Resource-oriented interventions for patients with severe mental illnesses in low- and middle-income countries: trials in Bosnia-Herzegovina, Colombia and Uganda.

Journal: BMC psychiatry

Volume: 19

Issue: 1

Year of Publication: 2020

Affiliated Institutions:  Unit for Social and Community Psychiatry (WHO Collaborating Centre for Mental Health Services Development), Queen Mary University of London, Newham Centre for Mental Health, E SP, London, UK. s.priebe@qmul.ac.uk. Unit for Social and Community Psychiatry (WHO Collaborating Centre for Mental Health Services Development), Queen Mary University of London, Newham Centre for Mental Health, E SP, London, UK. Department of Psychiatry, Makerere University College of Health Sciences, Kampala, Uganda. Department of Clinical Epidemiology and Biostatistics and Psychiatry and Mental Health, Pontifica Universidad Javeriana, Hospital Universitario San Ignacio, Bogotá, Colombia. Clinical Center University of Sarajevo, Sarajevo, Bosnia and Herzegovina. Department of Clinical Medicine, Pontificia Universidad Javeriana, Cali, Colombia. School of Medicine, Makerere University College of Health Sciences, Kampala, Uganda. Department of Social and Preventive Medicine and Psychiatry and Mental Health, Pontificia Universidad Javeriana, Bogotá, Colombia.

Abstract summary 

Severe mental illness (SMI) presents a major burden to societies worldwide. Low- and middle-income countries (LMICs) often do not have sufficient financial resources and qualified staff to provide extensive specialised services for outpatients with SMI. Our research therefore aims to explore and test low-cost interventions that use existing resources in routine patient-clinician meetings, families and communities.In Bosnia-Herzegovina, Colombia and Uganda, three psychosocial interventions will be tested, i.e. making patient-clinician meetings therapeutically effective through DIALOG+, family involvement in multi-family group meetings, and support for patients in befriending schemes with volunteers. All interventions will be provided to patients with SMI, delivered over a six-month period and evaluated with assessments at baseline and after six and 12 months. We will conduct nine trials including non-controlled trials, non-randomised controlled trials and randomised controlled trials (RCTs). Core outcome criteria will be used across all studies. However, details of study delivery and additional outcome criteria vary to accommodate local contexts, interests and priorities. The studies will be analysed separately, but with the option to compare and combine findings.The approach provides the opportunity to learn from commonalities and differences in the results and experiences across the three resource-oriented approaches and the three countries. If successfully implemented the studies can lead to more extensive research and are expected to inform health policies and clinical practice of community care for patients with SMI in the three participating countries and other LMICs.All RCTs were registered prospectively and non-randomised trials retrospectively within the ISRCTN Registry. DIALOG+ in Uganda: ISRCTN25146122 (Date of Registration: 20/11/2018, prospective); DIALOG+ in Colombia: ISRCTN83333181 (Date of Registration: 20/11/2018, prospective); DIALOG+ in Bosnia-Herzegovina: ISRCTN13347129 (Date of Registration: 20/11/2018, prospective); Volunteer Support in Uganda: ISRCTN86689958 (Date of Registration: 04/03/2019, retrospective); Volunteer Support in Colombia: ISRCTN72241383 (Date of Registration: 04/03/2019, retrospective);Volunteer Support in Bosnia-Herzegovina: ISRCTN51290984 (Date of Registration: 20/11/2018, prospective); Family Involvement in Uganda: ISRCTN78948497 (Date of Registration: 04/03/2019, retrospective); Family Involvement in Colombia: ISRCTN11440755 (Date of Registration: 04/03/2019, retrospective); Family Involvement in Bosnia-Herzegovina: ISRCTN13347355 (Date of Registration: 20/11/2018, prospective).

Authors & Co-authors:  Priebe Stefan S Fung Catherine C Sajun Sana Z SZ Alinaitwe Racheal R Giacco Domenico D Gómez-Restrepo Carlos C Kulenoviĉ Alma Džubur AD Nakasujja Noeline N Ramírez Sandra Milena SM Slatina Sabina S Sewankambo Nelson K NK Sikira Hana H Uribe Miguel M Bird Victoria Jane VJ

Study Outcome 

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Statistics
Citations :  Patel V, Prince M. Global mental health: a new Global Health field comes of age. JAMA. 2010;303:1397–1977.
Authors :  14
Identifiers
Doi : 181
SSN : 1471-244X
Study Population
Male,Female
Mesh Terms
Adolescent
Other Terms
Family involvement;Global mental health;LMICs;Psychosocial interventions;Resource-oriented approach;Severe mental illness;Solution-focused;Volunteer support
Study Design
Cross Sectional Study
Study Approach
Country of Study
Uganda
Publication Country
England