Social interventions in mental health: evidence review and development of a conceptual framework

Background: People with serious mental health conditions (SMI) are often socially excluded. They face increased risks of unemployment, homelessness, poverty, crime victimisation and social isolation. Poor social circumstances are bi-directionally associated with poor mental health. Evidence is needed regarding effective models of care and support to improve the social circumstances of people with SMI.



Methods: We conducted an evidence synthesis of systematic reviews and trials of social interventions for people with SMI designed to improve social outcomes in one or more of eight life domains: poverty and debt, housing, employment, family relationships, social isolation, crime victimisation, offending, rights and citizenship. We then scoped non-trial literature and conducted an online call for evidence to identify additional social intervention models. Through stakeholder discussion and with reference to our identified models, we developed a conceptual framework to support description and evaluation of social interventions for people with SMI.



Results: There is convincing trial evidence for the effectiveness of employment and housing support models for people with SMI. Evidence is lacking regarding effective models of support in other life domains. We identified 92 distinct models of support across our eight life domains and developed a conceptual framework which distinguished five different sources of support and five different types of support, which were necessary and sufficient to describe and categorise our identified models.



Discussion: Implications of this project will be considered, regarding promising directions for policy and practice, priorities for future research in mental health social care, and the utility of our conceptual framework to support future intervention development and evaluation.