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IMPROVING CARE FOR DEINSTITUTIONALIZED PEOPLE WITH MENTAL DISORDERS: EXPERIENCES OF THE USE OF KNOWLEDGE TRANSLATION TOOLS
Knowledge translation
Deinstitutionalization
Mental health
Community mental health services
Pesquisa Médica Translacional
Desinstitucionalização
Saúde Mental
Serviços Comunitários de Saúde Mental
Autor
Afiliación
University of Sorocaba. Graduate Program in Pharmaceutical Science. Sorocaba, SP. Brazil.
Fundação Oswaldo Cruz. Fiocruz Brasília. Brasília, DF, Brasil.
University of Sorocaba. Graduate Program in Pharmaceutical Science. Sorocaba, SP. Brazil.
University of Sorocaba. Graduate Program in Pharmaceutical Science. Sorocaba, SP. Brazil.
Fundação Oswaldo Cruz. Fiocruz Brasília. Brasília, DF, Brasil.
University of Sorocaba. Graduate Program in Pharmaceutical Science. Sorocaba, SP. Brazil.
University of Sorocaba. Graduate Program in Pharmaceutical Science. Sorocaba, SP. Brazil.
Resumen en ingles
Background: The deinstitutionalization process is complex, long-term and many
countries fail to achieve progress and consolidation. Informing decision-makers about
appropriate strategies and changes in mental health policies can be a key factor for
it. This study aimed to develop an evidence brief to summarize the best available
evidence to improve care for deinstitutionalized patients with severe mental disorders
in the community.
Methods: We used the SUPPORT (Supporting Policy Relevant Reviews and Trials) tools
to elaborate the evidence brief and to organize a policy dialogue with 24 stakeholders.
A systematic search was performed in 10 electronic databases and the methodological
quality of systematic reviews (SRs) was assessed by AMSTAR 2.
Results: Fifteen SRs were included (comprising 378 studies and 69,736 participants), of
varying methodological quality (3 high-quality SRs, 2 moderate-quality SRs, 7 low-quality
SRs, 3 critically low SRs). Six strategies were identified: (i). Psychoeducation; (ii).
Anti-stigma programs, (iii). Intensive case management; (iv). Community mental health
teams; (v). Assisted living; and (vi). Interventions for acute psychiatric episodes. They
were associated with improvements on a global status, satisfaction with the service,
reduction on relapse, and hospitalization. Challenges to implementation of any of them
included: stigma, the shortage of specialized human resources, limited political and
budgetary support.
Conclusions: These strategies could guide future actions and policymaking to improve
mental health outcomes.
Palabras clave en ingles
Evidence-informed policyKnowledge translation
Deinstitutionalization
Mental health
Community mental health services
DeCS
Política Informada por EvidênciasPesquisa Médica Translacional
Desinstitucionalização
Saúde Mental
Serviços Comunitários de Saúde Mental
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