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OBJECTIVE: This research aimed to determine the stigma toward people with mental illness among mental health personnel and identify individual, professional, and contextual predictors. METHODS: A descriptive, cross-sectional, and correlational design was used. The sample consisted of 218 mental health personnel working in Outpatient Psychiatric Units belonging to hospitals and Community Mental Health Centers in Chile. Stigma was evaluated using a scale of humanized treatment, a scale of social distance, and a scale of attitudes in health personnel. In addition, sociodemographic and professional information was collected from mental health personnel and contextual information, particularly the type of outpatient mental health center and the technical-administrative unit that groups all the health centers in a territory. RESULTS: It was found that mental health personnel, in general terms, present low levels of stigma expressed in behaviors of comfort and support toward users, a desire for closeness and social interaction, and reduced stigmatizing beliefs and attitudes of infantilization toward individuals with MHPs. However, intimacy and trust were lower than expected.Only educational levels and health centers were related to stigma. CONCLUSIONS: The low levels of stigma may be due to the evolution of this phenomenon and the country's mental health policies.

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Little is known about the contribution of psychosocial factors related to mental healthcare use among Mexican-origin women from farmworker families. Therefore, this study assessed relationships between acculturative stress, depressive symptoms, mental healthcare service use, and preferences for seeking care. Linear and logistic regression models and chi-square tests were performed to analyze survey data from 78 Mexican-origin women from farmworker families. Women were recruited in collaboration with promotoras and completed measures of acculturative stress, depressive symptoms, and mental healthcare use and preferences. Overall, 29.5% of the sample reported clinically significant depressive symptomatology. Acculturative stress was positively associated with depressive symptoms (b = 0.43, 95%CI = 0.27,0.59) after controlling for years in the U.S., primary language, and demographic characteristics. In addition, acculturative stress was associated with lower odds of mental healthcare use (OR = 0.96) after controlling for years in the U.S. and depressive symptoms. However, this association was no longer statistically significant when controlling for health insurance status and access to transportation. Mexican-origin women with high levels of acculturative stress were significantly more likely to seek care from a psychiatrist/psychologist than their peers (54.3% vs. 45.7%); however, this preference was not indicative of their use of mental healthcare services. Results suggest that acculturative stress is a risk factor for depressive symptoms and might contribute to a delay in seeking mental healthcare services in Mexican-origin women from farmworker families. Thus, interventions for this group should address aspects of acculturative stress as a strategy to increase mental health services use.

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Introduction: The COVID-19 pandemic has had an impact both in general and mental healthcare, challenged the health systems worldwide, and affected their capacity to deliver essential health services. We aimed to describe perceived changes in ease of access to general and mental healthcare among patients with a diagnosis of depression and/or unhealthy alcohol use in Colombia. Methods: This study is embedded in the DIADA project, a multicenter implementation research study aimed at evaluating the integration of mental healthcare in primary care in Colombia. Between November 2020 and August 2021, we conducted a COVID-19 pandemic impact assessment in a cohort of participants with newly diagnosed depression and/or unhealthy alcohol use part of DIADA project. We assessed the ease of access and factors related to perceived ease of access to general or mental healthcare, during the COVID-19 pandemic. Results: 836 participants completed the COVID-19 pandemic impact assessment. About 30% of participants considered their mental health to be worse during the pandemic and 84.3% perceived access to general healthcare to be worse during the pandemic. Most of participants (85.8%) were unable to assess access to mental health services, but a significant proportion considered it to be worse. Experiencing worse ease of access to general healthcare was more frequent among women, patients with diagnosis of depression, and patients with comorbidities. Experiencing worse ease of access to mental healthcare was more frequent among patients aged between 30 and 49.9 years, from socioeconomic status between 4 and 6, affiliated to the contributive social security regime, attending urban study sites, and those who perceived their mental health was worse during the pandemic. Discussion: Despite the overall perception of worse mental health during the pandemic, the use of mental healthcare was low compared to general healthcare. Ease of access was perceived to be worse compared to pre-pandemic. Ease of access and access were affected by geographical study site, socioeconomic status, age and gender. Our findings highlight the need for improved communication between patients and institutions, tailored strategies to adapt the healthcare provision to patients' characteristics, and continued efforts to strengthen the role of mental healthcare provision in primary care.

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BACKGROUND: Resources for mental healthcare are lacking in Guatemala, yet rates of mental illness and suicide are quite high. Mental healthcare providers often lack the knowledge needed to effectively work with young at-risk of suicide. To address this gap, we developed a training program for mental health professionals focused on increasing knowledge and understanding of engaging and working with youth at risk of suicide and present its acceptability and preliminary effectiveness. METHODS: Mental health providers (N = 17) from a low SES community participated in the training, Formacion CUIDAR (Comunidades Unidos para Individuales De Alto Riesgo; CARE Training; Communities United for Individuals at High Risk). Mixed methods were used to explore outcomes including, self-reported knowledge and understanding of warning signs; risk and protective factors; effective risk assessment; and, techniques for working with at-risk youth. RESULTS: Findings indicate that the training was effective at increasing all targeted domains of knowledge (t = 2.46, p < .05, Cohen's d = .56). Acceptability was also rated as high. CONCLUSION: Scarcity of mental health specialists and lack of training on suicide assessment and management have resulted in inadequate resources for at-risk youth in need of mental health services in Guatemala. Results of our study demonstrate that our training is an acceptable, effective program for practicing mental health providers to address their lack of specialized training on how to work with individuals at risk of suicide. Further examination of the training in a larger RCT is required to attain more robust indictors of effectiveness and to assess long-term impact.

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PURPOSE: Little is known about Cuba's mental healthcare system. We present background information and an interview with the President of the Cuban Society of Psychology to learn about current mental healthcare in today's Cuba. CONCLUSIONS: Mental and medical healthcare are free and fully integrated. Early diagnosis and intervention is standard as each patient is known by their community doctor/nurse team from infancy through old age and by yearly home visits. PRACTICE IMPLICATIONS: Free and integrated medical and mental healthcare facilitates early detection and intervention. Individuals in Cuba are assisted in maintaining job and schooling during treatment. Therapy is multimodal and eclectic.

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Resumo O artigo objetiva analisar as contribuições da contação de histórias para a saúde mental no contexto da pandemia de Covid-19. Trata-se de uma pesquisa-intervenção que posiciona o recurso das histórias como uma tecnologia leve em saúde, comprometida em reduzir distâncias, criar pontes entre as pessoas através do investimento na produção de vínculos e acolhimento. A contação de histórias articula literatura e psicologia, faz parte da caixa de ferramentas necessárias para a ativação de forças psíquicas expressivas dos afetos no cenário atual. O banco de dados da pesquisa pode ser designado como banco de histórias que passam por um processo de curadoria, sendo essa uma metodologia fundamental para o encadeamento de temas abordados nas histórias e a postagem das mesmas no Instagram do projeto. As histórias videogravadas foram analisadas a partir dos núcleos semânticos contexto-afeto-texto, com destaque para os conteúdos de memória e morte; e práticas de mutualidade em cuidado. A reação dos/as seguidores/as do Instagram expressam mensagens afetuosas aos/as contadores/as.

Resumen El artículo tiene como objetivo analizar las contribuciones de la narración a la salud mental en el contexto de la pandemia Covid-19. Se trata de una investigación-intervención que posiciona el recurso de las historias como una tecnología ligera en salud, comprometida con la reducción de distancias, creando puentes entre las personas a través de la inversión en la producción de vínculos y la acogida. La narración de cuenteros articula la literatura y la psicología, es parte de la caja de herramientas necesarias para la activación de las fuerzas psíquicas expresivas de los afectos en el escenario actual. La base de datos de investigación puede designarse como un banco de historias que se someten a un proceso curatorial, que es una metodología fundamental para vincular los temas tratados en las historias y publicarlos en el Instagram del proyecto. Se analizaron relatos videograbados a partir de los núcleos semánticos contexto-afecto-texto; con énfasis en los contenidos de la memoria y la muerte; y prácticas de cuidado mutuo en el cuidado. La reacción de los/las seguidores/as de Instagram expresan mensajes afectuosos a los/las cuenteros/as.

Abstract This article aims to analyze the contributions of the storytelling to mental health in the context of the Covid-19 pandemic. It is an intervention-research that places this story device as light health technology. It is committed to reduce distances, create bridges between people through investment in bonding and welcoming. Storytelling articulates literature and psychology, and is part of the toolbox that is necessary for the activation of expressive psychic forces of affections in the current scenario. The research database can be designated as a bank of stories that undergo a curatorial process, which is a fundamental methodology for linking topics covered in the stories and posting them on the project's Instagram. The videotaped stories were analyzed from mutual-care practices and the context-affection-text semantic nuclei, with emphasis on the contents of memory and death. The reactions of Instagram followers express affectionate messages to the storytellers.

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The use of embodied conversational agents in mental health has increased in the last years. Several studies exist describing the benefits and advantages of this technology as a complement to psychotherapeutic interventions for the prevention and treatment of depression, anxiety, or post-traumatic stress disorder, to name a few. A small number of these works implement capabilities in the virtual agent focused on the detection and prevention of suicidality risks. The work presented in this paper describes the development of an embodied conversational agent used as the main interface in HelPath, a mobile-based application addressed to individuals detected with any of the suicidal behaviours: ideation, planning or attempt. The main objective of HelPath is to continuously collect user's information that, complemented with data from the electronic health record, supports the identification of risks associated with suicidality. Through the virtual agent, the users also receive information and suggestions based on cognitive behaviour therapy that would help them to maintain a healthy condition. The paper also presents the execution of an exploratory pilot to assess the acceptability, perception and adherence of users towards the virtual agent. The obtained results are presented and discussed, and some actions for further improvement of the embodied conversational agent are also identified.

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Objective: The study's purpose has been to recognize the interfering factors on the ambulatory treatment adherence by drug users. Methods: It is a descriptive study with a qualitative approach. Data were collected over the period from August to December 2015 through an interview process with seven users and following taken to thematic content analysis. Results: The first contact with drugs usually occurs by friends influence, while the search for treatment in the Psychosocial Care Center for Alcohol and other Drugs [Centros de Atenção Psicossocial Álcool e outras Drogas (CAPS-AD)] occurs by own person's will, considering that the family interferes positively in the initiation and also in the continuity of the treatment. The factors favoring adherence to treatment were as follows: the availability of health professionals to provide the care, which goes against the difficulty in accessing the service. Conclusion: The following was perceived as necessary in order to maintain the adherence to ambulatory treatment: the user's desire to stop using drugs, family support, personal bonds with the professionals, and easy access to the service in regard to the geography, financial and structural parameters

Objetivo: Conhecer os fatores que interferem na adesão de usuários de drogas ao tratamento ambulatorial. Métodos: Estudo descritivo, de natureza qualitativa, cujos dados foram coletados entre agosto e dezembro de 2015 por meio de entrevista com sete usuários e submetidos à análise de conteúdo temática. Resultados: O primeiro contato com as drogas normalmente ocorre por influência de amigos, enquanto a busca por tratamento no CAPS-ad ocorre por vontade própria, sendo que a família interfere positivamente no início e também na continuidade do tratamento. Os fatores que favorecem a adesão ao tratamento foram: disponibilidade dos profissionais de saúde no atendimento aos pacientes, o que se contrapõe à dificuldade de acesso ao serviço. Conclusão: Para manter a adesão ao tratamento no âmbito ambulatorial se faz necessário: desejo do usuário em parar de usar drogas, apoio familiar, vínculo com os profissionais e facilidade de acesso ao serviço, em termos geográfico, financeiro e estrutural

Objetivo: Conocer los factores que interfieren en la adhesión de usuarios de drogas al tratamiento ambulatorial. Métodos: Estudio descriptivo, de naturaleza cualitativa, cuyos datos fueron recolectados entre agosto y diciembre de 2015 por medio de una entrevista con siete usuarios y sometidos al análisis de contenido temático. Resultados: El primer contacto con las drogas normalmente ocurre por influencia de amigos, mientras que la búsqueda por tratamiento en el CAPS-ad ocurre por voluntad propia, siendo que la familia interfiere positivamente al inicio y también en la continuidad del tratamiento. Los factores que favorecen la adhesión al tratamiento fueron: disponibilidad de los profesionales de salud en la atención a los pacientes, lo que se contrapone a la dificultad de acceso al servicio. Conclusión: Para mantener la adhesión al tratamiento en el ámbito ambulatorio se hace necesario: deseo del usuario en dejar de usar drogas, apoyo familiar, vínculo con los profesionales y facilidad de acceso al servicio, en términos geográfico, financiero y estructural

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Embodied conversational agents (ECAs) are advanced computational interactive interfaces designed with the aim to engage users in the continuous and long-term use of a background application. The advantages and benefits of these agents have been exploited in several e-health systems. One of the medical domains where ECAs are recently applied is to support the detection of symptoms, prevention and treatment of mental health disorders. As ECAs based applications are increasingly used in clinical psychology, and due that one fatal consequence of mental health problems is the commitment of suicide, it is necessary to analyse how current ECAs in this clinical domain support the early detection and prevention of risk situations associated with suicidality. The present work provides and overview of the main features implemented in the ECAs to detect and prevent suicidal behaviours through two scenarios: ECAs acting as virtual counsellors to offer immediate help to individuals in risk; and ECAs acting as virtual patients for learning/training in the identification of suicide behaviours. A literature review was performed to identify relevant studies in this domain during the last decade, describing the main characteristics of the implemented ECAs and how they have been evaluated. A total of six studies were included in the review fulfilling the defined search criteria. Most of the experimental studies indicate promising results, though these types of ECAs are not yet commonly used in routine practice. The identification of some open challenges for the further development of ECAs within this domain is also discussed.

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Este artigo resulta de pesquisa implementada na Residência Integrada em Saúde do Grupo Hospitalar Conceição. A pesquisa teve como base um projeto investigativo realizado em serviços de saúde mental e de saúde da família. O objetivo central do estudo foi conhecer as Práticas Integrativas e Complementares realizadas nos Centros de Atenção Psicossocial vinculados ao Serviço de Saúde Comunitária do Grupo Hospitalar Conceição. Como objetivos específicos, intencionou identificar espaços potenciais para a realização de Práticas Integrativas e Complementares nos serviços; conhecer as percepções dos profissionais sobre as Práticas Integrativas e Complementares, e refletir sobre os fatores que influenciam esses profissionais a utilizarem ou não as práticas integrativas e complementares nos atendimentos. A metodologia do estudo contou com coleta de informações por meio de entrevistas individuais e aplicação de questionário. Como principais resultados destacam-se o reconhecimento das diferentes modalidades de Práticas Integrativas e Complementares utilizadas, e a ampliação do cuidado em saúde mental proporcionada pelas Práticas Integrativas e Complementares, na medida em que agregam outras maneiras de conceber o corpo nas suas dimensões emocionais, físicas e espirituais. (AU)

This article is the product of research conducted during an Integrated Healthcare Residency at Grupo Hospitalar Conceição. The research was based on an investigative project carried out in mental and family healthcare services. The core goal of the study was to learn about the Integrative and Complementary Practicesin place at Psychosocial Service Centers connected to Grupo Hospitalar Conceição's Community Healthcare Services. This study's specific goals included identifying potential opportunities for carrying out the Integrative and Complementary Practices in the services; learning about the professionals' opinions on the Integrative and Complementary Practices, and looking into the factors that lead these professionals to either use the integrative and complementary practices when seeing patients or not. The study methodology comprised collecting information via individual interviews and the application of a questionnaire. The main results included detecting the different types of Integrative and Complementary Practices used and the expanded mental healthcare provided by the Integrative and Complementary Practices, as they incorporate other ways of understanding the body in its emotional, physical, and spiritual aspects.(AU)