Abstract
Work Overload and Time Constraint as Implementation Challenges in a Chilean Psychosis Treatment Program
APHA 2022 Annual Meeting and Expo
Background: In 2005, the Chilean healthcare system underwent a reform, allowing treatment of schizophrenia to be guaranteed regardless of health insurance status. Although the Chilean Ministry of Health made continued efforts to provide mental health services, there were insufficient resources to comprehensively accomplish the goals set for the prevention and treatment of schizophrenia and first-episode psychosis (FEP). OnTrack is a psychosis treatment program that was developed and successfully implemented in the United States. This study examines the potential barriers to implementing OnTrack in Chile and suggests strategies to address these challenges in their healthcare system.
Method: Data were gathered by conducting semi-structured interviews with policymakers (n=5), community mental healthcare managers (n=4), and mental health professionals (n=8). The focus group (n=6) comprised patients (n=2) and their family members (n=13). Mental health professionals who were not associated with the study conducted the interviews in Spanish. Native bilingual translators transcribed interviews verbatim and translated them into English. Participants’ roles, experiences, and opinions were extracted and analyzed based on thematic analysis.
Results: Participants expressed concerns about work overload and time constraints as potential challenges to implementing OnTrack in Chile. Psychologists and psychiatrists highlighted that their current tasks and treatment schedule might limit the time devoted to training and supervision of OnTrack. Moreover, the work burden might be exacerbated when mental health professionals attend training and supervision as clinic staff must spend more time completing additional duties. Community mental health managers and mental health professionals suggested several strategies to address the time constraint and overload. These approaches included generating a collaborative environment among mental health professionals and managers, hiring more clinic staff to distribute tasks and responsibilities, and clarifying cost-efficiency to avoid personal and equipment overload.
Discussion: Despite the tremendous strides made to the Chilean healthcare system, time constraints and work burdens limit the mental health professionals’ ability to attend training and supervision. Additionally, they continuously pose challenges to attending training and supervision to implement OnTrack in Chile. Ultimately, strategies to increase human resources and facilitate communication between mental health professionals and community mental healthcare managers may foster an optimal adoption of OnTrack.