Original Title: Caractéristiques des actions de démarchage en santé mentale réalisées auprès des personnes ou populations en situation de vulnérabilité

Authors' objectives: In Quebec, public mental health policies are gradually adopting community-based approaches aimed at improving the accessibility and continuity of services, particularly for individuals living with severe mental disorders or in situations of high vulnerability. As part of the Plan d’action interministériel en santé mentale 2022–2026 (Québec’s Interministerial Action Plan on Mental Health, 2022–2026), institutions within the réseau de la santé et des services sociaux (RSSS) (health and social services network) are encouraged to develop local services tailored to the realities of the populations living in situations of vulnerability, in accordance with the principle of population responsibility. In this context, the present state of knowledge aims to provide an overview of the characteristics of mental health outreach actions for individuals or populations in situations of vulnerability.

Authors' results and conclusions: RESULTS (#1 SELECTED PUBLICATIONS): Six publications were analyzed, providing a structured overview of the characteristics of mental health outreach actions involving individuals and populations living in situations of vulnerability. (#2 TARGETED POPULATIONS): Outreach actions mainly target people in situations of homelessness or housing instability, as well as elderly people who are not actively engaged in services. These populations present with mental health issues, which are sometimes severe or concurrent, and live in situations of vulnerability marked by economic insecurity, social isolation, and institutional disaffiliation. (#3 TYPES OF ACTIONS): The actions identified are divided into four main components, according to their purpose, intensity, and degree of integration into existing services: • Identification and active reach • Engagement support • Functional support •Clinical support (#4 STAKEHOLDERS INVOLVED): Mental health outreach actions mobilize field workers — front-line professionals, community workers and paraprofessionals, peer support workers — to provide direct support to people in situations of vulnerability, as well as institutional partners and mandated organizations, which are not part of the teams but ensure sustainability through intersectoral collaborations involving high-level organizations, university or research institutes, health institutions, and designated local organizations. (#5 EXPECTED OUTCOMES): Although the effectiveness of outreach actions is not assessed in this review, the publications identified describe potential outcomes, grouped into five categories: population-based (better crisis prevention, increased access to services), sociocultural (improved quality of life, residential stability), clinical (stabilization of mental health, care adherence, fewer hospitalizations), organizational (smoother pathways, stronger teams, less pressure on services), and economic (lower costs related to emergencies and hospitalizations). (#6 INTERVENTION SETTINGS): Mental health outreach actions are deployed in a variety of settings. Community social spaces (community centers, shelters, emergency accommodations, social cafés), outdoor or informal public spaces (streets, parks, transit stations), and residential settings (homes, apartments) are distinguished by their accessibility, community roots, and proximity to the living environments of the target individuals. CONCLUSION: Although this rapid scoping review is based on a limited number of publications, the results reveal that mental health outreach actions are not limited to a strategy for accessing care. They constitute a lever for interventions in their own right, tailored to the complexity of situations of vulnerability. By targeting individuals or populations often excluded from traditional pathways, these actions redefine the boundaries of psychosocial and clinical intervention.

Authors' methods: To meet this objective, a rapid scoping review was conducted using a descriptive approach without formal appraisal of the quality of the studies or the effectiveness of the outreach actions. The documentary research focused on outreach actions aimed at individuals in situations of vulnerability, aged 16 and over, who were not engaged in a formal mental health care pathway. It combines the publications identified by Jiao et al. (2022) for the 2008-2020 period and additional research conducted in the MEDLINE, PubMed, PsycInfo, and CINAHL Complete databases for the 2020-2025 period. Only publications presenting quantitative data were selected, according to predefined inclusion criteria based on the PIPOH model. The data, extracted using a structured grid, were analyzed inductively according to the thematic approach of Braun and Clarke (2006), based on conceptual benchmarks in mental health and public health. The results are presented in the form of an analytical synthesis.

Project Status: Completed

Year Published: 2026

URL for published report: https://www.inesss.qc.ca/fileadmin/doc/INESSS/Rapports/ServicesSociaux/Demarchage_Sante_Mentale_EC_INESSS.pdf

English language abstract: An English language summary is available

Publication Type: Other

Country: Canada

Province: Quebec

Organisation Name: Institut national d'excellence en sante et en services sociaux

Contact Address: L'Institut national d'excellence en sante et en services sociaux (INESSS) , 2021, avenue Union, bureau 10.083, Montreal, Quebec, Canada, H3A 2S9;Tel: 1+514-873-2563, Fax: 1+514-873-1369

Contact Name: demande@inesss.qc.ca

Contact Email: demande@inesss.qc.ca

Copyright: L'Institut national d'excellence en sante et en services sociaux (INESSS)