Data_Sheet_1_Community-based models of care for adolescent and adult depression, suicidal behavior, anxiety, trauma, and substance use in Africa: a scoping review.PDF

BackgroundCommunity-based care (CBC), where care is delivered outside of the traditional health facility setting, has been proposed to narrow the mental health (MH) and substance use (SU) treatment gap in Africa.
ObjectiveThis scoping review aims to comprehensively summarize CBC models addressing adolescent and adult MH (depression, anxiety, trauma, suicidal behavior) and (non-tobacco) SU problems in Africa.
MethodsWe searched PsycINFO, Embase, Scopus, CINAHL, and Medline Ovid. Studies and protocols were included if they reported on CBC intervention’s effects on MH or SU symptoms/ diagnoses, acceptability, feasibility, or patient engagement in care, regardless of whether the intervention itself was designed specifically for MH or SU.
ResultsAmong 11,477 screened publications, 217 were eligible. Of the unique intervention studies (n = 206), CBC models were classified into the following approaches (non-mutually exclusive): psychotherapeutic (n = 144), social (n = 81), lifestyle/physical health (n = 55), economic (n = 26), and psychopharmacological (n = 2). While quantitative results suggest possible efficacy of CBC models, description of CBC location was often poor. Fewer interventions addressed suicidal behavior (n = 12), the needs of adolescents (n = 49), or used traditional healers or religious figures as providers (n = 3).
ConclusionMany CBC models have been tested on MH and SU in Africa and should be critically appraised and meta-analyzed in subsequent reviews, where possible.

背景：社区照护（Community-based care, CBC）指在传统医疗机构场景之外提供的照护服务，已有研究提出其可缩小非洲地区心理健康（mental health, MH）与物质使用（substance use, SU）的治疗缺口。
目标：本范围综述旨在全面总结针对非洲青少年及成人心理健康问题（抑郁、焦虑、创伤、自杀行为）和（非烟草类）物质使用问题的社区照护模式。
方法：本研究检索了PsycINFO、Embase、Scopus、CINAHL及Medline Ovid数据库。纳入的研究与方案需报告社区照护干预对心理健康或物质使用症状/诊断、可接受性、可行性或患者诊疗参与度的影响，无论该干预是否专门针对心理健康或物质使用问题设计。
结果：在初筛的11477篇文献中，共有217篇符合纳入标准。在206项独立干预研究中，社区照护模式可分为以下非互斥类别：心理治疗类（n=144）、社会支持类（n=81）、生活方式/身体健康类（n=55）、经济支持类（n=26）及精神药物类（n=2）。尽管定量结果提示社区照护模式可能具有疗效，但对社区照护地点的描述往往不够充分。针对自杀行为的干预较少（n=12），针对青少年需求的干预较少（n=49），或以传统治疗师或宗教人士作为服务提供者的干预更为少见（n=3）。
结论：非洲地区已有多款社区照护模式被应用于心理健康与物质使用相关问题的干预，未来应在可行前提下对其开展严格评估，并在后续综述中进行元分析。