The Capability Approach in Mental Health Research: A Scoping Review

Backgrounds In recent years, the paradigm of defining mental health has evolved from focusing on the absence of mental illness to mental well-being, i.e., the presence of positive mental health. Amid growing interest in well-being research, the Capability Approach (CA) has been positioned as one of the major frameworks that inform the conceptualization of mental well-being. In conceptualizing well-being, CA centers on individual freedoms and choices reflecting one’s value system. Despite its merit in fostering the knowledge of multidimensional factors contributing to mental health issues and informing the development of tailored interventions to promote mental well-being, limited studies have explored mental health through the CA lens. To fill this gap, we conducted a scoping review to examine the scope of mental health research that incorporated the CA framework.

Methods The review was conducted based on the PRISMA guidelines, following the Arksey and O’Malley framework. Eligibility criteria included peer-reviewed mental health studies published since 1993, which explicitly mentioned the use or adaptation of CA. The initial search identified 329 articles and 105 articles were excluded after title and abstract screening. After full-text screening, 52 articles were included. Data extraction focused on identifying methodologies, findings, and the nature of CA applications, using Covidence, which was later imported to Excel to prepare reporting. Data extraction items were adjusted iteratively, and disagreements were resolved through discussion and/or consultation with additional reviewers.

Results Most included studies (98%) were published between 2010s to 2020s. Europe was the prominent study location (51.9%), suggesting that only selective countries have used CA in mental health research. The types of studies (60%) included case studies that utilized or adapted CA, validation studies of CA-based measurements (28.8%), and conceptual papers that discussed CA’s application to the conceptualization of well-bing for specific population (11.5%). Most studies utilized the cross-sectional design and employed either qualitative (48.1%) or quantitative (34.6%) methods, with 11.5% using mixed methods. CA was utilized to 1) provide a conceptual framework for research; 2) assess measurement validity (e.g., GLiCS, OxCAP-MH, ICECAP-A); and 3) provide evaluation frameworks for intervention studies. Most studies conceptualized mental health as a continuum while a few studies exclusively focused on psychological disorders despite CA’s focus on well-being.

Conclusion The results from this study confirmed limited utilization of CA in mental health research. Social work research and practices that emphasize capacity building and empowerment of marginalized populations are well suited to CA based studies. Specifically, more conceptual work is needed to further elaborate CA’s unique contribution to well-being research in locations beyond European countries including U.S. Researchers should describe more explicitely how CA informed the conceptualization of well-being, research design as well as data collection and analysis to further guide future research utilizing CA.