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Table 4 Summary of intervention strategies for tackling inequalities identified during research question 1

From: Advancing mental health equality: a mapping review of interventions, economic evaluations and barriers and facilitators

Intervention strategy

Brief description

Population or inequalities targeted

Number of studies includeda

Delivering education and training (DET)

Delivering skills-based training/teaching or providing information or tools for self-learning.

May be delivered to a person who has, or is at risk of, a mental health problem (e.g. training to aid self-management of symptoms), to the person’s family or teachers (e.g. training in parenting techniques or behaviour management) or to the health professionals who work with individuals with mental health problems (e.g. competence training).

• Minority ethnic or immigrant communities, indigenous communities, LGBTQ+ communities, people who have a sensory or physical impairment, people who have a learning disability, females young people, older adults

• Pregnancy and maternity, socioeconomic factors, rural or remote localities, urban localities

29

Providing reminders and feedback (PRF)

Providing prompts to promote adherence to the intervention or care programme.

Typically delivered as telephone or text reminders to encourage the participant.

• Minority ethnic or immigrant communities, young people

• Pregnancy and maternity, socioeconomic factors

3

Providing psychological support (PPS)

Delivery of psychological therapies that promote well-being, such as CBT or interpersonal therapy.

May be aimed at a person who has an existing mental health problem (intervention) or is at risk of a mental health problem (prevention), such as during pregnancy.

• Minority ethnic or immigrant communities, indigenous communities, religious communities, LGBTQ+ communities, people who have a sensory or physical impairment, males, young people, older adults, people experiencing homelessness, refugees

• Pregnancy and maternity, socioeconomic factors, rural or remote localities, urban localities

45

Restructuring the care team (RSCT)

The addition of new members to an existing care team, the introduction of a new role to the team or the shifting of duties among the team.

Directed at care teams. Changes may occur at a local level (e.g. within a single service or region) or at a national level as a result of change in policy.

• Minority ethnic or immigrant communities, indigenous communities, females, young people, older adults

• Pregnancy and maternity, socioeconomic factors

13

Engaging the community (EC)

Involving community members or organisations in mental health support or education, to improve engagement. This is best done outside of the health care setting.

May include outreach, co-production, education campaigns or the delivery of care in a community.

• Minority ethnic or immigrant communities, indigenous communities, religious communities, LGBTQ+ communities, females, young people, older adults, refugees

• Pregnancy and maternity, socioeconomic factors, rural or remote localities, urban localities

26

Providing financial incentives or removing financial barriers (PFIP)

Offering free provisions or money, subsidised services or removing financial barriers to accessing care or treatment.

May be delivered via policy change (e.g. national change in health insurance policies) or may be targeted at disadvantaged groups (e.g. renewal or regeneration of deprived housing areas).

• Minority ethnic or immigrant communities, indigenous communities, females, males, young people

• Socioeconomic factors, rural or remote localities, urban localities

7

Improving access to testing and screening (IATS)

Improves the accessibility of testing or screening by addressing logistical, social or financial barriers.

May introduce more routine mental health assessments for specific populations or address issues which can impede access to testing, such as diagnostic overshadowing (e.g. with a comorbid physical condition or learning disability).

• Minority ethnic or immigrant communities

• Socioeconomic factors, urban localities

2

Improving access to support, care and treatment for mental health problems (IASCT)

Addresses logistical barriers to accessing psychological therapies in order to reach a wider population or decrease wait-list durations.

May be national programmes addressing logistical barriers (e.g. lengthy waiting lists and lack of resources) or engagement programmes aimed at reaching underserved communities.

• Minority ethnic or immigrant communities, indigenous communities, religious communities, females, males, young people, older adults, socioeconomic factors, rural or remote localities, urban localities

8

Enhancing language, literacy and communication (ELLS)

Improving language or communication skills in order to improve engagement or adherence to care.

May be delivered to the individual with a mental health problem to improve accessibility of care (e.g. for those with limited proficiency in the local language or those who have a sensory impairment) or to the health professional to improve therapeutic communication with specific communities.

• Minority ethnic or immigrant communities, people who have a sensory or physical impairment, older adults

• Pregnancy and maternity, socioeconomic factors

3

Other—home-based care (OHBC)

Delivery of healthcare or support in the participant’s home.

Typically involves outreach visits from a healthcare professional or peer support worker to the individual with a mental health problem.

• Minority ethnic or immigrant communities, young people

• Pregnancy and maternity, socioeconomic factors

5

Other—culturally adapted interventions (OCA)

Tailored interventions which work within the cultural context of the recipient and take greater account of their cultural background and experiences.

May include culturally modified versions of well-evidenced therapies (e.g. cognitive behavioural therapy) or interventions developed specifically for the community of interest.

• Minority ethnic or immigrant communities, indigenous communities, religious communities, LGBTQ+ communities, people who have a sensory or physical impairment, females, males, young people, older adults, refugees

• Pregnancy and maternity, socioeconomic factors, rural or remote localities, urban localities

26

Other—technology (OT)

Providing information, skills-based training or therapeutic regimens delivered through the Internet, typically via mobile devices.

Often targeted at communities who face logistical barriers to accessing care, but may also be implemented in healthcare settings to improve information exchange between members of a care team.

• Minority ethnic or immigrant communities, indigenous communities, young people, older adults

• Pregnancy and maternity, socioeconomic factors, rural or remote localities

6

Other—community revitalisation (OCR)

Regeneration or renewal of deprived community areas or poorer socioeconomic localities.

Typically provided through government initiatives, investment or policy change.

• Minority ethnic or immigrant communities, young people

• Socioeconomic factors, urban localities

6

Other—not otherwise specified (O-NOS)

Alternative strategies not otherwise specified.

This included moving people to less deprived or distressed localities.

• Socioeconomic factors, rural or remote localities

1

  1. CBT cognitive behavioural therapy, DET delivering education and training, EC engaging the community, ELLS enhancing language/literacy and communication, IASCT improving access to support care and treatment for mental health problems, IATS improving access to testing and screening, LGBTQ+ lesbian, gay, bisexual, transgender and other, OCA other—culturally adapted interventions, OCR other—community revitalisation, OHBC other—home-based care, O-NOS other—not otherwise specified, OT other—technology; PFIP providing financial incentives or removing financial barriers, PPS, providing psychological support, PRF providing reminders and feedback, RSCT restructuring the care team. Text in italics provides further detail about the intervention strategies, including examples where relevant.
  2. aNumber of included studies by intervention for research question 1 and the populations or inequalities targeted. Some studies may be applied to multiple intervention types