Perceived sustainability of psychosocial treatment in low- and middle-income countries in South-Eastern Europe

Affiliations

¹ Clinical Center University of Sarajevo, Sarajevo, Bosnia and Herzegovina.
² Unit for Social and Community Psychiatry, Queen Mary University of London, London, UK; and WHO Collaborating Centre for Mental Health Services Development, Bart's and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK.
³ Unit for Social and Community Psychiatry, Queen Mary University of London, London, UK.
⁴ Unit for Social and Community Psychiatry, Queen Mary University of London, London, UK; and Newham Centre for Mental Health, London, UK.
⁵ Clinical Centre of Montenegro, Podgorica, Montenegro.
⁶ University Clinical Centre Mother Teresa Skopje, Skopje, Macedonia.
⁷ Department of Psychology, University of Prishtina 'Hasan Prishtina', Prishtina, Kosovo, Albania; and University of Prishtina, Kosovska Mitrovica, Serbia.
⁸ Department of Psychology, University of Prishtina 'Hasan Prishtina', Prishtina, Kosovo, Albania.
⁹ Department of Psychiatry, University Clinical Center of Serbia, Belgrade, Serbia; and Department of Psychiatry, Clinic for Psychiatry, Clinical Centre of Serbia, Belgrade, Serbia.
¹⁰ University Clinical Center of Serbia, Belgrade, Serbia.

PMID: 35968901
PMCID: PMC9438482
DOI: 10.1192/bjo.2022.539

Perceived sustainability of psychosocial treatment in low- and middle-income countries in South-Eastern Europe

Emina Ribic et al. BJPsych Open. 2022.

. 2022 Aug 15;8(5):e156.

doi: 10.1192/bjo.2022.539.

Authors

Affiliations

¹ Clinical Center University of Sarajevo, Sarajevo, Bosnia and Herzegovina.
² Unit for Social and Community Psychiatry, Queen Mary University of London, London, UK; and WHO Collaborating Centre for Mental Health Services Development, Bart's and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK.
³ Unit for Social and Community Psychiatry, Queen Mary University of London, London, UK.
⁴ Unit for Social and Community Psychiatry, Queen Mary University of London, London, UK; and Newham Centre for Mental Health, London, UK.
⁵ Clinical Centre of Montenegro, Podgorica, Montenegro.
⁶ University Clinical Centre Mother Teresa Skopje, Skopje, Macedonia.
⁷ Department of Psychology, University of Prishtina 'Hasan Prishtina', Prishtina, Kosovo, Albania; and University of Prishtina, Kosovska Mitrovica, Serbia.
⁸ Department of Psychology, University of Prishtina 'Hasan Prishtina', Prishtina, Kosovo, Albania.
⁹ Department of Psychiatry, University Clinical Center of Serbia, Belgrade, Serbia; and Department of Psychiatry, Clinic for Psychiatry, Clinical Centre of Serbia, Belgrade, Serbia.
¹⁰ University Clinical Center of Serbia, Belgrade, Serbia.

PMID: 35968901
PMCID: PMC9438482
DOI: 10.1192/bjo.2022.539

Abstract

Background: DIALOG+ is an evidence-based, generic, cost-saving and easily deliverable psychosocial intervention, adaptable to clinicians' personal manner of interaction with patients. It was implemented in mental health services in five low- and middle-income countries in South-Eastern Europe during a 12-month randomised-controlled trial (IMPULSE) to improve the effectiveness of out-patient treatment for people with psychotic disorders.

Aims: To investigate barriers and facilitators to the perceived sustainability of DIALOG+ that has been successfully implemented as a part of the IMPULSE project.

Method: Three months after the IMPULSE trial's end, perceived sustainability of the DIALOG+ intervention was assessed via a short survey of clinicians and patients who took part in the trial. Quantitative data collected from the survey were analysed using descriptive statistics; content analysis assessed qualitative survey data. The views and experiences of key informants (patients, clinicians and healthcare policy influencers) regarding the sustainability and scale-up of DIALOG+ were further explored through semi-structured interviews. These data were explored using framework analysis.

Results: Clinicians mostly appreciated the comprehensiveness of DIALOG+, and patients described DIALOG+ meetings as empowering and motivating. The barrier most commonly identified by key informants was availability of financial resources; the most important facilitators were the clinically relevant structure and comprehensiveness of the DIALOG+ intervention.

Conclusions: Participants showed a willingness to sustain the implementation of DIALOG+. It is important to maintain collaboration with healthcare policy influencers to improve implementation of DIALOG+ across different levels of healthcare systems and ensure availability of resources for implementing psychosocial interventions such as DIALOG+.

Keywords: Schizophrenia; bipolar affective disorders; low- and middle-income countries; psychosocial interventions; qualitative research.

PubMed Disclaimer

Cited by

Patients' and clinicians' experiences of DIALOG+ in primary health care in Bosnia and Herzegovina: a qualitative interview study using thematic analysis.
Selak N, Sikira H, Kiseljaković M, van Loggerenberg F, Priebe S, Kulenović AD. Selak N, et al. BMC Prim Care. 2025 Jun 7;26(1):194. doi: 10.1186/s12875-025-02845-7. BMC Prim Care. 2025. PMID: 40483458 Free PMC article.
Perceived sustainability of psychosocial treatment in low- and middle-income countries in South-Eastern Europe - CORRIGENDUM.
Ribic E, Sikira H, Dzubur Kulenovic A, Pemovska T, Russo M, Jovanovic N, Radojicic T, Repisti S, Milutinović M, Blazevska B, Konjufca J, Ramadani F, Jerotic S, Savic B. Ribic E, et al. BJPsych Open. 2023 Aug 4;9(5):e142. doi: 10.1192/bjo.2023.18. BJPsych Open. 2023. PMID: 37540024 Free PMC article. No abstract available.

References

1. Wainberg ML, Scorza P, Shultz JM, Helpman L, Mootz JJ, Johnson KA, et al. Challenges and opportunities in global mental health: a research-to-practice perspective. Curr Psychiatry Rep 2017; 19(5): 28. - PMC - PubMed
1. Wiltsey Stirman S, Kimberly J, Cook N, Calloway A, Castro F, Charns M. The sustainability of new programs and innovations: a review of the empirical literature and recommendations for future research. Implement Sci 2012; 7: 17. - PMC - PubMed
1. Scheirer MA, Dearing JW. An agenda for research on the sustainability of public health programs. Am J Public Health 2011; 101: 2059–67. - PMC - PubMed
1. Jovanovic N, Francis J, Maric NP, Arenliu A, Barjaktarov S, Kulenovic AD, et al. Implementing a psychosocial intervention DIALOG+ for patients with psychotic disorders in low and middle income countries in South Eastern Europe: protocol for a hybrid effectiveness-implementation cluster randomized clinical trial (IMPULSE). Global Psychiatry 2020; 3(1): 83–96.
1. IMPULSE. The IMPULSE Project. Queen Mary University of London, 2021. (http://impulse.qmul.ac.uk/home/ [cited 27 Mar 2021]).

Grants and funding

779334/Horizon 2020 Framework Programme

LinkOut - more resources

Full Text Sources

Save citation to file

Email citation

Add to Collections

Add to My Bibliography

Your saved search

Create a file for external citation management software

Your RSS Feed

Perceived sustainability of psychosocial treatment in low- and middle-income countries in South-Eastern Europe

Affiliations

Perceived sustainability of psychosocial treatment in low- and middle-income countries in South-Eastern Europe

Authors

Affiliations

Abstract

Similar articles

Cited by

References

Grants and funding

LinkOut - more resources

Full Text Sources