TY - JOUR
T1 - Implementing a community-based task-shifting psychosocial intervention for individuals with psychosis in Chile
T2 - Perspectives from users
AU - Agrest, Martin
AU - Le, Phuong Thao D.
AU - Yang, Lawrence H.
AU - Mascayano, Franco
AU - Alves-Nishioka, Silvia
AU - Dev, Saloni
AU - Kankan, Tanvi
AU - Tapia-Muñoz, Thamara
AU - Sawyer, Samantha
AU - Toso-Salman, Josefina
AU - Dishy, Gabriella A.
AU - Jorquera, Maria Jose
AU - Schilling, Sara
AU - Pratt, Charissa
AU - Price, Le Shawndra
AU - Valencia, Eliecer
AU - Conover, Sarah
AU - Alvarado, Ruben
AU - Susser, Ezra S.
N1 - Funding Information:
The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: Critical Time Intervention-Task Shifting (CTI-TS) was developed by RedeAmericas, a global network funded by the National Institute of Mental Health (NIMH), National Institutes of Health (NIH) under award number U19 MH095718, ‘Regional Network for Mental Health Research in Latin America’. The content is solely the responsibility of the authors and does not necessarily represent the official views of the NIMH, the NIH or the US Department of Health and Human Services.
Publisher Copyright:
© The Author(s) 2018.
PY - 2019/2/1
Y1 - 2019/2/1
N2 - 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.
AB - 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.
KW - Community mental health
KW - Critical Time Intervention
KW - Latin America
KW - task shifting
KW - user perspective
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U2 - 10.1177/0020764018815204
DO - 10.1177/0020764018815204
M3 - Article
C2 - 30791796
AN - SCOPUS:85059569084
SN - 0020-7640
VL - 65
SP - 38
EP - 45
JO - International Journal of Social Psychiatry
JF - International Journal of Social Psychiatry
IS - 1
ER -