Community-based psychosocial interventions for people with schizophrenia in LMIC: systematic review and meta-analysis

There is consensus that the treatment of schizophrenia should combine anti-psychotic medication and psychosocial interventions, yet the effectiveness of community-based psychosocial interventions in low- and middle-income countries is unclear. This review examined studies evaluating community-based psychosocial interventions for people with schizophrenia.

The review found that psychosocial interventions may have a significant impact on both symptoms and functioning of people with schizophrenia. However the quality of studies was sometimes low and there were some important gaps in the evidence. In particular, only in one study was the intervention delivered by trained lay persons. It was also interesting to note that interventions appeared to be effective even without employing community mobilisation. Such models of support, in particular community-based rehabilitation, have been recommended as appropriate approaches for low and middle income country contexts.

Further research is needed, particularly in low-income countries, to understand the role and utility of wider community engagement on outcomes for individuals and whether psychosocial interventions are effective when delivered in scalable formats using non-specialist workers.