Community interventions for anxiety and depression in adults and young people: A systematic review

Abstract

Background: Growing evidence suggests that community-based interventions may be effective for anxiety and depression. This study aimed to describe studies of community interventions delivered to adults and/or young people, either in person or online, evaluated in randomised controlled trials and provide an indication as to their effectiveness, acceptability, quality of data and where possible, mechanisms of action. We included interventions delivered at and/or by museums, art galleries, libraries, gardens, music groups/choirs and sports clubs. Method: We developed and followed a preregistered protocol: PROSPERO CRD42020204471. Randomised controlled trials in adults and young people were identified in an extensive search with no date/time, language, document type and publication status limitations. Studies were selected according to predetermined eligibility criteria and data independently extracted and then assessed using Risk of Bias 1. The studies were deemed too heterogeneous for meta-analysis and were therefore reported using a narrative synthesis. Results: Our analysis included 31 studies, with 2898 participants. Community interventions most studied in randomised controlled trials were community music (12 studies, 1432 participants), community exercise (14 studies, 955 participants) and community gardens/gardening (6 studies, 335 participants). The majority of studies were from high-income countries – many were in specific populations (such as those with physical health problems) and were generally of low quality. Dropout rates across the included studies were low (1 participant on average per 100 participants). The inadequate description of interventions limited identification of potential mechanisms of action. Discussion: The uncertainty of the evidence allows only a weak recommendation in support of community interventions for anxiety and depression. The results suggest community engagement is a promising area for wide-reaching interventions to be implemented and evaluated, but more high-quality trials are needed, especially in young people and under-represented communities.

Subjective Experience on Virtual Reality-Assisted Mental Health Promotion Program

“…One study reported that a psychoeducation program on mental health reduced caregiver burden, anxiety, and depression [ 6 ]. Additionally, community activity programs such as music classes, exercising, and gardening have been tried in community centers [ 7 ]. These programs appeared to be partially effective in reducing anxiety and depression in young adults [ 7 ].…”

“…Additionally, community activity programs such as music classes, exercising, and gardening have been tried in community centers [ 7 ]. These programs appeared to be partially effective in reducing anxiety and depression in young adults [ 7 ]. One systematic review found that the community-based psychiatric treatment focused on social support improved depressive symptoms and overall psychiatric symptoms [ 8 ].…”

Online arts and culture for mental health in young people: a qualitative interview study

“…While there is increasing interest in community assets in improving health, there is currently a lack of evidence for OAC for CMDs in young people 27 29. There is also a lack of engagement of young people in determining the most fruitful approaches to support their mental health,29 most being investigated from the perspective of mental health professionals 29…”

Community indicators for mental health in Europe: a scoping review

“…For example, ECCM-based chronic disease programs for hypertension and diabetes in Canada integrated community resources by strengthening community action (e.g., developing a community network on the condition, bringing services to marginalized groups, shifting decision-making to adapt to community needs and capacities, partnering with local businesses, and involving the non-profit sector to develop a strategic vision) ( 12 , 13 ). In the mental health field, linking patients to community-based assets, such as community music, community exercise, museums/arts, libraries, and gardening is increasingly used and could be a promising intervention to reduce depression and anxiety ( 14 ). For example, horticultural therapy included tours of a botanical garden, learning about the species and how to cultivate, grow, and harvest them, combined with activities such as planting, arranging flowers, etc.…”