Reimagining Mental Health Care by Focusing on Psychosocial Interventions

Psychosocial interventions — or psychosocial treatments — are various ways of addressing a person’s mental health challenges by looking at their psychological or social environment. 

These types of interventions focus less on the biology and more on the overlapping factors that affect a person’s mental and emotional state. They have been proven in many settings to improve the quality of life, leading to fewer difficulties in school, work, and community life.

Psychosocial interventions is an umbrella term that covers the following types of treatments, according to the National Alliance on Mental Illness (NAMI).

Types of Psychosocial Treatments

1. Psychotherapy. Talking with a therapist privately, with a family, or a group.

2. Psychoeducation. Learning about the condition, exploring coping strategies, and problem-solving with people in your life.

3. Self-help and Support Groups. Community-based approaches to recovery where members share frustrations, successes, and strategies.

4. Psychosocial Rehabilitation. Using a minimal amount of professional assistance to gain coping skills and reduce stressors.

5. Assertive Community Treatment (ACT). A team-based treatment model where multiple providers work together to help someone address every aspect of their life: medication, therapy, social support, employment, or housing.

6. Supported Employment. Programs that help people get ready to work, find jobs, and support them in the workplace, including:

   • Vocational Rehabilitation (VR) offers career counseling and job support for people with disabilities.
   • Individual Placement and Support (IPS) Supported Employment is a team approach to helping someone succeed in the workplace.
   • Clubhouses are community-based centers that are open to folks with mental health issues, offering housing, employment, and other staff support.
     
     

7. Case Management. When someone has a case manager, that person can help them locate medical, housing, or social support. They also help people navigate assistance and treatment options.

Psychosocial interventions show promise for addressing some of the aspects of a burgeoning mental health crisis.

Psychosocial Interventions and Depression

A meta-analysis of 69 studies of older people experiencing depression found that psychosocial interventions were beneficial and showed promise for alleviating symptoms of depression. The studies looked at the following psychosocial interventions:

• Physical exercise
• Skill training
• Reminiscence
• Social activities
• Group support
• Multicomponent interventions

“Meaningful social activities, tailored to the older individual’s abilities and preferences should be considered in aiming to improve mental health among older people,” the authors write.

Why do psychosocial interventions matter?

Revitalizing Mental Health Care

One of the world’s most prominent advocates for psychosocial interventions is Dr. Vikram Patel, one of the featured keynote speakers at the 2022 Trauma & Recovery Conference. Dr. Patel is the Pershing Square Professor of Global Health in the Blavatnik Institute’s Department of Global Health at the Harvard Medical School and an adjunct professor at the Public Health Foundation of India. He is also the founder of Sangat, an Indian non-governmental organization (NGO) that has won multiple prizes for its innovative approaches to health.

Earlier in 2022, Dr. Patel presented a lecture that was part of PSYCHE, an exhibition that was sponsored by Science Gallery Bengaralu. This multidisciplinary event earlier in 2022 brought together neuroscientists, psychiatrists, historians, and artists to explore the many dimensions of mental health and wellness.

Addressing a World Crisis

“I hope what I will do today is not only to give you a sense of why we need to have a completely new way of thinking about mental health care, but that this is perhaps the most urgent moment in our history to do so,” Patel says, noting that even before the pandemic, the world was facing a mental health crisis that has disproportionately affected people living on the margins: low-income groups, LGBTQIA+ individuals, and people who have been living amid war and violence.

“Our young people, who are arguably the greatest human resource asset of any society, are especially threatened because most mental health problems begin during this period of life,” says Dr. Patel, adding that three out of four cases of mental health problems in adulthood have an onset before the age of 24.

Based on the metrics on mental illness, substance use problems, self-harm, and suicide, Dr. Patel says the situation was getting worse even before the pandemic crashed into the world in 2020. 

A Vicious Cycle

“I have observed over the course of my career over the last three decades working as a psychiatrist in both wealthy countries such as Britain and Australia but also less-wealthy countries such as Zimbabwe, that unlike almost every other human ailment — from diabetes to cancer, from TB to Covid — all countries have failed to address the vicious cycle between social adversities and poor mental health. 

We know that social connectedness and social capital help people stay healthy and strong, yet we are experiencing a global erosion of these protective factors,” says Dr. Patel. He points to several:

• A dramatic increase in polarization and hate
• Loss of trust in the state
• Neoliberal economic policies that have increased wealth for a few individuals and contributed to income inequality

“We know that a more unequal society is exactly the kind of society where the fabric of social connectedness is stolen,” says Dr. Patel.

A New Path to Healing

Dr. Patel calls attention to Healing: Our Path from Mental Illness to Mental Health, a book by Dr. Thomas Insel, founder of Mindstrong Health and former Director of the National Institute of Mental Health (NIMH). “He describes in this book that every single metric reflecting poor mental health has worsened in the US despite the US spending more on mental health care than for any other health condition,” says Dr. Patel. We spend more on mental health care than we do on cancer, diabetes, or any other disease.

Why are we failing at addressing this crisis? 

Classification and Division

Dr. Patel describes a “crisis of care” that can only be addressed by shaking up the core assumptions that underpin our mental health system.

In the 1970s, the psychiatric system took a turn from a “person-centered framing to a very narrow biomedical conceptualization,” says Dr. Patel. People were divided and classified based on clusters of symptoms from patient reports to psychiatrists. Diagnoses were based on what psychiatrists in wealthy countries saw in their highly specialized practices. 

“Why do we have a mental health crisis?” asks Dr. Patel. “I will argue that the overarching reason is that we have focused incorrectly on a narrow binary biomedical framing of mental health which divides people into people with and without a mental health condition — a framing which has worked very well for TB and cancer, but is hopelessly inadequate to explain the complexities of the human experience of mental health problems.”

Part of the problem, says Dr. Patel, is an overreliance on diagnosis, medication, and prescribers. Instead, we should be focusing on person-focused care: people, place, and purpose.

People, Place, and Purpose

When behavioral health professionals explore the promise of using person-centered psychosocial interventions to address mental health challenges, we are helping to address the growing crisis by providing a community-focused, multi-pronged approach to helping people live their best lives.