Evaluation of a mental health training intervention for multidisciplinary teams in primary care in Brazil: a pre- and posttest study

Evaluation of a mental health training intervention for multidisciplinary teams in primary care in Brazil: a pre- and posttest study

Author Goncalves, Daniel A. Autor UNIFESP Google Scholar
Fortes, Sandra Google Scholar
Campos, Monica Google Scholar
Ballester, Dinarte Google Scholar
Portugal, Flavia Batista Google Scholar
Tofoli, Luis Fernando Google Scholar
Gask, Linda Google Scholar
Mari, Jair Autor UNIFESP Google Scholar
Bower, Peter Google Scholar
Institution Universidade Federal de São Paulo (UNIFESP)
Universidade do Estado do Rio de Janeiro (UERJ)
Fundacao Oswaldo Cruz
Univ Fed Ceara
Univ Manchester
Kings Coll London
Abstract Objectives: the aim of this research was to investigate whether a training intervention to enhance collaboration between mental health and primary care professionals improved the detection and management of mental health problems in primary health care in four large cities in Brazil. the training intervention was a multifaceted program over 96 h focused on development of a shared care model.Method: A quasiexperimental study design was undertaken with assessment of performance by nurse and general practitioners (GPs) pre- and postintervention. Rates of recognition of mental health disorders (compared with the General Health Questionnaire) were the primary outcome, while self-reports of patient-centered care, psychosocial interventions and referral were the secondary outcomes.Results: Six to 8 months postintervention, no changes were observed in terms of rate of recognition across the entire sample. Nurses significantly increased their recognition rates (from 23% to 39%, P=.05), while GPs demonstrated a significant decrease (from 42% to 30%, P=.04). There were significant increases in reports of patient-centered care, but no changes in other secondary outcomes.Conclusions: Training professionals in a shared care model was not associated with consistent improvements in the recognition or management of mental health problems. Although instabilities in the local context may have contributed to the lack of effects, wider changes in the system of care may be required to augment training and encourage reliable changes in behavior, and more specific educating models are necessary. (C) 2013 Elsevier Inc. All rights reserved.
Keywords Mental health
Primary health care
Shared care
Detection
Patient-centered care
Education
Training
Collaborative care
Language English
Date 2013-05-01
Published in General Hospital Psychiatry. New York: Elsevier B.V., v. 35, n. 3, p. 304-308, 2013.
ISSN 0163-8343 (Sherpa/Romeo, impact factor)
Publisher Elsevier B.V.
Extent 304-308
Origin http://dx.doi.org/10.1016/j.genhosppsych.2013.01.003
Access rights Closed access
Type Article
Web of Science ID WOS:000318995800015
URI http://repositorio.unifesp.br/handle/11600/36292

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