Implementation of early psychosis services in Latin America: A scoping review

Journal Article · 12 October 2020 · Early Intervention in Psychiatry

DOI: https://doi.org/10.1111/eip.13060 · OSTI ID:1787066

Aceituno, David  ^[1]; Mena, Cristián ^[2]; Vera, Norha ^[3]; Gonzalez‐Valderrama, Alfonso  ^[2]; Gadelha, Ary ^[4]; Diniz, Elton ^[5]; Crossley, Nicolas ^[6]; Pennington, Mark ^[3]; Prina, Matthew ^[3]

---

1. Health Service &, Population Research Department Institute of Psychiatry, Psychology and Neuroscience, King's College London London UK, Department of Psychiatry School of Medicine, Pontificia Universidad Católica de Chile Santiago Chile
2. Early Intervention Program, J. Horwitz Psychiatric Institute Santiago Chile, School of Medicine, Universidad Finis Terrae Santiago Chile
3. Health Service &, Population Research Department Institute of Psychiatry, Psychology and Neuroscience, King's College London London UK
4. Programa de Esquizofrenia (PROESQ), Department of Psychiatry School of Medicine, Universidade Federal de São Paulo São Paulo Brazil, Centro de Pesquisa e Inovação em Prevenção de Transtornos Mentais e uso de álcool e outras drogas (CEPIPREV) School of Medicine, Universidade Federal de São Paulo São Paulo Brazil
5. Programa de Esquizofrenia (PROESQ), Department of Psychiatry School of Medicine, Universidade Federal de São Paulo São Paulo Brazil
6. Department of Psychiatry School of Medicine, Pontificia Universidad Católica de Chile Santiago Chile, Department of Psychosis Studies Institute of Psychiatry, Psychology and Neuroscience, King's College London London UK

Abstract Aim The evidence of the effectiveness and cost‐effectiveness of early intervention for psychosis (EIP) services has motivated their implementation worldwide. However, complex interventions of such EIP services require local adaptations to successfully match population needs and cultural differences. Latin America is a heterogenous region where EIP services are progressively being adopted. Our aim is to map such initiatives in the region with a focus on implementation outcomes. Methods A scoping review following the Preferred Reporting Items for Systematic review and Meta‐Analysis extension for Scoping Reviews guidelines was conducted. International and regional databases were searched for publications describing EIP programmes in the region. Besides mapping the services, we described implementation outcomes based on the Standards for Reporting Implementation Studies Checklist. Results Ten articles describing seven EIP initiatives from the region were found. Four countries were represented: Argentina, Brazil, Chile and Mexico. The implementation outcomes reporting was heterogenous, although it was possible to ascertain EIP services are feasible and adequate for the region's context. Also, there is some evidence of effectiveness in terms of reducing hospitalizations and improving symptoms. Information about fidelity measures was scarce and there was no information about costs or cost‐effectiveness. Conclusions Only a small proportion of Latin American countries have adopted EIP services. Although these programmes seem to be feasible and effective, data on other implementation outcomes, such as fidelity, cultural appropriateness, cost‐effectiveness and affordability are not available. This might in part explain why this effective approach has not been yet scaled‐up at nationwide levels.

• Sponsoring Organization: USDOE
• OSTI ID: 1787066
• Journal Information: Early Intervention in Psychiatry, Journal Name: Early Intervention in Psychiatry Journal Issue: 5 Vol. 15; ISSN 1751-7885
• Publisher: Wiley-BlackwellCopyright Statement
• Country of Publication: Country unknown/Code not available
• Language: English