Integrated programs for common mental illnesses within primary care and community settings in Latin America: a scoping review of components and implementation strategies

Abstract

Integrated programs for common mental illnesses are evidence-informed practices yet to be routinely implemented in Latin America. It synthesizes the literature on integrated programs for common mental illnesses (anxiety, depression, and posttraumatic stress disorder) in Latin American primary care and community settings. It maps program components (the 'what') to the collaborative care model core components and implementation strategies (the 'how') to the Expert Recommendations for Implementing Change (ERIC) taxonomy. Results from 18 programs across six countries (Belize, Brazil, Chile, Colombia, Mexico, Peru) show wide heterogeneity in component and strategy combinations. Overall, provider-level components and strategies were more common than family- or community-level ones. 'Team-based care' was the most commonly reported component, and 'family/user engagement' the least. The most common implementation strategy was 'supporting clinicians,' while 'changing infrastructure' was the least. Programs commonly addressed depression and only four followed experimental designs. We found limited evidence on the potential mechanisms of integrated program components and strategies.

Keywords: Anxiety; Collaborative care; Depression; Implementation research; Implementation strategies; Integrated service; Latin America; PTSD; Primary care; Scoping review.

Fig. 1

Flowchart of the database searching process, removal of duplicates, title/abstract screening, full text review, and final narrative synthesis. Numbers and percentages of total records are shown.