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

Lookup NU author(s): Professor Matthew Prina

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This work is licensed under a Creative Commons Attribution 4.0 International License (CC BY 4.0).


Abstract

© 2020 The Authors. Early Intervention in Psychiatry published by John Wiley & Sons Australia, Ltd.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.


Publication metadata

Author(s): Aceituno D, Mena C, Vera N, Gonzalez-Valderrama A, Gadelha A, Diniz E, Crossley N, Pennington M, Prina M

Publication type: Review

Publication status: Published

Journal: Early Intervention in Psychiatry

Year: 2021

Volume: 15

Issue: 5

Pages: 1104-1114

Print publication date: 01/10/2021

Online publication date: 13/10/2020

Acceptance date: 26/09/2020

ISSN (print): 1751-7885

ISSN (electronic): 1751-7893

Publisher: John Wiley and Sons Inc

URL: https://doi.org/10.1111/eip.13060

DOI: 10.1111/eip.13060

PubMed id: 33047889


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