Mental health systems need to meet two related challenges: providing treatment and support which is personalised to the individual, and responding to environmental change. From the individual to the community and society levels, understanding context is pivotal in treating mental health problems and their psychosocial consequences.
Methodological innovation is needed if we want to build better models for personalised care. Group-based outcomes do not identify strengths and vulnerabilities of the individual. New models and techniques are needed to understand the impact of daily life stressors and rewards, and how these link to relapse and resilience. Such approaches need to be dynamic and embedded in real-life experiences.
At the community level, new demands are emerging. Changing legislation, financial pressures, the influx of refugees across Europe and broader socio-economic challenges all place pressure on community-based mental health systems to develop preventive interventions, harness the power of communities, and optimise the provision of effective and personalised treatments. New emerging technologies allow us to recast the concept of the ‘community’, offering opportunities to share knowledge and experience and to offer a broader range of acre. These are necessary to meet the challenges of the growing mental health burden in society.
The ENMESH 2017 conference will be organised around four topics
1. Assessment: Understanding the context
Implications of environmental changes for people developing, living with and recovering from mental health problems. Experience sampling methods, heart rate variability, actimeter or sleep-registration are examples of assessment approaches with ecological validity. Idiographic studies to understand how context influences the emergence and maintenance of psychiatric phenomena. Epidemiological studies to identify early warning signals for critical transitions to mental disorder, or for understanding the course of recovery. New approaches to identifying individual and community-level strengths and sources of resilience. Novel sophisticated ways of obtaining personalised and clinically relevant information, e.g. from administrative databases, social media or other sources of ‘big data’. Context analysis, dynamic systems and complex science approaches applied to mental health.
2. Epidemiology: Methodological approaches supporting personalised care
Developing new models to understand interactions between the person and their environment. More reliable estimations of prognosis and response to different forms of treatment, for example through studies on staging and profiling models. Novel statistical techniques which add to the predictive value of models for personalized medicine. New assessment and treatment approaches such as virtual reality therapy, e-health interventions and online learning modules providing real-word feedback. Strategies to implement truly person-centred and individualised care. Studies on routine outcome measurement as a tool to evaluate real-world treatments.
3. Approaches: Novel approaches using the patient’s own context
Self-management approaches such as Wellness Recovery Action Planning (WRAP) and strengths-based case management, service innovations such as FACT, REFOCUS and Trialogues, and rehabilitation approaches such as Individual Placement and Support (IPS) and Housing First, along with the growing involvement of people with lived experience as peer workers and close relatives and in Recovery Colleges, all focus on supporting people in their social context. Approaches to enhancing social inclusion and community engagement. Trauma-informed and recovery-oriented care.
4. Policy: Societal challenges for community mental health
Policy-making issues within the social context of mental health. Changes in the European perspective on community mental health services. The impact on mental health of societal changes, e.g. in stigma, employment patterns, migration, refugees and asylum-seekers. Preventive strategies and public health interventions addressing current and future challenges, such as approaches to meeting the mental health needs of refugees. Research characterising and amplifying social capital, or Amartya Sen’s concept of capabilities applied to mental health care. Initiatives based on ethical principles and social values to optimise the links between the mental health system and community resources, including charity and not-for-profit organisations.