Barriers and facilitators of integrating depression and tuberculosis treatment in primary care in Brazil
Autor(a) principal: | |
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Data de Publicação: | 2020 |
Outros Autores: | , , , , , , , , |
Tipo de documento: | preprint |
Idioma: | eng |
Título da fonte: | SciELO Preprints |
Texto Completo: | https://preprints.scielo.org/index.php/scielo/preprint/view/760 |
Resumo: | Mental disorders can affect up to 70% of individuals with tuberculosis (TB). The World Health Organization (WHO) End TB Strategy explicitly calls for TB and mental health service integration. The goal of this study was to explore the barriers and facilitators to integrating depression treatment in the TB Control Program and primary care system in the municipality of Itaboraí - Rio de Janeiro, using Interpersonal Counseling (IPC). IPC is an evidence-based treatment for depression that can be delivered by non-mental health specialists with expert supervision. This study was conducted between 2016 and 2017 in the municipality of Itaboraí. Data collection consisted of six focus groups (n = 42) with health professionals (n = 29), program coordinators (n = 7) and TB patients (n = 6). The main potential barriers identified were poverty, political instability, an overburdened and under-resourced health system, high levels of distress among professionals, violence in the community and stigma related to mental health and TB. Potential facilitators included a high receptivity to, and demand for, mental health training; strong community relationships through the Community Health Workers (CHW); overall acceptability of IPC delivered by non-specialists for the treatment of depression among individuals with and without comorbid TB. Despite many challenges, integrating depression treatment into primary care in Itaboraí using IPC was perceived as an acceptable and feasible option. |
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Barriers and facilitators of integrating depression and tuberculosis treatment in primary care in BrazilBarreiras e facilitadores à integração dos serviços de depressão e tuberculose na rede de atenção primária no BrasilTuberculosisDepressionMental HealthPrimary Health CareMental disorders can affect up to 70% of individuals with tuberculosis (TB). The World Health Organization (WHO) End TB Strategy explicitly calls for TB and mental health service integration. The goal of this study was to explore the barriers and facilitators to integrating depression treatment in the TB Control Program and primary care system in the municipality of Itaboraí - Rio de Janeiro, using Interpersonal Counseling (IPC). IPC is an evidence-based treatment for depression that can be delivered by non-mental health specialists with expert supervision. This study was conducted between 2016 and 2017 in the municipality of Itaboraí. Data collection consisted of six focus groups (n = 42) with health professionals (n = 29), program coordinators (n = 7) and TB patients (n = 6). The main potential barriers identified were poverty, political instability, an overburdened and under-resourced health system, high levels of distress among professionals, violence in the community and stigma related to mental health and TB. Potential facilitators included a high receptivity to, and demand for, mental health training; strong community relationships through the Community Health Workers (CHW); overall acceptability of IPC delivered by non-specialists for the treatment of depression among individuals with and without comorbid TB. Despite many challenges, integrating depression treatment into primary care in Itaboraí using IPC was perceived as an acceptable and feasible option.Os transtornos mentais podem afetar até 70% dos indivíduos com tuberculose (TB). A Organização Mundial da Saúde (OMS), como estratégia para o fim da TB, exige a integração do seu tratamento com a saúde mental. O objetivo deste estudo foi explorar as barreiras e facilitadores para integrar serviços de saúde mental no Programa de Controle de Tuberculose (PCT) e em Unidades de Saúde da Família (USF) do município de Itaboraí – Rio de Janeiro, com a aplicação do Aconselhamento Interpessoal (AIP). O AIP é um tratamento para depressão baseado em evidências que pode ser aplicado por não especialistas em saúde mental com supervisão especializada. Seis grupos focais foram realizados entre 2016 e 2017 no município de Itaboraí. A amostra (n=42) incluiu profissionais de saúde (n=29), coordenadores de programas (n=7) e pacientes com TB (n=6). Os grandes desafios encontrados foram: pobreza, instabilidade política, um sistema de saúde sobrecarregado e com poucos recursos, alta frequência de estresse entre os profissionais, violência na comunidade e estigma relacionado à saúde mental e à TB. Os facilitadores potenciais incluíram uma grande receptividade e demanda para capacitações em saúde mental; boa relação com a comunidade pelos Agentes Comunitários de Saúde (ACS) e; aceitação geral do AIP aplicado por não especialistas em saúde mental para o tratamento de depressão em pessoas com e sem TB. Apesar de muitos desafios, integrar o tratamento de depressão na atenção primária de Itaboraí aplicando o AIP foi percebido como uma alternativa aceitável e factível.SciELO PreprintsSciELO PreprintsSciELO Preprints2020-06-15info:eu-repo/semantics/preprintinfo:eu-repo/semantics/publishedVersionapplication/pdfhttps://preprints.scielo.org/index.php/scielo/preprint/view/76010.1590/SciELOPreprints.760enghttps://preprints.scielo.org/index.php/scielo/article/view/760/1052Copyright (c) 2020 Annika Claire Sweetland, Claudio Gruber Mann, Maria Jose Fernandes, Fatima Virginia Silva, Camila Matsuzaka, Maria Cavalcanti, Sandra Fortes, Afranio Kritski, Julio Cesar Ambrosio, Milton L Wainberghttps://creativecommons.org/licenses/by/4.0info:eu-repo/semantics/openAccessSweetland, AnnikaMann, Claudio GruberFernandes, Maria JoseSilva, Fatima VirginiaMatsuzaka, CamilaCavalcanti, MariaFortes, SandraKritski, AfranioAmbrosio, Julio CesarWainberg, Milton Lreponame:SciELO Preprintsinstname:SciELOinstacron:SCI2020-06-12T16:04:45Zoai:ops.preprints.scielo.org:preprint/760Servidor de preprintshttps://preprints.scielo.org/index.php/scieloONGhttps://preprints.scielo.org/index.php/scielo/oaiscielo.submission@scielo.orgopendoar:2020-06-12T16:04:45SciELO Preprints - SciELOfalse |
dc.title.none.fl_str_mv |
Barriers and facilitators of integrating depression and tuberculosis treatment in primary care in Brazil Barreiras e facilitadores à integração dos serviços de depressão e tuberculose na rede de atenção primária no Brasil |
title |
Barriers and facilitators of integrating depression and tuberculosis treatment in primary care in Brazil |
spellingShingle |
Barriers and facilitators of integrating depression and tuberculosis treatment in primary care in Brazil Sweetland, Annika Tuberculosis Depression Mental Health Primary Health Care |
title_short |
Barriers and facilitators of integrating depression and tuberculosis treatment in primary care in Brazil |
title_full |
Barriers and facilitators of integrating depression and tuberculosis treatment in primary care in Brazil |
title_fullStr |
Barriers and facilitators of integrating depression and tuberculosis treatment in primary care in Brazil |
title_full_unstemmed |
Barriers and facilitators of integrating depression and tuberculosis treatment in primary care in Brazil |
title_sort |
Barriers and facilitators of integrating depression and tuberculosis treatment in primary care in Brazil |
author |
Sweetland, Annika |
author_facet |
Sweetland, Annika Mann, Claudio Gruber Fernandes, Maria Jose Silva, Fatima Virginia Matsuzaka, Camila Cavalcanti, Maria Fortes, Sandra Kritski, Afranio Ambrosio, Julio Cesar Wainberg, Milton L |
author_role |
author |
author2 |
Mann, Claudio Gruber Fernandes, Maria Jose Silva, Fatima Virginia Matsuzaka, Camila Cavalcanti, Maria Fortes, Sandra Kritski, Afranio Ambrosio, Julio Cesar Wainberg, Milton L |
author2_role |
author author author author author author author author author |
dc.contributor.author.fl_str_mv |
Sweetland, Annika Mann, Claudio Gruber Fernandes, Maria Jose Silva, Fatima Virginia Matsuzaka, Camila Cavalcanti, Maria Fortes, Sandra Kritski, Afranio Ambrosio, Julio Cesar Wainberg, Milton L |
dc.subject.por.fl_str_mv |
Tuberculosis Depression Mental Health Primary Health Care |
topic |
Tuberculosis Depression Mental Health Primary Health Care |
description |
Mental disorders can affect up to 70% of individuals with tuberculosis (TB). The World Health Organization (WHO) End TB Strategy explicitly calls for TB and mental health service integration. The goal of this study was to explore the barriers and facilitators to integrating depression treatment in the TB Control Program and primary care system in the municipality of Itaboraí - Rio de Janeiro, using Interpersonal Counseling (IPC). IPC is an evidence-based treatment for depression that can be delivered by non-mental health specialists with expert supervision. This study was conducted between 2016 and 2017 in the municipality of Itaboraí. Data collection consisted of six focus groups (n = 42) with health professionals (n = 29), program coordinators (n = 7) and TB patients (n = 6). The main potential barriers identified were poverty, political instability, an overburdened and under-resourced health system, high levels of distress among professionals, violence in the community and stigma related to mental health and TB. Potential facilitators included a high receptivity to, and demand for, mental health training; strong community relationships through the Community Health Workers (CHW); overall acceptability of IPC delivered by non-specialists for the treatment of depression among individuals with and without comorbid TB. Despite many challenges, integrating depression treatment into primary care in Itaboraí using IPC was perceived as an acceptable and feasible option. |
publishDate |
2020 |
dc.date.none.fl_str_mv |
2020-06-15 |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/preprint info:eu-repo/semantics/publishedVersion |
format |
preprint |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
https://preprints.scielo.org/index.php/scielo/preprint/view/760 10.1590/SciELOPreprints.760 |
url |
https://preprints.scielo.org/index.php/scielo/preprint/view/760 |
identifier_str_mv |
10.1590/SciELOPreprints.760 |
dc.language.iso.fl_str_mv |
eng |
language |
eng |
dc.relation.none.fl_str_mv |
https://preprints.scielo.org/index.php/scielo/article/view/760/1052 |
dc.rights.driver.fl_str_mv |
https://creativecommons.org/licenses/by/4.0 info:eu-repo/semantics/openAccess |
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https://creativecommons.org/licenses/by/4.0 |
eu_rights_str_mv |
openAccess |
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application/pdf |
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SciELO Preprints SciELO Preprints SciELO Preprints |
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SciELO Preprints SciELO Preprints SciELO Preprints |
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