Individual Placement and Support (IPS) for serious mental illness in Jalisco, Mexico

墨西哥哈利斯科州严重精神疾病的个人安置和支持 (IPS)

基本信息

批准号：
10696078
负责人：
RICARDO ARTURO SARACCO ALVAREZ
金额：
$ 20.66万
依托单位：
NATIONAL INSTITUTE OF PSYCHIATRY
依托单位国家：
美国
项目类别：
财政年份：
2022
资助国家：
美国
起止时间：
2022-09-02 至 2025-08-31
项目状态：
未结题

来源：
https://reporter.nih.gov/project-details/10696078
关键词：
Address Affect Ambulatory Care Facilities Attitude COVID-19 pandemic effects Chile Client Clinic Collaborations Community Integration Comprehensive Health Care Country Data E-learning Education Educational Curriculum Employment Employment Opportunities Evidence based practice Exclusion Family Funding Future Goals Government Grant Health Health Care Costs Health Personnel Health system Hospitalization Human Resources Income Individual Intervention Interview Latin America Latin American Latinx Mental Health Mental Health Services Mental disorders Methods Mexico Modeling Modification Monitor Multiple Trauma National Institute of Mental Health Nature Outcome Participant Pattern Personal Satisfaction Persons Pharmaceutical Preparations Policy Maker Population Poverty Primary Care Process Provider Psyche structure Psychiatric Hospitals Psychoses Quality of life Randomized, Controlled Trials Reporting Research Research Personnel Resources Services Source Structure Supported Employment Symptoms Techniques Time Training Violence Vulnerable Populations care systems evidence base experience implementation evaluation implementation process improved instrument job market learning materials low and middle-income countries marginalized community meetings programs psychosocial rehabilitation rehabilitation service self esteem severe mental illness social integration symptomatology treatment as usual urban area

项目摘要

Project Summary Substantial data indicate that the Individual Placement and Support (IPS) model, a well-know, evidence-practice, can help mental illness (PSMI) to succeed in competitive employment (i.e., average 55%, but over 60% in credible studies). However, not a single country offers IPS services in Latin America. Moreover, services to support employment and education other tend to be ad hoc, low intensity, and not well assessed, because most clinicians are not trained in evidence-based approaches and do not provide high-fidelity services. The overarching goal of this project is to pilot IPS for PSMI in the Center for Comprehensive Care in Long-Stay Mental Health (CAISAME-EB, in Spanish), the largest mental health clinic in Jalisco, Mexico. CAISAME-EB integrates primary care and provides medication and psychosocial rehabilitation services to a large population of PSMI (n=~5,000). This team serves marginalized communities resembling other urban areas of low-and- middle-income countries (LMICs) in Latin America and elsewhere. We will use the Dynamic Adaptation Process model to first inform the adaptation of IPS in Mexico, using our prior experiences adapting IPS and deep understanding of the local context (e.g., the nature of the job market in Mexico) to inform the adaptations. We will then evaluate the implementation and impact of the adapted IPS in a pilot RCT (N = 200). This pilot RCT will include quantitative and qualitative assessments at baseline, 6, and 12 months, conducted with clients, providers, and other key stakeholders. We aim to refine implementation processes, understand outcomes and instruments, and estimate power for a future, regional trial in Latin America.

项目概要大量数据表明，个人安置和支持（IPS）模式是一种众所周知的证据实践，可以帮助精神疾病 (PSMI) 在竞争性就业中取得成功（即平均 55%，但在职业中超过 60%）可信的研究）。然而，拉丁美洲没有一个国家提供 IPS 服务。此外，服务支持就业和教育的其他举措往往是临时性的、强度低且没有得到充分评估，因为大多数临床医生没有接受过循证方法方面的培训，也不提供高保真的服务。这该项目的总体目标是在长期住院综合护理中心试点针对 PSMI 的 IPS 心理健康（CAISAME-EB，西班牙语）是墨西哥哈利斯科州最大的心理健康诊所。凯撒梅-EB 整合初级保健，并为大量人口提供药物和心理康复服务 PSMI (n=~5,000)。该团队为类似于其他低收入城市地区的边缘化社区提供服务拉丁美洲和其他地区的中等收入国家 (LMIC)。我们将使用动态适应过程模型首先利用我们之前适应 IPS 的经验和深入的经验，首先为墨西哥的 IPS 适应提供信息了解当地情况（例如墨西哥就业市场的性质），为调整提供信息。我们然后将在试点 RCT（N = 200）中评估改编后的 IPS 的实施和影响。该试点随机对照试验将包括与客户进行的基线、6 个月和 12 个月的定量和定性评估，供应商和其他主要利益相关者。我们的目标是完善实施流程、了解结果并仪器，并估计拉丁美洲未来区域试验的功率。