Knowledge Translation for Improving the Care of Deinstitutionalized People With Severe Mental Illness in Health Policy

Abstract

Background: Knowledge translation (KT) is an effective strategy that uses the best available research evidence to bring stakeholders together to develop solutions and improve public health policy-making. Despite progress, the process of deinstitutionalization in Brazil is still undergoing consolidation, and the changes and challenges that are involved in this process are complex and necessitate evidence-informed decision-making. Accordingly, this study used KT tools to support efforts that aim to improve the care that is available to deinstitutionalized people with severe mental disorders in Brazil. Methods: We used the Supporting Policy Relevant Reviews and Trials tools for evidenceinformed health policymaking and followed eight steps: 1) capacity building; 2) identification of a priority policy issue within a Brazilian public health system; 3) meetings with policymakers, researchers and stakeholders; 4) development of an evidence brief (EB) that addresses the problem of deinstitutionalization; 5) facilitating policy dialogue (PD); 6) the evaluation of the EB and PD; 7) post-dialogue mini-interviews; and 8) dissemination of the findings. Results: Capacity building and meetings with key informants promoted awareness about the gap between research and practice. Local findings were used to define the problem and develop the EB. Twenty-four individuals (policy-makers, stakeholders, researchers, representatives of the civil society, and public defense) participated in the PD. They received the EB to subsidise their deliberations during the PD, which in turn were used to validate and improve the EB. The PD achieved the objective of promoting an exhaustive discussion about the problem and proposed options and improved communication and interaction among those who are involved in mental health care. The features of both the EB and PD were considered to be favorable and helpful. Conclusions: The KT strategy helped participants understand different perspectives and values, the interpersonal tensions that exist among those who are involved in the field of

Improving Care for Deinstitutionalized People With Mental Disorders: Experiences of the Use of Knowledge Translation Tools

“…Twenty-four individuals participated of policy dialogue (5 of them were policymakers, 11 health care providers, 6 researches, 1 from civil society organization and 1 representant from public defense). The process, outcomes and lessons learnt during this dialogue were showed in details in elsewhere ( 16 ).…”

Familiarity for Serious Mental Illness in Help-Seeking Adolescents at Clinical High Risk of Psychosis

“…Finally, for better specifying the clinical profile of UHR adolescents with family history of SMI (especially psychosis), UHR+ participants were further dichotomized using the following criteria: (a) family history of SMI (i.e., considering all the degrees of family relationships), (b) presence of at least one first-degree relative with psychosis or other SMI, and (c) presence of a GRFD syndrome (i.e., alone or in comorbidity with APS or BLIPS condition). As suggested by Fulone et al ( 30 ), for SMI, we expressly intended schizophrenia spectrum disorders or other related psychosis, bipolar disorder, and major depression.…”

Approaches to monitoring and evaluation of knowledge translation platforms in low- and middle-income countries: A scoping review

“…The four studies that made the inclusion criteria were by Fulone et al 2019, 25 Ongolo-Zogo et al 2018 26 Yehia et al 2015 27 and Nabyonga-Orem et al 2014 28 . All the studies included involve KTPs which have a formal partnership with stakeholders.…”

“…Two of the studies are from the African region, (Nabyonga-Orem et al 2014 and Ongolo-Zogo et al 2018), 26,28 one from the middle east (Yehia et al 2015) 27 and one from South America (Fulone et al 2019). 25…”

“…Institution where the KTP is domiciled The KTP in Fulone et al (2019), 25 is housed by the Seriama group at the University of Sorocaba Brazil, while the KPT from the study by Yehia et al (2015) 27 is housed at the Knowledge to policy Centre (K2P) group at American University of Beirut. Both KTP in Fulone et al (2019) and Yehia et al (2015) are in private non-profit Universities 25,27 while the two KPTs compared in the study by Ongolo-Zogo et al (2018) 26 in Uganda and Cameroon are housed in tertiary public institutions of learning own by the government. On the other hand, the KTP in Nabyonga-Orem et al (2014) 28…”