Browsing by Author "Mascayano, Franco"
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- Item30 years from the Caracas Declaration: the situation of psychiatric hospitals in Latin America and the Caribbean prior, during and after the COVID-19 pandemic(2021) Mascayano, Franco; Alvarado, Rubén; Martínez-Viciana, Carmen; Irarázaval, Matías; Durand-Arias, Sol; Freytes, Marcela; Montenegro Cortés, Cristián; Susser, Ezra; Bruni, AndreaLatin America and the Caribbean (LAC) recently celebrated 30 years from the Caracas Declaration, which, in 1990, set forth the principles to transition from hospital-based mental health care into community mental health services [1]. Since then, significant efforts have been made to reduce the number of psychiatric hospital beds, increase mental health teams within general hospitals, integrate mental health into primary care, implement outpatient mental health facilities, and encourage the participation of community members in the provision and implementation of mental health care [2]. Nonetheless, progress has been uneven across countries [2]. Many large psychiatric hospitals (PHs) still exist and consume most of the scanty national mental health budgets [3]. Moreover, PH residents in LAC were poor and socially excluded even before the COVID-19 pandemic hit. The COVID-19 pandemic has worsened the living conditions of these people, especially in resource-constrained settings.
- ItemAdaptation and validation of a questionnaire to measure stigma toward mental illness among health professionals working in primary care in Chile(2019) Sapag Muñoz de la Peña, Jaime; Velasco Grandón, Paola Renée; Parra, Claudia; Anríquez, Samanta; Villarroel, Luis; Alvarado, Rubén; Poblete, Fernando; Jofré, Ana; Aracena Álvarez, Marcela; Bravo, Paulina; Mascayano, Franco; Álvarez, Cinthia; Chacón, Sergio; De Arcas, Michelle; Ulloa, Viviana; Barrios, Daniela; Díaz, Andrés; Sena, Brena
- ItemCross-cultural adaptation of four instruments to measure stigma towards people with mental illness and substance use problems among primary care professionals in Chile(2022) Parra Videla, Claudia; Sapag Muñoz de la Peña, Jaime; Klabunde, Rachel; Velasco, Paola R.; Anríquez, Samanta; Aracena Álvarez, Marcela; Mascayano, Franco; Bravo, Paulina; Sena, Brena F.; Jofré Escalona, Ana; Bobbili, Sireesha J.; Corrigan, Patrick W.; Bustamante, Inés; Poblete, Fernando; Alvarado, RubénStigma toward people with mental illness and substance use problems is a significant global concern, and prevents people with these conditions from accessing treatment, particularly in primary health care (PHC) settings. Stigma is a cultural phenomenon that is influenced by particular contexts and can differ by country and region. The majority of stigma research focuses on Europe or North America leading to a lack of culturally relevant stigma research instruments for the Latin American context. The present study describes and discusses the methodology for cross-culturally adapting four stigma measurement scales to the Chilean context. The cross-cultural adaptation process included nine phases: (1) preparation; (2) independent translations; (3) synthesis 1 with expert committee; (4) focus groups and interviews with researchers, PHC professionals, and PHC users; (5) synthesis 2 with expert committee; (6) independent back translations; (7) synthesis 3 with expert committee; (8) pilot with PHC professionals; and (9) final revisions. The adaptation process included an array of diverse voices from the PHC context, and met three adaptation objectives defined prior to beginning the process (Understandability, Relevance, and Acceptability and Answer Options). The resulting, culturally adapted questionnaire is being validated and implemented within PHC settings across Chile to provide in-depth insight into stigma among PHC professionals in the country. The authors hope it will be useful for future research on mental illness and substance use stigma in similar settings across Latin America.
- ItemIncluding culture in programs to reduce stigma toward people with mental disorders in low- and middle-income countries(2020) Mascayano, Franco; Toso-Salman, Josefina; Ho, Yu Chak Sunny; Dev, Saloni; Tapia, Thamara; Thornicroft, Graham; Cabassa, Leopoldo J.; Khenti, Akwatu; Sapag, Jaime; Bobbili, Sireesha J.; Alvarado, Ruben; Yang, Lawrence Hsin; Susser, EzraStigma is one of the main barriers for the full implementation of mental health services in low- and middle-income countries (LMICs). Recently, many initiatives to reduce stigma have been launched in these settings. Nevertheless, the extent to which these interventions are effective and culturally sensitive remains largely unknown. The present review addresses these two issues by conducting a comprehensive evaluation of interventions to reduce stigma toward mental illness that have been implemented in LMICs. We conducted a scoping review of scientific papers in the following databases: PubMed, Google Scholar, EBSCO, OVID, Embase, and SciELO. Keywords in English, Spanish, and Portuguese were included. Articles published from January 1990 to December 2017 were incorporated into this article. Overall, the studies were of low-to-medium methodological quality-most only included evaluations after intervention or short follow-up periods (1-3 months). The majority of programs focused on improving knowledge and attitudes through the education of healthcare professionals, community members, or consumers. Only 20% (5/25) of the interventions considered cultural values, meanings, and practices. This gap is discussed in the light of evidence from cultural studies conducted in both low and high income countries. Considering the methodological shortcomings and the absence of cultural adaptation, future efforts should consider better research designs, with longer follow-up periods, and more suitable strategies to incorporate relevant cultural features of each community.
- ItemInequality on the frontline: A multi-country study on gender differences in mental health among healthcare workers during the COVID-19 pandemic(2024) Czepiel, Diana; Mccormack, Clare; da Silva, Andrea T. C.; Seblova, Dominika; Moro, Maria F.; Restrepo-Henao, Alexandra; Martinez, Adriana M.; Afolabi, Oyeyemi; Alnasser, Lubna; Alvarado, Ruben; Asaoka, Hiroki; Ayinde, Olatunde; Balalian, Arin; Ballester, Dinarte; Barathie, Josleen A. l.; Basagoitia, Armando; Basic, Djordje; Burrone, Maria S.; Carta, Mauro G.; Durand-Arias, Sol; Eskin, Mehmet; Fernandez-Jimenez, Eduardo; Frey, Marcela I. F.; Gureje, Oye; Isahakyan, Anna; Jaldo, Rodrigo; Karam, Elie G.; Khattech, Dorra; Lindert, Jutta; Martinez-Ales, Gonzalo; Mascayano, Franco; Mediavilla, Roberto; Gonzalez, Javier A. Narvaez; Nasser-Karam, Aimee; Nishi, Daisuke; Olaopa, Olusegun; Ouali, Uta; Puac-Polanco, Victor; Ramirez, Dorian E.; Ramirez, Jorge; Rivera-Segarra, Eliut; Rutten, Bart P. F.; Santaella-Tenorio, Julian; Sapag, Jaime C.; Seblova, Jana; Soto, Maria T. S.; Tavares-Cavalcanti, Maria; Valeri, Linda; Sijbrandij, Marit; Susser, Ezra S.; Hoek, Hans W.; van der Ven, ElsHealthcare workers (HCWs) were at increased risk for mental health problems during the COVID-19 pandemic, with prior data suggesting women may be particularly vulnerable. Our global mental health study aimed to examine factors associated with gender differences in psychological distress and depressive symptoms among HCWs during COVID-19. Across 22 countries in South America, Europe, Asia and Africa, 32,410 HCWs participated in the COVID-19 HEalth caRe wOrkErS (HEROES) study between March 2020 and February 2021. They completed the General Health Questionnaire-12, the Patient Health Questionnaire-9 and questions about pandemic-relevant exposures. Consistently across countries, women reported elevated mental health problems compared to men. Women also reported increased COVID-19-relevant stressors, including insufficient personal protective equipment and less support from colleagues, while men reported increased contact with COVID-19 patients. At the country level, HCWs in countries with higher gender inequality reported less mental health problems. Higher COVID-19 mortality rates were associated with increased psychological distress merely among women. Our findings suggest that among HCWs, women may have been disproportionately exposed to COVID-19-relevant stressors at the individual and country level. This highlights the importance of considering gender in emergency response efforts to safeguard women's well-being and ensure healthcare system preparedness during future public health crises.
- ItemSTIGMA TOWARD MENTAL ILLNESS AMONG PRIMARY CARE PROFESSIONALS: A NATIONAL SURVEY STUDY IN CHILE (vol 25, pg 1, 2018)(SPRINGER, 2019) Muñoz de la Pena, Jaime Camilo Sapag; Alvarado Vera, Rubén Evanán; Velasco Grandón, Paola Renée; Poblete A., Fernando; Villarroel del Pino, Luis A.; Jofré Escalona, Ana-Danae; Álvarez, Cinthia; Anríquez, Samanta; Barrios, Daniela; Aracena Alvarez Marcela paz emma; Ulloa, Viviana; Díaz, Andres; De Arcas, Michelle; Mascayano, Franco; Bravo Valenzuela, Paulina Fabiola; Bobbili, Sireesha; Sena, Brena
- ItemStigma Toward Psychosis in Urban Chile: Engaging "What Matters Most" to Resist Stigma Through Recovery-Oriented Services(2023) Becker, Timothy D.; Blasco, Drew; Burrone, Maria Soledad; Dishy, Gabriella; Velasco, Paola; Reginatto, Gabriel; Mascayano, Franco; Wu, Maximillian S.; Hu, Cindy; Bharadwaj, Simran; Khattar, Shivangi; Calderon, Liz; Filgueira, Cynthia; Alvarado, Ruben; Susser, Ezra S.; Yang, Lawrence H.Objective: Stigma jeopardizes recovery and successful implementation of mental health services (MHS) globally. Despite cultural variation in how stigma manifests, few studies have examined how culture fundamentally impacts the concept of "personhood " in Latin America. Chile has expanded MHS, providing universal coverage for evaluation and treatment of first episode psychosis (FEP). We applied the "what matters most " (WMM) framework of stigma to identify culturally salient factors that shape or protect against stigma in urban Chile, identifying potential implications for MHS and recovery. Methods: In-depth interviews (n = 48) were conducted with MHS users with psychotic disorders (n = 18), their family members (n = 15), and community members (n = 15), from two urban regions in Chile. Interviews were coded and analyzed to identify WMM, how WMM shapes stigma, and how MHS can influence achieving WMM. Results: Traditional values emphasizing physical/social appearance, gender roles, family, and social connectedness are highly valued. Socioeconomic transitions have engendered capitalistic variations on traditional values, with increasing emphasis on professional careers for men and women, individualism, and independence. Psychotic disorders interfere with fulfillment of both traditional and capitalist values, thereby reinforcing stigma. However, MHS are seen as partially effective in enabling fulfillment of some goals, including employment, appearance, and independence, while often remaining insufficient in enabling capacity to achieve marriage and having a family. Conclusions and Implications for Practice: MHS that facilitate recovery by engaging users in services, such as pharmacotherapy, education/vocational rehabilitation, and family-centered care aligned with cultural values can mitigate stigma and facilitate recovery by enabling users to fulfill WMM.
- ItemValidation of the Opening Minds Scale and patterns of stigma in Chilean primary health care(2019) Sapag, Jaime C.; Klabunde, Rachel; Villarroel, Luis; Velasco, Paola R.; Alvarez, Cinthia; Parra, Claudia; Bobbili, Sireesha J.; Mascayano, Franco; Bustamante, Ines; Alvarado, Ruben; Corrigan, PatrickObjectives