Community-Based Mental Healthcare Considerably Improves Outcomes in Southeast Europe, Landmark Study Finds
SOFIA, Bulgaria – A large-scale, multi-country study reveals that a recovery-oriented, community-based mental healthcare (CMH) approach dramatically improves functioning and quality of life for individuals with severe mental illness compared to traditional, treatment-as-usual (TAU) care. The findings, stemming from pooled data across five randomized trials in Bulgaria, Croatia, Macedonia, Montenegro, and Romania, offer compelling evidence for a shift in mental healthcare delivery across Southeast Europe and beyond.
The research, published today, demonstrates a critically importent reduction in disability and a boost in overall well-being for patients receiving CMH. This is especially crucial as healthcare systems worldwide grapple with the ongoing impacts of the COVID-19 pandemic, wich exacerbated existing challenges in mental health service provision. The study’s rigorous methodology, including sensitivity analyses to account for pandemic-related disruptions, strengthens the reliability of its conclusions and provides a roadmap for scalable, effective interventions.
The five-country study followed participants with schizophrenia, bipolar disorder, and severe depression for 18 months. Results showed those receiving CMH experienced a 4.55 point reduction in WHODAS disability scores (b=-4.55, SE=1.21, z=-3.75, p<0.001) – a statistically significant advancement.Furthermore,quality of life improved by 0.07 utility units (b=0.07, SE=0.014, z=4.56, p<0.001), translating to an estimated 25 additional days of full health. These positive effects were consistent across all five countries and across all assessed WHODAS subdomains, including cognition, mobility, self-care, social interaction, and daily activities.
Researchers employed mixed modelling and a sensitivity analysis to adjust for the impact of COVID-19 on healthcare delivery and outcomes,ensuring the robustness of the findings. The study’s implications are clear: recovery-oriented CMH is an effective model for improving the lives of people living with severe mental illness, and its implementation should be prioritized across diverse healthcare systems.
Trial registration numbers are available for each country: Bulgaria (NCT03922425), Croatia (NCT03862209), Macedonia (NCT03892473), Montenegro (NCT03837340), and Romania (NCT03884933).
Keywords: Health services research; Mental Health & psychiatry; Randomised control trial.
