The overall goal of our Hub for Latin America (HLA) is to generate sustained progress toward Community Health Care for individuals with Severe Mental Disorders (CHC-SMD). We envision CHC-SMD as an integrated system of primary care and secondary mental health services that are delivered as close as possible to the communities that use them;that are accessible to all people with severe mental disorders and their families;that promote full community integration;and that engage the affected individuals, their families, and their communities in shaping the health services offered to them. The Research Component proposes to test a pilot regional randomized controlled trial (RCT) of a Critical Time Intervention-Task Shifting (CTI-TS) intervention. CTI-TS is a task shifting integration, and, at the system level, strengthens the connections between mental health and primary care clinics. The proposed pilots are a necessary preparatory step toward a full-scale regional RCT. We wili conduct pilot RCTs (N=40) of CTI-TS at three sites (total N = 120): Rio de Janeiro, Santiago, and a third HLA site selected during year 1. The study complements our Capacity Building Component, because HLA sites will gain experience with R(5TS, with task shifting interventions, and with coordination of research among sites.
The aims of the Research Component then are : (a) to complete a pilot RCT of CTI-TS at three HLA sites;(b) to analyze the data collected to infomi the design of a full scale regional RCT;and (c) to share results and challenges encountered with all relevant stakeholders.

Public Health Relevance

The purpose of the Research Component is to implement three pilot randomized controlled trials in Latin America of a Critical Time Inten/ention-Task Shifting intervention (CTI-TS) that aims to provide support for better community living and promotes social integration of persons with severe mental disorder and strengthen the connections between mental health and primary care clinics. The pilot RCTs will lead to a full-scale regional RCT that aims to move us towards a full model of Community Health Care for individuals with Severe Mental Disorders (CHC-SMD) in the region.

National Institute of Health (NIH)
National Institute of Mental Health (NIMH)
Research Program--Cooperative Agreements (U19)
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Special Emphasis Panel (ZMH1)
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Columbia University (N.Y.)
New York
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