 4-10% of people in England experience

depression across their lifetime. From 1993 to 2014, The mental health problem has been
increased by 20% in both men and women, among them younger are facing more mental health
issue. Along with that, there are many people across worldwide and United Kingdom that have
mental health needs (Kohrt and et.al., 2018). Thereby the study will help in understanding
whether the community-based care is effective in meeting severe needs of mental health people.
RESEARCH METHODOLOGY
Search strategy
Search strategy is related to structure of key terms that are being used to search specific
particular database relevant to the research questions. The main concept of search question are
being combined in order to retrieve actual results. For pursing the current research, systematic
search strategy will be used in which all the search terms are being identified, appropriate
database are selected for suitable articles (Mourão and et.al., 2017). Inclusion and exclusion
criteria, Boolean operators are several research methods that has been used by researcher to
accumulate more detailed related to the topic.
Key search terms
Search term can be defined as words or phrase that are being used by someone in order to
find out relevant material, articles and other information in context of topic. Search engine is
used to search word on internet to have sufficient information related to effectiveness of
community care services on individuals that are suffering severe mental health issue (Wang and
et.al., 2019). Such as:
Terms Synonyms
Mental health Mental well being
Issue Problem
Effectiveness Useful, effective
Community care Public care
Needs Want and requirement
Outcomes Results

Databases
Database can be defined as organised collection of structure information or data that are stored
in electronical form such as computer system. The data can be effectively accessed, managed,
modified and updated to have relevant information (Cui and et.al., 2018). Likewise,
DATABASE DESCRIPTION
CINAHL This is one of the important databases which contain various articles and
journals related with nursing. This is a research toll for nursing and allied
health professionals. This is the most authoritative nursing and allied
health platform which contain various full text journals.
PubMed This is the free search engine that provides various literature related
with the retrieval of life sciences and biomedical that make focus
towards the improvement of health at the personal and global level. It
contains all those articles that are related with the chemical science,
behaviour science and other related topics.
Science Direct This is also a major database that contain information related with
science and its associated concepts. It contains large number of books,
articles and journals that is related with the science and its topics. It
covers large collection of engineering publication and physical science
from the theoretical to the application perspective.
Boolean operators
Boolean’s operator are words such as And, or, not and Not are conjunction that are used to
combine or exclude keyword in a search. In another words, they are set of command that could
be used in every search engine, online catalogue and database. They help in connecting the
search word together either to make narrow or broaden the set of results. Such as, And is search
that helps in narrow down the results for examples: The effectiveness of community based care
and support that are provided to individual that are suffering from severe mental health issue
(Morgan and et.al., 2018). On the contrary note, the or is being used to broaden the search

likewise, effectiveness of community-based care or services that are offered to mental health
people for their health and wellbeing.
Inclusive and exclusive criteria
Inclusion criteria are characteristics that prospective subject must need to be included in
the study, while things that are being excluded that does not fit in the eligibility criteria of study.
Likewise, the dates, when the study has been designed, population and outcome are key criteria
that are being used to include and exclude study to have relevant information (Patino and
Ferreira, 2018).
INCLUSION CRITERIA EXCLUSION CRITERIA
Language is also one of the criteria that has been
used to include and exclude. Such as, only articles
that are published in English are being included.
The article or study that have make use of other
language than English are being directly excluded
in the research.
All those articles that are published between
2011 to 2021 has been included in the study to
gathered more relevant and current information.
On the other hand, the articles that has been old
or published before 2011 are being excluded in
the research to have only useful information.
The study that has included information related
to Community care services in context of mental
health issue are being part of research.
The study that are not related to community care
services that provide care to people that are
suffering from mental health issue are being
excluded.
Patient that are suffering mental health issue are
only being included in the study.
While, the individual that are facing other health
issue than mental are being excluded to select
best articles.
RESULTS OF THE SEARCH STRATEGY
Zeeman and et.al (2020) conducted a randomised control trial (RCT) on community
based and recovery oriented care for mental disorders within Southern and Eastern Europe
where aims and design of multi-country implementation within evaluation study. The article
presents in depth analysis on further significant aspect connected to implementing evidence-base
service delivery models for patients of mental illness in middle income countries within Central

and Eastern Europe. Findings from article presents explanation on recent community-based
services are very efficient and recovery-oriented aspects connected to care for mental disorders
cases. Recover-E project development has demonstrated implementation of evidence-based
services model for people with severe mental illness in community-based service models for
health systems.
Kohrs and et.al (2018) conducted met-review on competence and competencies, within
role of varied communities in mental health care aspects as per in within low- and middle-
income countries. The authors in research have shed light on importance of community mental
health care, which holds greater relevance in low- and middle-income countries as compared to
high income countries within recent time period. Community competent are vital for addressing
global mental health needs, for improvising mental disorders and access to evidence-base
interventions effectively. Findings evaluated in article has presented in depth review on varied
global burden of diseases within diseases related to mental and substance disorders, where it has
presented significant aspects onnected to mental health care.
Vahine and et.al, (2018) has conducted national evaluation on aspects connected to
community based mental health strategies in Finland, where high quality mental health care
strategies set vision for future to determine keen long term efficacy. The article has developed
research on mental health strategies adopted within healthcare professionals where out of 320
municipalities, documents for 129 municipalities have been included within study. Mental health
strategy documents have been gathered though online search and an email survey based on
municipalities, based on multi country implementation within evaluation study. Findings within
study has been also found to be precise where community based mental health strategies in
Finland are widely effective, and specific strengthened as per new requirements.
McNish an et.al, (2018) has conducted research on community based behavioural health
interventions, developing effective strong community partnerships which plays crucial role for
enhancing optimum recovery of patients. Research done by authors explains popularity of
community-based interventions which are authentically crucial for analytical understanding and
revival over past two decades. The analysis done in involvement has solicited formation of
community coalitions, where 16 grantees were asked to provide inputs in development and
implementation of initiatives. Article has presented strategies that were found most successful,
highly competent based on community based behavioural health interventions.

Steve and et.al, (2012) has conducted authentic research on informing development of
services for severe and long term mental health conditions which are analysed to be a mixed
study of community based mental health initiatives within England. The research based on
development of advanced self-care services for mental health patients, within community based
mental health initiatives within England have been found to be highly competent.. Research
presented by author is widely competent and productive, for strengthened efficacy and improved
self-care services based on mental healthcare conditions aspects. It is mixed method study
undertaken with psychosocial measures and health services use with qualitative interviews of
120 new referrals.
Strand and et.al, (2020) has conducted exploratory and descriptive study research on
combining online and offline peer support groups within community mental health care settings.
It is qualitative study of service users’ experiences, where experiences were collected from focus
groups and individual interviews and inductive analysed in thematic format for effective
research. Identified benefits have been found to be based on service users’ options, where
benefits have been appeared to arise from service users within values. Also, research study,
explains effective working methods based on optimum aspects for extended online and offline
peer support group users within community healthcare.
(Refer appendix 1)
QUALITY APPRAISAL
For appraising the selected papers, the CASP tool has been used. It is an important generic
toll that appraise the strength and limitation of the qualitative research methodology. This toll
contains certain checklist that will judge the quality of the articles (Martínez-Plumed, and et.al.,
2017). In the present research with the use of the CASP tool the quality of the paper in terms of
its strength and limitation was judged and analysed. (refer appendix 2)
SUMMARY AND SYNTHESIS OF THE PAPERS
The article selected to study” effectiveness of community-based care in provided better care
and support to the people that are suffering from severe mental health issue. Likewise, the one of
the articles has main aim to evaluate local mental health strategy that are being used by

community based mental health services. In it there are municipalities document has been
included in the study that has been gathered while making use of online search and e- mail
survey. In short, the outcome gathered is evaluation of process, operation in against of 31
indicators that are present in checklist. It has been suggested that commitment to preventive
work and dedication to develop community-based care will helps in providing more effective
services to people (Gössl and Sorajja, 2018). There are been increase in popularity of
community-based program to make people aware about the key mental health issue and the
manner in which they can be overcome. Such as, strategies related to successful partnership with
local organisation will contribute in providing more good services to severe mental health
individual.
Furthermore, through study, it has also derived information related to the role of community
services in mental health care within low- and medium-income countries. Likewise countries
such as Brazil, China, South Africa are demonstrating extensive care in context of individual that
are being suffering from mental health issue. The community component has helped in filling
gap in setting where the mental health services does not exist in primary care. Making use of new
and innovative technology will helps in expanding the scope and improving the quality of
community health services. For example: the digital mobile application can be used to aware
people about the services so that they can easily book as and when required. At the same time,
mobile tools which are connected to facilitate diagnosis and detection of various mental
disorders, online self-help program can be organised for individual.
The study has helped in learning what all modification or changes that needs to be made in
the policy of five sites in order to inform and engage policy makers about the way community-
based recovery model of services can helps in improving the health and social outcome at both
regional and national level. At the same time, this has contributed in knowing about the recover –
e project in which function of peer workers or individual that experienced severe mental disorder
have work in five sites (Kohrt and et.al., 2018). In short, practice of various peer workers as
partner with mental health care provision will lead in improving the effectiveness of community-
based care for individual. Thereby the study will help in making development of more
community-based services in countries that have limited availability of the same.

Moreover, development in providing support for self-care in mental health need to be
considered by government of the country to helps people that are facing severe mental health
issue. Self-care outcome can be improved through greater empowerment, more engagement of
people with positive collaboration with support staff. Therefore, emphasis need to be lay on
encouraging people to take care of themselves in effective way. At last, the study has contributed
in understanding that both online and offline peer support group acts as adjunct to ongoing
mental health care people. Along with that are complementary and combined with two formats
with an motivate to facilitate friendship, community connectedness and social relationship
(Knapp and Wong, 2020). Therefore, the peer support of people that are facing mental health
issue is central to recovery-oriented approaches in context of mental health care.
The study are reliance or interlinked with each other as all are mainly based on
effectiveness of community care services in providing support and care to individual that are
facing several mental health issue. All has helped in finding what all better strategy that could be
used to improve the community care services such as partnership, making use of digital
technology and peer work, etc.
ISSUES OF IMPLEMENTATION
The stakeholders within community-based care are patients, public and community where
issues of implementation are highly essential for analysing in depth research based on significant
goals extensively. With changing medical conditions availability, within community-based care
in managing care of individuals with severe mental health needs there are issues rising which
need is to be further optimized. Analysis of specific factors and managing further care needs of
patients, mental health recovery can be more diversified with specific new fundamentals as per
stakeholders preferences. Effectiveness of community-based care in managing care of
individuals with severe mental health needs, can be analysed to be highly essential for
strengthened working within healthcare practices. Community based services stakeholders, feel
that there can be various issues in specific cases among mental health needs assessment variedly.
The issues of implementation within community-based care in managing care of individuals
within severe mental health needs patients will enable to generate in depth productive research
done. Issues of implementation among stakeholders are based on systems, policies engagement,
community involvement and specific policies based on extended new services.

Also, stakeholders need to maintain privacy of patients secure, as per the preferences
within community-based services among mental health illness. It can be also analysed that issues
analysis also shed light on further strengthened vision, based on reporting and engagement of
healthcare services for improvised healthcare services. Holistic individual health assessment
plays crucial role, where healthcare professionals, doctors and nurses have to be specific
regarding providing effective mental healthcare therapies.
This can be also analysed to be essentially crucial regarding stakeholders’ approach in
practice, where maintaining prior hygienic standards for patients is crucial within community-
based services. The patients, public and communities being the most essential stakeholders
among community-based care services are focused towards managing individuals with severe
mental health needs. The analysis of mental health needs prior plays crucial role for developing
strengthened vision in bringing change within community-based care and advancing prior needs,
as per patients’ preferences. Public best healthcare needs analysis, further plays keen importance
in primitive improvement within patient’s healthcare needs analysis diversely. Cost, access and
quality parameters also hold specific importance for keen functional improvement in healthcare
services availability within community-based services delivery. Also developing innovation,
professional quality standards further develop proper leveraged growth based on extensive
improvised new services optimization functionally.
CONCLUSION
From the above research it can be concluded that in low and medium countries there are
limited community care services for people so they need to be developed. It has been found out
that there is lack of consideration of human right, financial planning to effective and successfully
plan services that need to be offered to people. Furthermore, best practices for forming
community partnerships acts as guideline related to community-based evaluators and program
planner. It has also helped in learning that adaptation of new and innovative technology will
contribute community care services to effectively provide services to people facing severe
mental health issue. At last, it can be summarised that Peer support, partnership and development
of self-care among people will helps in reducing the mental health issue suffered by individual
within the society.

REFERENCES
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income countries: a meta-review of components and competencies. International journal
of environmental research and public health, 15(6). p.1279.
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Combining online and offline peer support groups in community mental health care settings: a
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Community-based behavioral health interventions: Developing strong community partnerships,
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APPENDIX 1
Evidence summary table
Question: What is the efficacy of St John's Wort in treating clients in acute wards who presented with
Recurrent depressive disorder?
Author, Date Study
Design/
Evidence
type
S
et
ti
n
g
Sample
size
Evi
den
ce
leve
l
Rat
ing
Study Findings that help answer the question
Zeeman and
et.al (2020)
Systematic 180 3 Quality of care and outcomes of those with a mental
health problem, -based services were focused on.
Kohrs and
et.al (2018)
Randomised
control trial
23 2 Availability and integration of mental health recovery services
into communities’ analysis in promotion of accessible and
affordable clinical services.
Vahine and
et.al, (2018)
Systematic 129 3 High-quality mental health care strategies have enabled to set
a vision for the future with systematic information’s conducted
within research.
McNeish an
et.al, (2018)
Systematic 16 2 Greater communities' involvement has provided research
practitioners, to be culturally relevant with information for
making interventions successful.
Steve and
et.al, (2012)
Cohort 120 3 Framework approach has been taken to qualitative analysis,
based on exploratory aspect within statistical analysis which

are based on possible associations.
Strand
and et.al,
(2020)
Qualitative 10 3 Qualitative data about service users’ and varied experiences
were collected through focus groups and individual interviews
which have been inductively formulated.

17

APPENDIX 2
Kohrt, B.A., and et.al., 2018. The role of communities in mental health care in low-and middle-
income countries: a meta-review of components and competencies. International
journal of environmental research and public health. 15(6). p.1279.
Paper for appraisal and reference:
……………………………………………………………………………………………

19

21

Shields-Zeeman, L., and et.al., 2020. Towards community-based and recovery-oriented care for
severe mental disorders in Southern and Eastern Europe: aims and design of a multi-
country implementation and evaluation study (RECOVER-E). International journal of
mental health systems. 14(1). pp.1-14.
23

25

27

Vähäniemi, A., and et.al., 2018. A national evaluation of community-based mental health
strategies in Finland. International Journal for Quality in Health Care. 30(1). pp.57-64.
29

31

33

35

Vähäniemi, A., and et.al., 2018. A national evaluation of community-based mental health
strategies in Finland. International Journal for Quality in Health Care. 30(1). pp.57-64.

37

39

Steve, G., and et.al., 2012. Informing the development of services supporting self-care for
severe, long term mental health conditions: a mixed method study of community
41

based mental health initiatives in England. BMC health services research. 12(1).
pp.1-16.

43

45