Adults with severe mental illness (SMI) in Dakar, Senegal, frequently experience profound social isolation and community exclusion. Community integration is a central aim of mental health occupational therapy, yet evidence for structured community-based interventions in this setting is scarce. This study evaluated the impact of a structured therapeutic community outing programme on perceived social integration for adults with SMI attending a psychiatric day hospital in Dakar. A pre-post intervention study was conducted. Participants (n=32) with a primary diagnosis of SMI undertook a 12-week programme of weekly, facilitated community outings. The primary outcome was change in the Community Integration Measure (CIM) score, administered pre- and post-intervention. Secondary outcomes included qualitative feedback from participants and facilitators. A statistically significant improvement in mean CIM scores was observed post-intervention (p<0.01). The mean score increased from 18.4 (SD 4.1) to 25.7 (SD 3.8), indicating enhanced perceived integration. Qualitative data identified themes of increased confidence in public settings and the development of new social routines. The therapeutic community outing programme was associated with improved self-reported social integration. This suggests structured, real-world community engagement is a valuable component of occupational therapy for this population in Dakar. Programmes facilitating community outings should be considered for integration into standard occupational therapy services for adults with SMI in comparable settings. Further research employing a control group and longer-term follow-up is warranted. mental health, community integration, occupational therapy, social participation, Senegal, psychosocial intervention This study provides original evidence for the effectiveness of a community-based occupational therapy intervention in a West African context.
Abed et al. (Sun,) studied this question.