scholarly journals Implementing a community-based task-shifting psychosocial intervention for individuals with psychosis in Chile: Perspectives from users

2019 ◽  
Vol 65 (1) ◽  
pp. 38-45 ◽  
Author(s):  
Martin Agrest ◽  
PhuongThao D Le ◽  
Lawrence H Yang ◽  
Franco Mascayano ◽  
Silvia Alves-Nishioka ◽  
...  
Keyword(s):  
Mental Health ◽  
Community Mental Health ◽  
Latin American ◽  
Psychosocial Intervention ◽  
Structural Characteristics ◽  
Critical Time ◽  
Psychosocial Interventions ◽  
Task Shifting ◽  
Community Based

Background: Latin America, and Chile in particular, has a rich tradition of community mental health services and programs. However, in vivo community-based psychosocial interventions, especially those with a recovery-oriented approach, remain scarce in the region. Between 2014 and 2015, a Critical Time Intervention-Task Shifting project (CTI-TS) was implemented in Santiago, Chile, as part of a larger pilot randomized control trial. CTI is a time-limited intervention delivered at a critical-time to users, is organized by phases, focuses on specific objectives and decreases in intensity over time. CTI-TS, which combines both the task-shifting strategy and the use of peers, introduces a novel approach to community mental health care that has not yet been tried in Chile. Aims: We aim to evaluate the feasibility, acceptability and applicability of such a community-based psychosocial intervention in urban settings in Latin America – specifically, in Santiago (Chile) from a user perspective. Method: We analyzed 15 in-depth interviews ( n = 15) with service users who participated in the intervention about their perceptions and experiences with CTI-TS through thematic analysis. Results: Three themes were revealed. The first was related to the structural characteristics of CTI-TS, especially regarding the timing, duration and phasic nature of the intervention. The second pertained to the acceptability of the in vivo community-based approach. The third theme dealt with the task-shifting aspect, that is, users’ perceptions of the peer support workers and the community mental health workers. Conclusions: CTI-TS was generally acceptable in this Latin American context. Users’ perspectives pointed to the need to make adjustments to some of the structural characteristics of the CTI model and to combine this type of intervention with others that can address stigma. Thus, future adaptations of CTI-TS or similar psychosocial interventions in Latin American contexts are feasible and can enhance community mental health in the region.

scholarly journals Telerehabilitation in Psychiatry

2020 ◽  
Vol 42 (5_suppl) ◽  
pp. 57S-62S
Author(s):  
Deepak Jayarajan ◽  
Thanapal Sivakumar ◽  
John B Torous ◽  
Jagadisha Thirthalli
Keyword(s):  
Mental Health ◽  
Mental Health Professionals ◽  
Healthcare Delivery ◽  
Psychosocial Interventions ◽  
Task Shifting ◽  
Mental Illnesses ◽  
Community Based ◽  
Welfare Benefits ◽  
Community Based Rehabilitation ◽  
Delivery Of Services

The COVID-19 pandemic has interrupted the usual mechanisms of healthcare delivery and exacerbated symptoms of mental illnesses. Telemedicine has morphed from niche service to essential platform, with newly released guidelines that cover various aspects of tele-mental health delivery. Rehabilitation services, which incorporate a range of psychosocial interventions and liaison services, have been significantly impacted too. They are currently more institute-based than community-based in India. However, recent legislation has mandated that community-based rehabilitation options be available. While a large treatment gap for mental health issues has always existed, telemedicine provides an opportunity to scale services up to minimize this gap. Community-based rehabilitation can be delivered over various platforms, from text to phone to videoconferencing, and various devices. Telemedicine is cost-effective, and enables delivery of services where existing services are inadequate. The recent guidelines allow other healthcare workers to be involved in mental health service delivery. Hence, in addition to direct delivery of services, telerehabilitation can facilitate task-shifting, with mental health professionals mentoring and supervising existing human resources, such as ASHA workers, VRWs, DMHP programme staff, and others. Tele-rehabilitation also poses challenges - not all needs can be met; access and privacy can be a problem in resource-scarce settings; liaison with existing services is required; and organisations need to plan appropriately and re-allocate resources. Digital access to welfare benefits and interventions must be expanded without disadvantaging those without internet access. Yet, many rehabilitation interventions can be adapted to telemedicine platforms smoothly, and task-shifting can broaden access to care for persons with disability.

scholarly journals Implementation of a pilot community-based psychosocial intervention for patients with psychoses in Chile and Brazil: a comparative analysis of users' perspectives

2021 ◽  
Vol 8 ◽  
Author(s):  
Saloni Dev ◽  
Tanvi Kankan ◽  
Drew Blasco ◽  
PhuongThao D. Le ◽  
Martin Agrest ◽  
...  
Keyword(s):  
Mental Health ◽  
Community Violence ◽  
Secondary Analysis ◽  
Critical Time ◽  
Task Shifting ◽  
Cultural Barriers ◽  
Mental Health Systems ◽  
Community Based ◽  
Services Delivery ◽  
Mental Health Centers

Abstract Background Few studies provide clear rationale for and the reception of adaptations of evidence-based interventions. To address this gap, we describe the context-dependent adaptations in critical time intervention-task shifting (CTI-TS), a manualized recovery program for individuals with psychosis in Rio de Janeiro, Brazil and Santiago, Chile. Implications of the adaptations – incorporating a task-shifting approach and modifying the mode of community-based service delivery – are examined from users' perspectives. Methods A secondary analysis of in-depth interviews with CTI-TS users (n = 9 in Brazil; n = 15 in Chile) was conducted. Using the framework method, we thematically compared how participants from each site perceived the main adapted components of CTI-TS. Results Users of both sites appreciated the task-shifting worker pair to provide personalized, flexible, and relatable support. They wanted CTI-TS to be longer and experienced difficulty maintaining intervention benefits in the long-term. In Chile, stigma and a perceived professional hierarchy toward the task-shifting providers were more profound than in Brazil. Engagement with community-based services delivery in homes and neighborhoods (Chile), and at community mental health centers (Brazil) were influenced by various personal, familial, financial, and social factors. Uniquely, community violence was a significant barrier to engagement in Brazil. Conclusion CTI-TS’ major adaptations were informed by the distinct mental health systems and social context of Santiago and Rio. Evaluation of user experiences with these adaptations provides insights into implementing and scaling-up task-shifting and community-oriented interventions in the region through the creation of specialized roles for the worker pair, targeting sustained intervention effects, and addressing socio-cultural barriers.

Community Psychiatry in a Latin American Context: Perú as a Case Example

2020 ◽  
Vol 10 (2) ◽  
pp. 84-91
Author(s):  
Renato D. Alarcón ◽  
Horacio Vargas-Murga ◽  
July Caballero-Peralta ◽  
Yuri Cutipé-Cárdenas
Keyword(s):  
Mental Health ◽  
Community Mental Health ◽  
Latin American ◽  
Community Health Centers ◽  
Community Psychiatry ◽  
Health Centers ◽  
Health Policies ◽  
Community Based ◽  
Mental Health Centers ◽  
Mental Health Policies

Background: Historical and conceptual issues related to community psychiatry as an innovative approach to clinical assistance across the world, precede a more or less detailed examination of its presence, role and current accomplishments in Latin America, particularly related to child and adolescent subpopulations. Information about transition processes from the traditional hospital-centered model to the community-based approach, applicable mental health policies, levels of implementation and quality of the available reports in different countries, are duly evaluated. Objective: Within an understanding of the broader Latin American context, the paper describes the situation in Perú, a country considered representative of the Low and Middle Income (LMIC) group in the subcontinent. Methods: The situation in Perú is presented with particular emphasis on a recently established community-based mental health centers program across its territory. Results: This description includes consideration of variables such as personal, family and identity empowerment, a focus on integrated care, and clinical outcomes and community relations. The development of community mental health centers across Perú is described. Conclusion: Adolescents represent the unique future of socio-culturally diverse Latin American countries, and must be the target population of well-conceived, cohesive community mental health policies and programs. The importance of political will to promote community health centers that provide adolescents access to services is critical.

scholarly journals Introducing peer support work in Latin American mental health services

2012 ◽  
Vol 20 (4) ◽  
pp. 473-481 ◽  
Author(s):  
Peter Stastny
Keyword(s):  
Mental Health ◽  
Peer Support ◽  
Latin American ◽  
Health Workers ◽  
Critical Time ◽  
Mental Health Workers ◽  
Service Development ◽  
Mental Health Workforce ◽  
Training And Research ◽  
Community Mental Health Workers

In the course of implementing a recently funded network of hubs for building capacities in mental health service development, training, and research (RedeAmericas), the peer support workers are being introduced into the mental health workforce in three Latin American countries for the very first time. They will be part of a team, along with community mental health workers, that provides a modified Critical Time Intervention to individuals with severe psychiatric disorders living in the community. This article reviewed the background of this increasingly widespread development, and discussed its merits, as well as potential obstacles within local contexts.

North Staffordshire Community Beds Study: Longitudinal evaluation of psychiatric in-patient units attached to community mental health centres

1999 ◽  
Vol 175 (1) ◽  
pp. 70-78 ◽  
Author(s):  
Anthony P. Boardman ◽  
Richard E. Hodgson ◽  
Martyn Lewis ◽  
Keith Allen
Keyword(s):  
Mental Health ◽  
Community Mental Health ◽  
Unmet Need ◽  
Community Based ◽  
Care Services ◽  
After Care ◽  
Catchment Areas ◽  
Health Centres ◽  
Acute Psychiatric Wards ◽  
Satisfaction With Services

BackgroundThis study evaluates two in-patient units attached to community mental health centres (CMHCs) that were designed to supplement acute in-patient care and to integrate with community-based after-care services.AimTo examine the comparative outcome of patients with severe mental illness (SMI) admitted to the two units.MethodAll patients with SMI admitted to the acute psychiatric wards serving the two CMHCs, those transferred to the community in-patient units and those admitted directly to these units (n=110) were compared with patients (n=67) admitted to acute wards serving two similar catchment areas without associated community beds. Baseline clinical and social measures were made and repeated at six and 12 months. Satisfaction with services was assessed at 12 months.ResultsThe experimental group showed significantly better outcomes, significant reduction in unmet need and better satisfaction with services.ConclusionsThe use of the community beds appears to have significant benefits for patients with SMI.

A Causal Model of Attitudes toward Mental Health Facilities

1983 ◽  
Vol 15 (4) ◽  
pp. 525-542 ◽  
Author(s):  
G B Hall ◽  
S M Taylor
Keyword(s):  
Mental Health ◽  
Community Mental Health ◽  
Mentally Ill ◽  
Causal Model ◽  
Health Facilities ◽  
Community Mental Health Care ◽  
Community Based ◽  
Mental Health Facilities ◽  
Perceived Impacts ◽  
Community Facilities

Nonuser responses to community facilities are recognised as among the most important factors determining the success or failure of community-based systems of service delivery. A causal model of individual attitudes to community mental health care is defined and tested with survey data collected in Toronto, Ontario. The results from a path analysis show the strong antecedent influence of attitudes toward facility users and of perceived impacts of facilities on facility desirability. The importance of personal nonattitudinal characteristics on reactions to facilities is also revealed. The implications of familiarity with mental illness and of attitudes toward the mentally ill for the acceptance of community mental health facilities are considered.

scholarly journals Should consultant psychiatrists be trained in psychotherapy?

1999 ◽  
Vol 5 (4) ◽  
pp. 288-295 ◽  
Author(s):  
Nick Temple
Keyword(s):  
Mental Health ◽  
Psychosocial Interventions ◽  
Basic Knowledge ◽  
Successful Outcome ◽  
Therapeutic Approaches ◽  
Community Based ◽  
Staff Morale ◽  
Leading Role ◽  
Appropriate Treatment ◽  
Multi Disciplinary Team

Psychosocial aspects of treatment have become increasingly important with the changes in psychiatric practice away from the hospital to the community. Effective psychosocial interventions and high staff morale are likely to be the key to the success of a community-based mental health service. There is a growing expectation that all psychiatrists should have a basic knowledge of therapeutic approaches in order to take a leading role in the multi-disciplinary team. They should be able to assess patients for a range of psychological and psychotherapeutic treatments. This role is vital as the matching of the patient's needs with the appropriate treatment is the key to a successful outcome.

scholarly journals A PSYCHOSOCIAL INTERVENTION FOR MENTAL HEALTH OF PEOPLE WITH HIV (PLWH): A LITERATURE REVIEW

2019 ◽  
Vol 2 (3) ◽  
pp. 45-57
Author(s):  
Reineldis Gerans ◽  
Agung Waluyo
Keyword(s):  
Mental Health ◽  
Psychosocial Intervention ◽  
Mental Health Problems ◽  
Psychosocial Interventions ◽  
Well Being ◽  
Health Problems ◽  
Interpersonal Therapy ◽  
Literature Searches ◽  
Immunodeficiency Virus ◽  
Negative Effect

Mental health problems such as depression and anxiety are common for people living with Human Immunodeficiency Virus (PLWH). It may have a various negative effect on psychological well-being and the quality of life for PLWH. These adverse effects are in the form of worsening diseases, decreasing the immune system, non-compliance with ARV therapy, and even causing suicide. Various psychosocial interventions were developed to improve the mental health of PLWH. But it often creates confusion and misunderstanding because it seems to overlap each other. The effectiveness of this intervention has been widely investigated, but there is still little confirmatory research on various psychosocial intervention techniques, especially for PLWH. The study aimed at describing the psychosocial interventions for the mental health of PLWH. We conducted literature searches from multiple relevant sources. The four databases we cut included PROQUEST, PubMed, Plos One, and Ebsco. Three types of psychosocial interventions consisted of symptom-oriented interventions, supportive intervention, and meditation. Based on the kind of intervention there are several psychosocial intervention techniques such as cognitive behavior therapy (CBT), stress management, interpersonal therapy (IPT), peer support, psychoeducation, meditation, relaxation, and mindfulness. There is no difference in the effectiveness of all types and intervention techniques in improving the mental health of PLWH. Psychosocial interventions proved to have a positive effect on the mental health of PLWH. Psychosocial interventions can be combined in PLHIW therapy programs with mental health problems Keywords: PLWH, psychosocial interventions, mental health problems.

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