“About Navigating Chaos”: Latin American and Caribbean Mental Health Workers’ Personal Impact Due to SARS-CoV-2 in the First Hundred Days

Objectives: The personal impact of COVID-19 on mental health care workers (MHWs) has received scarce attention despite their work addressing the emotional wellbeing of those affected by the pandemic. This study aims to analyze Latin American and Caribbean’s MHWs’ subjective impact in connection to working during the initial times of the pandemic. Methods: One hundred and fifty-five persons (n = 155) from seventeen countries were contacted in May–June 2020 through a snowball approach. Complementary methodological strategies of analysis used for data triangulation included content analysis, thematic analysis, and interpretative phenomenological analysis. Results: Participants reported feelings of fear, anxiety, anguish, and fatigue. Milder negative impacts (e.g., uncertainty, concern), and complex feelings (e.g., ambivalence) were also frequent. One third of participants acknowledged their capacity to learn from this situation and/or experience satisfaction. Conclusion: Mental health of MHWs in Latin America and the Caribbean were under severe strain and the ongoing mental health reforms at risk during the pandemic’s beginning. More research and additional care may be needed to offer support to those involved in caring for the wellbeing of others.Fil: Agrest, Martin. Proyecto Suma: Asistencia y Rehabilitación En Salud Men; ArgentinaFil: Rosales, Melina Laura. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Universidad de Buenos Aires. Facultad de Psicología. Instituto de Investigaciones; ArgentinaFil: Fernández, Marina. Universidad de Buenos Aires. Facultad de Psicología. Instituto de Investigaciones; ArgentinaFil: Kankan, Tanvi. Columbia University; Estados UnidosFil: Matkovich, Andrés. Universidad Nacional de Rosario; ArgentinaFil: Velzi Díaz, Alberto. Universidad Nacional de Rosario; ArgentinaFil: Ardila Gómez, Sara Elena. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Universidad de Buenos Aires. Facultad de Psicología. Instituto de Investigaciones; Argentin

COVID-19 impact on the provision of psychosocial rehabilitation services in Latin America and the Caribbean

Health care services have been deeply affected worldwide by the COVID-19 pandemic. However, and despite its importance to psychiatric reforms, very little has been written on actual responses to the COVID-19 pandemic in community psychiatry and psychosocial rehabilitation settings. Fifty-two mental health professionals from thirteen countries in Latin America and the Caribbean were interviewed in May and June 2020 and shared their opinions on the state of psychosocial rehabilitation services and programs during the first one-hundred days of the COVID-19 pandemic. Simple quantitative measures were added to a thematic analysis of responses. The results indicated that the disruption of group activities deeply affected psychosocial rehabilitation services, non-core activities (e.g., food and medication supply) became the most relevant aspects of these programs, shifting to remote mode proved to be a significant hurdle for many psychosocial rehabilitation service users, and long-term effect on rehabilitation services is expected by almost 90% of interviewees.Fil: Agrest, Martín. Universidad de Buenos Aires. Facultad de Psicología. Instituto de Investigaciones; ArgentinaFil: Kankan, Tanvi. Columbia University; Estados UnidosFil: Fernández, Marina. Universidad de Buenos Aires. Facultad de Psicología. Instituto de Investigaciones; ArgentinaFil: Rosales, Melina Laura. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Universidad de Buenos Aires. Facultad de Psicología. Instituto de Investigaciones; ArgentinaFil: Matkovich, Andrés. Universidad Nacional de Rosario; ArgentinaFil: Velzi Díaz, Alberto. Universidad Nacional de Rosario; ArgentinaFil: Ardila Gómez, Sara Elena. Universidad de Buenos Aires. Facultad de Psicología. Instituto de Investigaciones; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentin

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

© The Author(s) 2018.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) fro

Utility of a multidimensional recovery framework in understanding lived experiences of Chilean and Brazilian mental health service users

The understanding and application of recovery, despite its potential benefits for mental health services, is still in its incipient development in Latin America. Psychiatric reform in the region has been broadly known and discussed; yet, the recovery framework requires further exploration. Whitley and Drake (2010) suggested a recovery framework including five dimensions: clinical, existential, functional, physical, and social, offering a comprehensive perspective of the recovery process. The present study aimed to explore Chilean and Brazilian users’ perspectives on recovery identifying their endorsement of these five dimensions. Twenty-four users and six peer support workers were interviewed on their experiences with the Critical Time Intervention-Task Shifting (CTI-TS) carried out in Santiago (Chile) and in Rio de Janeiro (Brazil). Using a framework analysis approach focused on the users’ recovery process, we examined the utility of Whitley & Drake’s recovery framework in Chile and Brazil. Results showed that: 1. The framework was applicable to this population; 2. For Chilean and Brazilian users, dimensions were intertwined and influenced by salient processes (i.e., continuum of care, centrality of functioning and social life); and 3. Cultural values, stigma, and social determinants (e.g., housing, welfare) were mentioned as crucial factors affecting  treatment and recovery but had not been sufficiently accounted for in the framework. A reinterpretation of the framework was proposed based on Chilean and Brazilian users’ lived experiences. Findings add to the international literature on recovery by increasing the social validity of the multidimensional framework and expanding its utility to diverse populations.La comprensión y aplicación del concepto de recuperación, a pesar de sus posibles beneficios para los servicios de salud mental, aún se encuentra en incipiente desarrollo en América Latina. Si bien la reforma psiquiátrica en la región ha tenido algunos avances, el marco de la recuperación no ha sido suficientemente explorado. Whitley y Drake (2010) sugirieron un marco conceptual integral para la recuperación que incluye cinco dimensiones: clínica, existencial, funcional, física y social. El presente estudio tuvo como objetivo explorar las perspectivas de los usuarios chilenos y brasileños sobre la recuperación identificando su adscripción y aplicabilidad de estas cinco dimensiones. Se entrevistó a treinta participantes de la Intervención en Momento Crítico-Delegación de Funciones (CTI-TS) realizada en Santiago (Chile) y en Río de Janeiro (Brasil) sobre sus experiencias de recuperación. Se exploró la aplicabilidad del marco de Whitley y Drake al contexto de Chile y de Brasil. Los resultados mostraron que: 1. El marco era aplicable a esta población; 2. Las dimensiones presentaban un tipo particular de entrelazamiento y estaban influenciadas por una serie de procesos tales como la continuidad en el proceso de atención/cuidado/autocuidado, y sobresalía la funcionalidad y la esfera social; 3. Los valores culturales, el estigma y los determinantes sociales emergieron como factores cruciales que afectan el tratamiento y la recuperación. Se propuso una reinterpretación del esquema referencial. Los hallazgos representan un aporte a la literatura internacional sobre recuperación al aumentar la validez de este marco referencial multidimensional y su aplicabilidad a diversas poblaciones