Table 1 Evidence for content of psycho-social interventions relating to older people and BME communities
From: Researching the mental health needs of hard-to-reach groups: managing multiple sources of evidence
Source of Evidence | How to make the intervention acceptable | How to make the intervention accessible | Evidence base | Who should be involved in the delivery | Service considerations |
|---|---|---|---|---|---|
Systematic review | Â | People can benefit from existing interventions | Consistent evidence that older people could benefit from various psychological treatments; and evidence that modified psychological treatments may be effective for people from BME groups. | Â | Â |
Grey literature | Focus on the individual not the condition Culturally appropriate Interventions should work to normalise mental health and recalibrate the boundaries between mental health, physical health and social life | Reaching out to the community Collaborative working Users need information on how to access services | Â | Advocacy to help people navigate their way through the service | Low intensity and social support Services should be bottom up |
Stakeholder perspective | Communicative, flexible, holistic, integral, positive, proactive, responsive | Â | Â | Â | Â |
Secondary analysis of qualitative data | Pluralistic, adaptive, holistic, resonant and socially conscious Somatisation of mental suffering Cultural sensitivity Use of metaphors and individuals explanatory models | Stigma prevents access and help seeking | Â | Â | Social deprivation and isolation Improving availability and reach-ability; understanding and improving experience and expectation of care |
Service-user perspectives | Isolation and loneliness Decreasing stigma | Lack of knowledge about available services | Â | Â | Lack of compassion and communication from health professionals |
Qualitative review-Meta synthesis | Reengagement with the wider social world Use of diagnostic labels may be counter productive Build on current strengths | Information to make informed choices | Â | Respect and interest in culture | Willingness by health professionals to understand service users views of themselves |
Conclusions drawn on Synthesis day | Working with patients' explanatory models Focus on both psychological and social issues | Signposting to relevant services Culturally acceptable Variable site delivery Multi delivery system | Evidence-based psychological interventions | Community 'champions' Understanding of local services and referral criteria Peer-led and professional-led | Â |