Publications by authors named "Martin Agrest"

Background: Mental health problems represent a growing global concern. This has intensified since the coronavirus pandemic and is also partly due to greater awareness of the extent of mental health problems and the lack of attention they have received over time. In many high-income countries, increases in service provision have been accompanied by efforts to increase the mental health literacy of the general population.

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Objective: Communication between patients and mental health professionals by means of messaging platforms in the interval between synchronous encounters became a kind of asynchronous teleconsultation (AT) whose usefulness and effect on providers’ workload have not been explored. Method: Mental health providers working in Argentina were invited to answer a survey exploring the intensity and usefulness of AT, and the resulting overload.

Results: A total of 527 responses from professionals working throughout the country were received.

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Background: Exposure to potentially traumatic events increases the risk of a person developing a mental disorder. Training community members to offer support to a person during and after a traumatic situation may help lower this risk. This study reports on the cultural adaptation of Australian mental health first aid guidelines for individuals exposed to a potentially traumatic event to the Chilean and Argentinian context.

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Background: Psychotic symptoms may be less common than anxiety or affective symptoms, but they are still frequent and typically highly debilitating. Community members can have a role in helping to identify, offer initial help and facilitate access to mental health services of individuals experiencing psychosis. Mental health first aid guidelines for helping a person experiencing psychosis have been developed for the global north.

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Article Synopsis
  • A qualitative study explored the barriers and facilitators of implementing a pilot trial of Critical Time Intervention-Task-Shifting for individuals with psychosis in Rio de Janeiro, Brazil, and Santiago, Chile, using 40 semi-structured interviews.
  • Analysis revealed that barriers and facilitators were categorized into five domains: Personal, Interpersonal, Intervention, Mental Health System, and Contextual.
  • Key findings indicated that while mental health stigma and community violence posed challenges, the intervention is generally seen as acceptable and feasible, presenting a valuable opportunity to enhance mental health care systems in Latin America.
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Background: Neighbors are an important component of personal social network (PSN) and despite their peripheral role and being considered as familiar strangers, they typically provide instrumental support. For people who is discharged after long-term psychiatric hospitalizations, neighbors would offer other types of social support and play a different role fostering the process of becoming full member of a given community.

Aims: To analyze the effects of neighboring on both, those who have had long-term psychiatric hospitalizations and their neighbors.

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Article Synopsis
  • A psychiatric reform is being implemented in Latin America, particularly in Argentina, focusing on community mental health while still facing challenges from prolonged hospitalizations.
  • A study in Buenos Aires Province investigated neighborhood attitudes towards prolonged psychiatric hospitalization by using questionnaires and interviews with residents and key informants.
  • Results showed no significant differences in attitudes toward prolonged hospitalization between neighbors and non-neighbors, but key informants emphasized the importance of support teams for facilitating community integration.
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Objetive: To characterise the impact of the COVID-19 pandemic on psychiatric hospitalisations in the Latin American and Caribbean (LAC) region.

Methods: Descriptive study. 85 semi-structured interviews were conducted with health workers involved with psychiatric hospitalisations in general hospitals (GHs) and specialised psychiatric hospitals (SHs) from 18 LAC countries.

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Background: Depression is one of the most common mental health problems worldwide and, while prevalence rates in Latin America are relatively high, most people who meet the criteria for diagnosis do not receive treatment. Family and friends of a person with depression can play an important role in supporting a person to seek and engage with treatment. However, many people do not have the necessary skills or confidence to help.

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Background: Lockdowns have been one of the government's primary measures to control COVID-19, especially during the initial waves of the pandemic, but there is concern on the impact of lockdowns on people's mental health. Confinement is still today the reality of many people with severe mental illness in many places of the world.

Objective: Given that the general population experienced confinement during the COVID-19 pandemic, we sought to explore if that affected perceptions about long-term psychiatric hospitalizations.

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The personal impact of COVID-19 on mental health care workers (MHWs) has received scarce attention despite their work addressing the emotional wellbeing of those affected by the pandemic. This study aims to analyze Latin American and Caribbean's MHWs' subjective impact in connection to working during the initial times of the pandemic. One hundred and fifty-five persons ( = 155) from seventeen countries were contacted in May-June 2020 through a snowball approach.

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Background: Among all psychoactive substances, alcohol consumption presents the most significant public health problem and is a leading risk factor for overall disease burden in Latin America. However, most people who meet criteria for a substance use disorder do not receive treatment in primary or secondary care sources. Community members can play a role in helping people to seek help as they are likely to encounter people experiencing problem drinking and recognize the signs.

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Introduction: The impact of the COVID-19 pandemic on health workers has been studied on an international level. However, mental health workers, who are also called upon to address such ailments both in the general population as well as in the health personnel, have not been asked about their experiences.

Methods: Seventy mental health workers in five regions of Argentina were interviewed between May and June 2020 regarding the subjective impact of changes in their work due to the pandemic.

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Objetive: To characterise the impact of the COVID-19 pandemic on psychiatric hospitalisations in the Latin American and Caribbean (LAC) region.

Methods: Descriptive study. 85 semi-structured interviews were conducted with health workers involved with psychiatric hospitalisations in general hospitals (GHs) and specialised psychiatric hospitals (SHs) from 18 LAC countries.

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Background: Few studies provide clear rationale for and the reception of adaptations of evidence-based interventions. To address this gap, we describe the context-dependent adaptations in critical time intervention-task shifting (CTI-TS), a manualized recovery program for individuals with psychosis in Rio de Janeiro, Brazil and Santiago, Chile. Implications of the adaptations - incorporating a task-shifting approach and modifying the mode of community-based service delivery - are examined from users' perspectives.

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Background: Affective polarization and stigma toward individuals with schizophrenia and toward immigrants in Argentina are not new despite its importance and dissemination. However, no research has been conducted taking into consideration political partisanship and attitudes toward these groups.

Aims: Political polarization and attitudes toward socialization across party lines are studied in conjunction with attitudes toward immigrants and toward individuals with schizophrenia.

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This study explores the beliefs and attitudes about the psychosocial mechanisms of peer support work among users who participated in Critical Time Intervention-Task Shifting (CTI-TS), which tested the acceptability and feasibility of a peer support work model to improve community-based mental health care for individuals with psychosis in Latin America. We conducted a secondary analysis of 15 in-depth interviews with CTI-TS participants in Chile, using the framework method and defined the framework domains based on five major mechanisms of peer support work identified by a recent literature review. The analysis revealed that users' perceptions of peer support work mechanisms were strongly shaped by personal motivations, beliefs about professional hierarchies, familial support, and the Chilean mental health system's incipient recovery orientation.

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Background: Latin America, and Chile in particular, has a rich tradition of community mental health services and programs. However, in vivo community-based psychosocial interventions, especially those with a recovery-oriented approach, remain scarce in the region. Between 2014 and 2015, a Critical Time Intervention-Task Shifting project (CTI-TS) was implemented in Santiago, Chile, as part of a larger pilot randomized control trial.

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This paper describes and analyzes the psychiatric reform process in three Latin American countries (Brazil, Chile and Colombia) based on the Caracas Declaration of 1990. It compares the psychiatric reform processes in these three countries and highlights the role of national mental health laws in these processes. Our goal when investigating the experiences in other countries of Latin America is to draw conclusions for the Argentine psychiatric reform and for the future of such reforms in the region.

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The mental health users' movement is a worldwide phenomenon that seeks to resist disempowerment and marginalisation of people living with mental illness. The Latin American Collective Health movement sees the mental health users' movement as an opportunity for power redistribution and for autonomous participation. The present paper aims to analyze the users' movement in Argentina from a Collective Health perspective, by tracing the history of users' movement in the Country.

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The concept of "recovery" is still controversial as to what its principal components/dimensions are. From the perspective of a mental health professional, recovery is related to a clinical improvement and to a higher functioning. However, from a users' perspective, its major component is related to hope and having a meaningful life.

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