Community Engagement in a complex intervention to improve access to primary mental health care for hard-to-reach groups
Corresponding Author
Jonathan Lamb PhD
Research Associate
Centre for Primary Care, Institute of Population Health, University of Manchester, Manchester, UK
Correspondence
Dr Jonathan Lamb
Centre for Primary Care
University of Manchester
5th Floor
Williamson Building
Oxford Road
Manchester M13 9PL
UK
E-mail: [email protected]
Search for more papers by this authorChristopher Dowrick MD
Professor
Institute of Psychology Health and Society, University of Liverpool, Liverpool, UK
Search for more papers by this authorHeather Burroughs PhD
Research Fellow
Institute of Primary Care and Health Sciences, Keele University, Keele, UK
Search for more papers by this authorSusan Beatty PhD
Research Associate
Centre for Primary Care, Institute of Population Health, University of Manchester, Manchester, UK
Search for more papers by this authorSuzanne Edwards PhD
Lecturer
Institute of Psychology Health and Society, University of Liverpool, Liverpool, UK
Search for more papers by this authorKate Bristow PhD
Research Fellow
Institute of Psychology Health and Society, University of Liverpool, Liverpool, UK
Search for more papers by this authorPam Clarke MSc
PhD Student
Institute of Psychology Health and Society, University of Liverpool, Liverpool, UK
Search for more papers by this authorJonathan Hammond MSc
PhD Student
Centre for Primary Care, Institute of Population Health, University of Manchester, Manchester, UK
Search for more papers by this authorWaquas Waheed MD
Academic Consultant Psychiatrist
Centre for Primary Care, Institute of Population Health, University of Manchester, Manchester, UK
Search for more papers by this authorMark Gabbay MD
Professor
Institute of Psychology Health and Society, University of Liverpool, Liverpool, UK
Search for more papers by this authorLinda Gask PhD
Professor
Centre for Primary Care, Institute of Population Health, University of Manchester, Manchester, UK
Search for more papers by this authorCorresponding Author
Jonathan Lamb PhD
Research Associate
Centre for Primary Care, Institute of Population Health, University of Manchester, Manchester, UK
Correspondence
Dr Jonathan Lamb
Centre for Primary Care
University of Manchester
5th Floor
Williamson Building
Oxford Road
Manchester M13 9PL
UK
E-mail: [email protected]
Search for more papers by this authorChristopher Dowrick MD
Professor
Institute of Psychology Health and Society, University of Liverpool, Liverpool, UK
Search for more papers by this authorHeather Burroughs PhD
Research Fellow
Institute of Primary Care and Health Sciences, Keele University, Keele, UK
Search for more papers by this authorSusan Beatty PhD
Research Associate
Centre for Primary Care, Institute of Population Health, University of Manchester, Manchester, UK
Search for more papers by this authorSuzanne Edwards PhD
Lecturer
Institute of Psychology Health and Society, University of Liverpool, Liverpool, UK
Search for more papers by this authorKate Bristow PhD
Research Fellow
Institute of Psychology Health and Society, University of Liverpool, Liverpool, UK
Search for more papers by this authorPam Clarke MSc
PhD Student
Institute of Psychology Health and Society, University of Liverpool, Liverpool, UK
Search for more papers by this authorJonathan Hammond MSc
PhD Student
Centre for Primary Care, Institute of Population Health, University of Manchester, Manchester, UK
Search for more papers by this authorWaquas Waheed MD
Academic Consultant Psychiatrist
Centre for Primary Care, Institute of Population Health, University of Manchester, Manchester, UK
Search for more papers by this authorMark Gabbay MD
Professor
Institute of Psychology Health and Society, University of Liverpool, Liverpool, UK
Search for more papers by this authorLinda Gask PhD
Professor
Centre for Primary Care, Institute of Population Health, University of Manchester, Manchester, UK
Search for more papers by this authorAbstract
Background
Despite the availability of effective evidence-based treatments for depression and anxiety, many ‘harder-to-reach’ social and patient groups experience difficulties accessing treatment. We developed a complex intervention, the AMP (Improving Access to Mental Health in Primary Care) programme, which combined community engagement (CE), tailored (individual and group) psychosocial interventions and primary care involvement.
Objectives
To develop and evaluate a model for community engagement component of the complex intervention. This paper focuses on the development of relationships between stakeholders, their engagement with the issue of access to mental health and with the programme through the CE model.
Design
Our evaluation draws on process data, qualitative interviews and focus groups, brought together through framework analysis to evaluate the issues and challenges encountered.
Setting & participants
A case study of the South Asian community project carried out in Longsight in Greater Manchester, United Kingdom.
Key findings
Complex problems require multiple local stakeholders to work in concert. Assets based approaches implicitly make demands on scarce time and resources. Community development approaches have many benefits, but perceptions of open-ended investment are a barrier. The time-limited nature of a CE intervention provides an impetus to ‘do it now’, allowing stakeholders to negotiate their investment over time and accommodating their wider commitments. Both tangible outcomes and recognition of process benefits were vital in maintaining involvement.
Conclusions
CE interventions can play a key role in improving accessibility and acceptability by engaging patients, the public and practitioners in research and in the local service ecology.
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