(PO-092) (PO-092) Developing a Curriculum for Mental Health Specialists to Support Community Perinatal Primary Care in Low- and Middle-Income Countries

Background:

Perinatal mental health disorders create a significant global health burden and highlights the shortage of mental health providers in low- and middle-income countries (Do, 2016). Using the Collaborative Care model, which has been shown to effective in LMICs and in the perinatal population, we can adapt existing primary care systems to provide mental health care, but psychiatrists in these countries must be trained in Collaborative Care (Unützer, 2020).

Methods:

A team of family medicine physicians and psychiatrists from University of Washington (UW) and Can Tho University of Medicine and Pharmacy (CTUMP) meets bi-weekly to plan the implementation of collaborative care and had additional meetings to discuss training psychiatrists.

We reviewed existing training materials created by the Advancing Integrated Mental Health Solutions center and by the American Psychiatric Association. We also did a literature review and received input from co-investigators who worked in settings including Nigeria, India, and Lebanon.

We will evaluate trainee’s comfortability with collaborative care and get feedback before and after the training and while they are implementing collaborative care.

Results:

We are currently working on implementing the training and getting further feedback from psychiatrists in Vietnam. Feedback from psychiatrists in Vietnam thus far revolves around themes of how to rely on mental health assessments from lay health workers, how to properly escalate patient with suicidal ideation, and how to provide sufficient consultation to the primary care team.

Discussion:

We identified gaps in training and added supplemental information about consultations and a protocol for patients with suicidality. Training material also took into consideration concerns of voiced by psychiatrists in Vietnam such as making provisional diagnosis and telehealth.

An obstacle we uncovered was that our lead psychiatrist at CTUMP had initial difficulties recruiting other psychiatrists to join the project. We also plan to address communication issues that might arise when psychiatrist are working with lay health workers.

Conclusion:

Using a guided framework, we were able to develop Collaborative Care training materials for Psychiatrists that is both culturally informed and setting appropriate. We were able to create a training program that was tailored to the practice settings of psychiatrists in Vietnam and removed content that is limited to the US setting.

Reference:

Do TKL, Nguyen TTH, Pham TTH. Postpartum Depression and Risk Factors among Gelaye B, Rondon MB, Araya R, Williams MA. Epidemiology of maternal depression, risk factors, and child outcomes in low-income and middle-income countries. Lancet Psychiatry. 2016;3(10):973-982. doi:10.1016/S2215-0366(16)30284-X Women.

Unützer J, Carlo AD, Collins PY. Leveraging collaborative care to improve access to mental health care on a global scale. World Psychiatry. 2020;19(1):36-37. doi:10.1002/wps.20696

Thomas PA, et al: Curriculum Development for Medical Education – A SixStep Approach. Baltimore: The Johns Hopkins Univ. Press. 1998, 3rd edition, 2016