Addressing Severe Mental Illness Rehabilitation in Colombia, Costa Rica, and Peru

Cubillos, Leonardo; Muñoz, Juliana; Caballero, July; Mendoza, Maria C.B.; Pulido-Álvarez, Adriana Cristina; Carpio, Karen; Udutha, Anirudh K; Botero, Catalina Sosa; Borrero, Elizabeth; Rodríguez, Diana; Cutipé, Yuri; Emeny, Rebecca T.; Schifferdecker, Karen E.; Torrey, William C.

doi:10.1176/appi.ps.201900306

Cited by 11 publications

(14 citation statements)

References 25 publications

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“…In addition, there is a group needing urgent attention not only in LAC countries but also worldwide when it comes to vaccination intention and hesitancy: individuals with severe mental illness. This is a particularly big challenge in the LAC context, as many countries such as Brazil, Colombia, Costa Rica, and Peru are facing the challenge to provide treatment for a growing number of patients while transitioning to a community-based care model, and face shortage of mental health services provision in the community ( 47 , 48 ). It is also important to highlight that many people with severe mental illness in LAC are socially marginalized and face many difficulties in terms of access to health and social services.…”

Section: Discussionmentioning

confidence: 99%

Understanding and addressing COVID-19 vaccine hesitancy in low and middle income countries and in people with severe mental illness: Overview and recommendations for Latin America and the Caribbean

et al. 2022

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Despite the speedy development of vaccines for COVID-19, their rollout has posed a major public health challenge, as vaccine hesitancy (VH) and refusal are high. Addressing vaccine hesitancy is a multifactorial and context-dependent challenge. This perspective focuses on VH in the world region of Latin America and the Caribbean (LAC) and includes people suffering from severe mental illness, therefore covering populations and subpopulations often neglected in scientific literature. We present an overview of VH in LAC countries, discussing its global and historical context. Vaccine uptake has shown to widely vary across different subregions of LAC. Current data points to a possible correlation between societal polarization and vaccination, especially in countries going through political crises such as Brazil, Colombia, and Venezuela. Poor accessibility remains an additional important factor decreasing vaccination rollout in LAC countries and even further, in the whole Global South. Regarding patients with severe mental illness in LAC, and worldwide, it is paramount to include them in priority groups for immunization and monitor their vaccination coverage through public health indicators.

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Section: Discussionmentioning

confidence: 99%

Understanding and addressing COVID-19 vaccine hesitancy in low and middle income countries and in people with severe mental illness: Overview and recommendations for Latin America and the Caribbean

et al. 2022

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“…15 studies were excluded due to the lack of description of mental health services (48)(49)(50)(51)(52)(53)(54)(55)(56)(57)(58)(59)(60)(61)(62), two because of their focus on characterising mental health disorders (63,64), two were only recommendations and were not implemented (65,66), and 1 due to the type of publication…”

Section: Study Selectionmentioning

confidence: 99%

“…Historically, in Colombia, mental health services were primarily focused on clinical understandings of mental health, thus contributing to the medicalisation of human life (60), which promotes the excessive medical control of non-medical affairs and the overlooking of social factors instigating disease.…”

Section: Community Mental Healthmentioning

confidence: 99%

Mental health services implementation in Colombia – a systematic review

Garavito

Burgess

Sanguinetti

et al. 2023

Preprint

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Colombia's mental health services have a complex history shaped by 60 years of armed conflict, a predominantly clinical approach to mental health, and social factors such as inequities and stigma. The 1990 Caracas declaration proposed a shift towards decentralised community mental health services and interventions based on the recovery approach and emphasis on social determinants of mental health in the Americas. Colombia has adopted these approaches in its legal and practical framework in recent years, but implementation has been uneven. This systematic review aims to contribute to mental health services understanding in Colombia by reviewing published studies about mental health services and interventions. A search was conducted to explore peer-reviewed studies on Colombian mental health services across five databases (Medline, PubMed, Scopus, Scielo and BVS [Biblioteca Virtual de Salud in Spanish]) on papers published in the last ten years and without language restrictions. The Consolidated Framework for Implementation Research (CFIR) was used to structure the analysis and identify barriers and facilitators during the implementation of mental health services. We adapted the CFIR to attend to gender, race and age informed by the Socio-Political Economy of Global Mental Health framework, given the importance of these factors to the Colombian health landscape. 1 530 records were identified, and 12 articles met all inclusion criteria and were included in the analysis. 8 papers described substance use disorders services, 11 involved multidisciplinary healthcare professionals, and 7 were implemented at a local scale. The primary barriers to implementation were the lack of coordination, high workloads, and low funding. Facilitators included the use of protocols, and the involvement of communities, stakeholders, users, and external champions. Findings suggest the continued importance of community and recovery approaches and efforts to improve coordination between multi-sector actors involved in the mental health spaces (e.g., public, and private organisations, users and their families).

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“…In this sense, different standardized and validated measures can be used by services to assess its level of recoveryorientation and its implementation. [18,20].…”

Section: Introductionmentioning

confidence: 99%

Factors associated with personal recovery in an outpatient sample of people with Schizophrenia in Brazil

Silva

Rezende

Russinova

et al. 2022

Preprint

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PurposeThis study aimed to assess the level of personal recovery and its associated factors in a Brazilian sample of people with schizophrenia. Methods This cross-sectional study comprised a non-probabilistic sample of 104 people with schizophrenia receiving outpatient care in a university psychiatric centre. Personal Recovery was measured using the short-version of the Recovery Assessment Scale (RAS), comprising 24 items. We first examined the domains of personal recovery in the study sample and their associations of with the following clinical measures were also used: the Self-Assessment of Occupational Functioning Scale (SAOF); the general psychopathology, the Positive and Negative Syndrome Scale (PANSS); the Calgary Depression Scale for Schizophrenia; the Independent Living Skills Survey (ILSS) and the Clinical Global Impression (CGI). The mean scores of RAS domains were compared using ANOVA for repeated measures and clinical measures associated with RAS total score were identified using linear multiple regression. Significance level was p<0.05. Results RAS domains with the highest levels of recovery were “Goal/success orientation” and “Reliance on others”, while the domain “Not dominated by symptoms” presented the lowest score. Higher levels of personal recovery in general were associated only with a lower level of depressive symptoms (as measured by Calgary scale) and a higher score for occupational functioning (as measured by SAOF). ConclusionThis study replicated findings from the international literature about the domains of personal recovery and its associations with important clinical constructs. It also identified specific cultural aspects such as the importance of affective and social relationships (friends, family) for life and as support for processes recovery.

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Addressing Severe Mental Illness Rehabilitation in Colombia, Costa Rica, and Peru

Cited by 11 publications

References 25 publications

Understanding and addressing COVID-19 vaccine hesitancy in low and middle income countries and in people with severe mental illness: Overview and recommendations for Latin America and the Caribbean

Understanding and addressing COVID-19 vaccine hesitancy in low and middle income countries and in people with severe mental illness: Overview and recommendations for Latin America and the Caribbean

Mental health services implementation in Colombia – a systematic review

Factors associated with personal recovery in an outpatient sample of people with Schizophrenia in Brazil

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