Key study characteristics.

This scoping review aimed to synthesise current evidence related to psycho-social groups as part of community-based mental health interventions in South Asia. We used a realist lens to pay attention to the contexts and mechanisms supporting positive outcomes. We included studies published from January 2007 to February 2022 that: were based in communities in South Asia, included a group component, reported on interventions with a clear psychosocial component, targeted adults and were implemented by lay community health workers. Two reviewers extracted data on intervention components, groups and facilitators, participant demographics and enabling contexts, mechanisms and outcomes. Expert reference panels including people with lived experience of psycho-social disability, mental health professionals and policy makers confirmed the validity and relevance of initial review findings. The review examined 15 interventions represented by 42 papers. Only four interventions were solely psycho-social and nearly all included psychoeducation and economic support. Only 8 of the 46 quantitative outcome measures used were developed in South Asia. In a context of social exclusion and limited autonomy for people with psychosocial disability, psychosocial support groups triggered five key mechanisms. Trusted relationships undergirded all mechanisms, and provided a sense of inclusion, social support and of being able to manage mental distress due to improved skills and knowledge. Over time group members felt a sense of belonging and collective strength meaning they were better able to advocate for their own well-being and address upstream social health determinants. This led to outcomes of improved mental health and social participation across the realms of intrapersonal, interpersonal and community. Psychosocial groups merit greater attention as an active ingredient in community interventions and also as an effective, relevant, acceptable and scalable platform that can promote and increase mental health in communities, through facilitation by lay community health workers.本范围综述（scoping review）旨在整合南亚地区基于社区的心理健康干预措施中作为组成部分的社会心理小组（psycho-social groups）相关现有证据。本研究采用现实主义视角，重点关注可促成积极结局的干预情境与作用机制。本综述纳入了2007年1月至2022年2月发表的符合以下条件的研究：研究地点为南亚社区、包含小组干预环节、报告的干预措施具备明确的社会心理属性、研究对象为成年人且由基层社区卫生工作者（lay community health workers）实施。由两名研究者提取干预组成要素、小组与引导者、参与者人口学特征、有利情境、作用机制及结局指标等维度的数据。由社会心理残疾亲历者、心理健康专业人员及政策制定者组成的专家咨询小组，验证了本综述初始研究结果的有效性与相关性。本综述共纳入42篇文献所报道的15项干预措施，其中仅4项干预措施仅包含社会心理干预内容，其余几乎所有干预措施均涵盖心理教育（psychoeducation）与经济支持。所使用的46项量化结局指标中，仅8项是在南亚地区开发的。在社会排斥与社会心理残疾群体自主权受限的背景下，社会心理支持小组可激活五大核心作用机制：信任关系为所有作用机制奠定基础，使参与者产生归属感、获得社会支持，并通过技能与知识的提升得以更好地应对心理痛苦；随着时间推移，小组成员会产生归属感与集体力量感，进而能够更好地为自身健康福祉发声，并应对上游层面的社会健康决定因素，最终实现个体内在、人际及社区三个层面的心理健康水平提升与社会参与度改善。社会心理小组作为社区干预措施的核心活性要素，同时也是由基层社区卫生工作者开展引导、可有效、适切、易被接受且可推广的社区心理健康促进平台，值得获得更多关注。