A mobile clinic approach to the delivery of community-based mental health services in rural Haiti

This study evaluates the use of a mental health mobile clinic to overcome two major challenges to the provision of mental healthcare in resource-limited settings: the shortage of trained specialists; and the need to improve access to safe, effective, and culturally sound care in community settings....

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Veröffentlicht in:PloS one 2018-06, Vol.13 (6), p.e0199313-e0199313
Hauptverfasser: Fils-Aimé, J Reginald, Grelotti, David J, Thérosmé, Tatiana, Kaiser, Bonnie N, Raviola, Giuseppe, Alcindor, Yoldie, Severe, Jennifer, Affricot, Emmeline, Boyd, Katherine, Legha, Rupinder, Daimyo, Shin, Engel, Stephanie, Eustache, Eddy
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container_volume 13
creator Fils-Aimé, J Reginald
Grelotti, David J
Thérosmé, Tatiana
Kaiser, Bonnie N
Raviola, Giuseppe
Alcindor, Yoldie
Severe, Jennifer
Affricot, Emmeline
Boyd, Katherine
Legha, Rupinder
Daimyo, Shin
Engel, Stephanie
Eustache, Eddy
description This study evaluates the use of a mental health mobile clinic to overcome two major challenges to the provision of mental healthcare in resource-limited settings: the shortage of trained specialists; and the need to improve access to safe, effective, and culturally sound care in community settings. Employing task-shifting and supervision, mental healthcare was largely delivered by trained, non-specialist health workers instead of specialists. A retrospective chart review of 318 unduplicated patients assessed and treated during the mobile clinic's first two years (January 2012 to November 2013) was conducted to explore outcomes. These data were supplemented by a quality improvement questionnaire, illustrative case reports, and a qualitative interview with the mobile clinic's lead community health worker. The team evaluated an average of 42 patients per clinic session. The most common mental, neurological, or substance abuse (MNS) disorders were depression and epilepsy. Higher follow-up rates were seen among those with diagnoses of bipolar disorder and neurological conditions, while those with depression or anxiety had lower follow-up rates. Persons with mood disorders who were evaluated on at least two separate occasions using a locally developed depression screening tool experienced a significant reduction in depressive symptoms. The mental health mobile clinic successfully treated a wide range of MNS disorders in rural Haiti and provided care to individuals who previously had no consistent access to mental healthcare. Efforts to address these common barriers to the provision of mental healthcare in resource-limited settings should consider supplementing clinic-based with mobile services.
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subjects Anxiety
Bipolar disorder
Care and treatment
Case reports
Clinics
Community Health Services
Delivery of Health Care
Disorders
Drug abuse
Drug use
Earthquakes
Educational Status
Epilepsy
Female
Follow-Up Studies
Haiti
Health aspects
Health care
Health services
Humans
Lead
Low income groups
Male
Medical diagnosis
Medical personnel
Medicine and Health Sciences
Mental depression
Mental disorders
Mental health
Mental health care
Mental Health Services
Mobile businesses
Mobile Health Units
Mood
Patients
People and Places
Primary care
Psychiatry
Quality control
Rural areas
Rural communities
Rural Population
Social Sciences
Substance abuse
Treatment Outcome
Workers
title A mobile clinic approach to the delivery of community-based mental health services in rural Haiti
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