Community-based health promotion is a method that prioritises preventive interventions while simultaneously taking a broad population-focused approach. These are comprehensive, reaching beyond the boundaries of traditional medical settings and actively engaging community stakeholders, media campaigns, public education efforts, and enacting environmental policies.
Community-based interventions understand that an individual's behaviour is influenced by their surroundings. They use an individual's behaviour to influence other people and are successful in behavioural improvement. However, this may create moral hazards; people may engage in riskier behaviours because they believe community initiatives will safeguard them. Geoffrey Rose's "population strategy," which emphasises that subjecting a larger population to tiny risks can result in big health advantages for the whole population, is central to this approach.
The balance between the costs of these programmes and their long-term benefits is critical, especially when considering potentially dangerous individual behaviours. Geoffrey Rose contends that exposing a big population to minor hazards could have more significant health impacts than exposing a smaller group to greater dangers. Rose advocates employing a "population strategy" rather than a "high-risk strategy," arguing that a small rise in prevalent risky behaviours might result in huge benefits. This concept emphasises the importance of targeting entire communities, including low-risk ones, to improve public health outcomes.
This strategy also shows promise for lowering healthcare system expenses. Evidence suggests that it would be impractical to entrust the promotion and prevention of mental health completely to mental health professionals. It is critical to provide integrated and interdisciplinary services to broaden the spectrum of potential interventions and reduce the possibility of negative long-term effects.
A Stepped Wedge Cluster Randomised Controlled Trial (SW-CRCT) on Atmiyata, undertaken between 2017 and 2019, confirmed the efficacy of community-based interventions. The findings demonstrated that those who participated in the programme intervention were three times more likely to have reduced depression and anxiety symptoms. Preliminary economic evaluations indicate that for every $1 invested, there is a $9.35 return, demonstrating its cost-effectiveness. The World Health Organisation ranks among the top 25 global community-based mental health care practices.
Studies on other disorders, such as moderate to severe schizophrenia, demonstrate that community-based therapies, including supervised community health workers, outperform facility-only services. Especially in terms of lowering disability associated with the illness and improving adherence to recommended treatments. The community-based strategy employed is Assertive Community Treatment (ACT), which is carried out within the community environment. According to research, ACT resulted in a significant improvement in symptom reduction and sickness severity. Improving the overall functioning and quality of life for those with mental illnesses.
These interventions have also been linked to a significant increase in the number of people seeking depression treatment, which was seen by improving mental health literacy and ensuring equitable contact coverage for depression, which is covered by the National Mental Health Programme but has yet to be implemented.
In conclusion, community-based health promotion takes a proactive, population-focused approach, engaging stakeholders, media, and policies to influence behaviour positively. These interventions prioritise the broader community, yielding significant health benefits. With a focus on mental health literacy and equitable access to care, community-based interventions offer cost-effective solutions for improving public health outcomes globally.