Mental Health Task-Shifting in Community-Based Organizations: Implementation, Impact, and Cost — Evaluation of the Connections to Care Program

2020 ◽  
Author(s):  
Lynsay Ayer ◽  
Dana Schultz ◽  
Michele Abbott ◽  
Dionne Barnes-Proby ◽  
Wing Chan ◽  
...  
Keyword(s):  
Mental Health ◽  
Care Program ◽  
Task Shifting ◽  
Community Based ◽  
Community Based Organizations

Individual and healthcare supply-related barriers to treatment initiation in HIV-positive patients enrolled in the Cameroonian antiretroviral treatment access programme

2020 ◽  
Author(s):  
Pierre-Julien Coulaud ◽  
Camélia Protopopescu ◽  
Khadim Ndiaye ◽  
Maël Baudoin ◽  
Gwenaëlle Maradan ◽  
...  
Keyword(s):  
Antiretroviral Treatment ◽  
Cox Model ◽  
Task Shifting ◽  
Hiv Positive ◽  
Treatment Access ◽  
Community Based ◽  
Related Factors ◽  
Hiv Services ◽  
Community Based Organizations ◽  
Art Initiation

Abstract Increasing demand for antiretroviral treatment (ART) together with a reduction in international funding during the last decade may jeopardize access to ART. Using data from a cross-sectional survey conducted in 2014 in 19 HIV services in the Centre and Littoral regions in Cameroon, we investigated the role of healthcare supply-related factors in time to ART initiation in HIV-positive patients eligible for ART at HIV diagnosis. HIV service profiles were built using cluster analysis. Factors associated with time to ART initiation were identified using a multilevel Cox model. The study population included 847 HIV-positive patients (women 72%, median age: 39 years). Median (interquartile range) time to ART initiation was 1.6 (0.5–4.3) months. Four HIV service profiles were identified: (1) small services with a limited staff practising partial task-shifting (n = 4); (2) experienced and well-equipped services practising task-shifting and involving HIV community-based organizations (n = 5); (3) small services with limited resources and activities (n = 6); (4) small services providing a large range of activities using task-shifting and involving HIV community-based organizations (n = 4). The multivariable model showed that HIV-positive patients over 39 years old [hazard ratio: 1.26 (95% confidence interval) (1.09–1.45), P = 0.002], those with disease symptoms [1.21 (1.04–1.41), P = 0.015] and those with hepatitis B co-infection [2.31 (1.15–4.66), P = 0.019] were all more likely to initiate ART early. However, patients in the first profile were less likely to initiate ART early [0.80 (0.65–0.99), P = 0.049] than those in the second profile, as were patients in the third profile [association only significant at the 10% level; 0.86 (0.72–1.02), P = 0.090]. Our findings provide a better understanding of the role played by healthcare supply-related factors in ART initiation. In HIV services with limited capacity, task-shifting and support from community-based organizations may improve treatment access. Additional funding is required to relieve healthcare supply-related barriers and achieve the goal of universal ART access.

scholarly journals Evaluating the Mental Health Training Needs of Community-based Organizations Serving Refugees

10.18060/1963 ◽  
2012 ◽  
Vol 13 (2) ◽  
pp. 325-339 ◽  
Author(s):  
Jennifer Anne Simmelink ◽  
Patricia Shannon
Keyword(s):  
Mental Health ◽  
Health Knowledge ◽  
Training Needs ◽  
Mental Health Training ◽  
Mental Health Symptoms ◽  
Community Based ◽  
Health Symptoms ◽  
Staff Members ◽  
Community Based Organizations ◽  
Ethnic Organizations

This exploratory study examines the mental health knowledge and training needs of refugee-serving community based organizations in a Midwestern state. A survey was administered to 31 staff members at 27 community based organizations (CBOs) to assess the ability of staff to recognize and screen for mental health symptoms that may interfere with successful resettlement. Of the 31 respondents 93.5% (n=29) see refugees with mental health issues and 48.4% (n=15) assess refugees for mental health symptoms – primarily through informal assessment. Mainstream organizations were more likely than ethnic organizations to have received training related to the mental health needs of refugees. Results indicate that while refugee led CBOs recognize mental health symptoms of refugees they may be less likely to assess mental health symptoms and refer for treatment. Policy recommendations for improving CBO services to refugees are offered.

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 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 FACTORS FACILITATING COLLABORATION AND ENGAGEMENT: BUILDING AND SUSTAINING STATEWIDE COALITIONS

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S807-S807
Author(s):  
Cristine B Henage ◽  
Ellen C Schneider ◽  
Ellen Roberts ◽  
Vicki Tilley ◽  
Jan Busby-Whitehead
Keyword(s):  
Mental Health ◽  
Social Services ◽  
Shared Governance ◽  
Economies Of Scale ◽  
Falls Prevention ◽  
Community Based ◽  
Community Based Organizations ◽  
History Of ◽  
Area Health ◽  
Area Health Education Centers

Abstract Sustaining collaboration across multiple community-based organizations (CBOs) creates synergies and economies of scale to support age-friendly communities beyond the provision of direct services any single CBO can achieve. The Carolina Geriatrics Workforce Enhancement Program (CGWEP) created and sustained multiple statewide coalitions focused on geriatrics syndromes. More than 290 CBOs, including Area Health Education Centers, social services programs and nongovernmental organizations, meet quarterly to form linkages, promote education and build infrastructure to support rural and underserved older adults. Shared governance with pooled resources has been achieved because of a long history of partnership, mutually beneficial relationships, flexibility, and frequent communication. The strength of the partnership is evidenced by continued growth in number of CBOs, number of sponsored events, and number of referrals to CBOs. Two coalitions, focused on falls prevention and mental health respectively, have been adopted by partners and sustained beyond grant funding.

scholarly journals Facilitating mental health service use for older Chinese immigrants: a case study of community-based organizations

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 916-917
Author(s):  
Yuanyuan Hu ◽  
Qingwen Xu
Keyword(s):  
Mental Health ◽  
New York ◽  
New York City ◽  
Mental Health Services ◽  
Health Services ◽  
York City ◽  
Health Services Use ◽  
Community Based ◽  
Community Based Organizations ◽  
Older Chinese

Abstract New York City has the largest older Chinese population of any city in the United States. Older Chinese adults in New York City often meet significant stress to fulfill their needs, and mental health issues are common among this population (Mui, 1996; Dong, 2012). Despite the high prevalence, Asian Americans have the lowest rates of mental health services use compared to other ethnic groups (Abe-Kim et al., 2007). Additional to wide disparities in mental health access, older immigrants experience additional factors that affect their decision making to use mental health services. Limited knowledge exists about community-based organizations facilitating mental health services use for this population. This study aimed to fill this gap by case study approach and conducted a qualitative analysis of data collected as part of a study that investigated the resilience of the Chinese communities in New York City in the context of aging and immigration. Data from five community-based organizations serving this population were examined, through reading agency history and program introduction, visiting agency location and observing its operation, and interviewing the agency staff and program directors. Data collected were integrated, synthesized, and analyzed. Findings represent organizational staff’s perceptions of the mental health issues among older Chinese immigrants, needs and accessibility of mental health services, and facilitation of access and utilization of services by screening, education and referral. The qualitative results address individual help-seeking behavior and pattern, organizational response to and coordination of mental health needs, and capacity building on the community level.

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.

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