Improving Care for Deinstitutionalized People With Mental Disorders: Experiences of the Use of Knowledge Translation Tools

Abstract

Background: The deinstitutionalization process is complex, long-term and many countries fail to achieve progress and consolidation. Informing decision-makers about appropriate strategies and changes in mental health policies can be a key factor for it. This study aimed to develop an evidence brief to summarize the best available evidence to improve care for deinstitutionalized patients with severe mental disorders in the community.Methods: We used the SUPPORT (Supporting Policy Relevant Reviews and Trials) tools to elaborate the evidence brief and to organize a policy dialogue with 24 stakeholders. A systematic search was performed in 10 electronic databases and the methodological quality of systematic reviews (SRs) was assessed by AMSTAR 2.Results: Fifteen SRs were included (comprising 378 studies and 69,736 participants), of varying methodological quality (3 high-quality SRs, 2 moderate-quality SRs, 7 low-quality SRs, 3 critically low SRs). Six strategies were identified: (i). Psychoeducation; (ii). Anti-stigma programs, (iii). Intensive case management; (iv). Community mental health teams; (v). Assisted living; and (vi). Interventions for acute psychiatric episodes. They were associated with improvements on a global status, satisfaction with the service, reduction on relapse, and hospitalization. Challenges to implementation of any of them included: stigma, the shortage of specialized human resources, limited political and budgetary support.Conclusions: These strategies could guide future actions and policymaking to improve mental health outcomes.

Impact of stigma on the placement of mental health facilities: insights from early career psychiatrists worldwide

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Large‐scale evaluation of staff training in programs for adults with intellectual and developmental disabilities

“…The late 1960s are partly notable for the deinstitutionalization movement that resulted in the relocation of many adults with intellectual and developmental disabilities (IDD) from institutions to community‐based homes and day programs (Bouras & Jacobson, 2002; Fulone et al., 2021). The transition from institutions to community‐based programs for many adults with IDD has resulted in more choice, access to integration, and notably, an opportunity for caregivers (e.g., staff and families) to be involved in service delivery for adults with IDD (Bouras & Jacobson, 2002).…”

Community mental health interventions for people with major depressive disorder: A scoping review

“…The community-based delivery of mental healthcare is driven by a move to de-institutionalize care and alleviate stigmas for persons with mental health conditions (Fulone et al 2021). With the adherence to evidencebased care delivery models, past CMHIs have not only reduced hospital admissions amongst persons with severe mental illness (PSMI) such as MDD, but also improved their employment and treatment adherence (Bergmark et al 2018;Fam et al 2007).…”