Debate: Mental health, social crisis and the COVID‐19 pandemic in Chile

Fischman, Patricio; Irarrázaval, Matías

doi:10.1111/camh.12424

Cited by 14 publications

(15 citation statements)

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“…In Chile, the use of technology-based solutions for mental health care of remote and underserved populations has been important due to the geography, and it has become increasingly relevant during the COVID-19 pandemic—with a rapid shift to this mode of mental health service delivery to ensure access and continuity of care [ 11 ]. For instance, partnerships between centralized SMHC teams and PHC clinicians through the implementation of call centers and EHRs have been reported to be acceptable and satisfactory for PHC clinicians as well as adults and adolescents with depression [ 12 , 20 ].…”

Section: Discussionmentioning

confidence: 99%

“…Technology-based solutions increase the access to care, are acceptable by culturally diverse populations, and provide mental health outcomes comparable to in-person care [8,9]. These characteristics have also contributed to the role of telepsychiatry in emergency response to the current COVID-19 pandemic [10,11]. In Chile [12] and other countries [13][14][15], child and adolescent telepsychiatry services have shown promising results for the treatment of mental disorders in PHC.…”

Section: Introductionmentioning

confidence: 99%

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Telepsychiatry Consultation for Primary Care Treatment of Children and Adolescents Receiving Child Protective Services in Chile: Mixed Methods Feasibility Study

Mundt

Irarrázaval

Fernández

et al. 2021

JMIR Public Health Surveill

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Background Children and adolescents living under the supervision of child protective services have complex mental health care needs. The scarcity and uneven distribution of specialized mental health teams in Chile may limit the provision and quality of care for this vulnerable population. Telepsychiatry can address such health inequities. Objective The objective of this study was to evaluate the feasibility of a telepsychiatry consultation program for primary health care (PHC) treatment of children and adolescents living under the supervision of child protective services. Methods We developed a telepsychiatry consultation program for two rural PHC clinics located in central Chile (Valparaíso Region) and evaluated its implementation using a mixed methods study design. The program consisted of videoconferencing mental health consultation sessions scheduled twice per month (each 90 minutes long), over a 6-month period, delivered by child and adolescent psychiatrists based in Santiago, Chile. We described the number of mental health consultation sessions, participant characteristics, perceived usefulness and acceptability, and experiences with the telepsychiatry consultation program. Results During the 6-month study period, 15 videoconferencing mental health consultation sessions were held. The telepsychiatry consultation program assisted PHC clinicians in assigning the most adequate diagnoses and making treatment decisions on pharmacotherapy and/or psychotherapy of 11 minors with complex care needs. The intervention was perceived to be useful by PHC clinicians for improving the resolution capacity in the treatments of this patient population. Limitations such as connectivity issues were resolved in most sessions. Conclusions The telepsychiatry consultation program was feasible and potentially useful to support PHC clinicians in the management of institutionalized children and adolescents with complex psychosocial care needs living in a poorly resourced setting. A larger scale trial should assess clinical outcomes in the patient population. Regulations and resources for this service model are needed to facilitate sustainability and large-scale implementation.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Telepsychiatry Consultation for Primary Care Treatment of Children and Adolescents Receiving Child Protective Services in Chile: Mixed Methods Feasibility Study

Mundt

Irarrázaval

Fernández

et al. 2021

JMIR Public Health Surveill

View full text Add to dashboard Cite

show abstract

“…Chilean circumstances have been particularly challenging. First, the pandemic started above a disrupted social context due to the 2019 social outbreak that has had important social, political and economic consequences [ 50 ], which are known risk factors for mental health [ 51 ]. Second, since mid-March 2020 Chile adopted severe restrictions on movement and social contact [ 52 ] with already known negative consequences on people’s mental health [ 53 ].…”

Section: Introductionmentioning

confidence: 99%

Social Support and Depressive Symptoms in the Context of COVID-19 Lockdown: The Moderating Role of Attachment Styles

Costa-Cordella

Vivanco-Carlevari²,

Rossi³

et al. 2022

Int J Public Health

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Objectives: COVID-19 sanitary measures (social distancing, school closures) have deeply impacted social life, support networks, and their protective role in mental health. The present study aims to understand how attachment styles influence the way individuals experience social support. Particularly, investigating its moderating role in the relationship between social support and depression.Methods: An online survey was designed to clarify the role of adult attachment styles (ECR-S) in the perceived social support (MOSS) and self-reported depressive symptoms (BDI-SF) in the COVID-19 context.Results: Positive social interactions was the most important dimension of social support for lower depression symptoms. Individuals attachment strategies have a moderating role in the relation between of social support and depression. Crucially, insecure attachment style wanes the positive impact of social support in depression.Conclusion: Aligned with the existing literature, attachment security is an essential factor in our current understanding of relationships and mental health. Exploring specific and indivual attachment strategies might be a powerful tool to protect population’s mental healt.

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“…Unfortunately, the conditions of COVID-19 have exacerbated preexisting mental health care access problems due to safety precautions and other limitations to in-person care [ 6 – 8 ]. To increase public safety and abide by social distancing policies, there has been a widespread shift to Internet-based and related telehealth methods of treatment since the beginning of 2020 [ 9 – 12 ]. Therefore, it is important to study the efficacy of offering existing treatment modalities (e.g., cognitive behavioral therapy) through virtual platforms.…”

Section: Introductionmentioning

confidence: 99%

Virtual versus Face-to-Face Cognitive Behavioral Treatment of Depression: Meta-Analytic Test of a Noninferiority Hypothesis and Men’s Mental Health Inequities

Charron

Gorey

2022

Depression Research and Treatment

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Global rates of depression have increased significantly since the beginning of the COVID-19 pandemic. It is unclear how the recent shift of many mental health services to virtual platforms has impacted service users, especially for the male population which are significantly more likely to complete suicide than women. This paper presents the findings of a rapid meta-analytic research synthesis of 17 randomized controlled trials on the relative efficacy of virtual versus traditional face-to-face cognitive behavioral therapy (CBT) in mitigating symptoms of depression. Participants’ aggregated depression scores were compared upon completion of the therapy (posttest) and longest follow-up measurement. The results supported the noninferiority hypothesis indicating that the two modes of CBT delivery are equally efficacious, but the results proved to be significantly heterogeneous indicating the presence of moderating effects. Indirect suggestive evidence was found to support moderation by gender; that is, depressed males may benefit more from virtual CBT. Perhaps, this field’s most telling descriptive finding was that boys/men have been grossly underrepresented in its trials. Future trials ought to oversample those who have been at this field’s margins to advance the next generation of knowledge, allowing us to best serve people of all genders, those who live in poverty, Indigenous, Black, and other Peoples of Colour, as well as any others at risk of being marginalized or oppressed in contemporary mental health care systems.

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Debate: Mental health, social crisis and the COVID‐19 pandemic in Chile

Cited by 14 publications

References 0 publications

Telepsychiatry Consultation for Primary Care Treatment of Children and Adolescents Receiving Child Protective Services in Chile: Mixed Methods Feasibility Study

Telepsychiatry Consultation for Primary Care Treatment of Children and Adolescents Receiving Child Protective Services in Chile: Mixed Methods Feasibility Study

Social Support and Depressive Symptoms in the Context of COVID-19 Lockdown: The Moderating Role of Attachment Styles

Virtual versus Face-to-Face Cognitive Behavioral Treatment of Depression: Meta-Analytic Test of a Noninferiority Hypothesis and Men’s Mental Health Inequities

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