Preprint / Version 1

Barriers and facilitators of integrating depression and tuberculosis treatment in primary care in Brazil

##article.authors##

  • Annika Sweetland Columbia University https://orcid.org/0000-0002-1727-6316
  • Claudio Gruber Mann Instituto de Psiquiatria da Universidade Federal do Rio de Janeiro (IPUB/UFRJ)
  • Maria Jose Fernandes Secretaria Municipal de Saúde de Itaboraí / Coordenação do Programa de Controle da Tuberculose (PCT)
  • Fatima Virginia Silva Universidade do Estado do Rio de Janeiro (UERJ)
  • Camila Matsuzaka Universidade Federal de São Paulo (UNIFESP)
  • Maria Cavalcanti Instituto de Psiquiatria da Universidade Federal do Rio de Janeiro (IPUB/UFRJ)
  • Sandra Fortes Universidade do Estado do Rio de Janeiro (UERJ)
  • Afranio Kritski Universidade Federal do Rio de Janeiro (UFRJ)
  • Julio Cesar Ambrosio Secretaria Municipal de Saúde de Itaboraí
  • Milton L Wainberg Columbia University / New York State Psychiatric Institute

DOI:

https://doi.org/10.1590/SciELOPreprints.760

Keywords:

Tuberculosis, Depression, Mental Health, Primary Health Care

Abstract

Mental disorders can affect up to 70% of individuals with tuberculosis (TB). The World Health Organization (WHO) End TB Strategy explicitly calls for TB and mental health service integration. The goal of this study was to explore the barriers and facilitators to integrating depression treatment in the TB Control Program and primary care system in the municipality of Itaboraí - Rio de Janeiro, using Interpersonal Counseling (IPC). IPC is an evidence-based treatment for depression that can be delivered by non-mental health specialists with expert supervision. This study was conducted between 2016 and 2017 in the municipality of Itaboraí. Data collection consisted of six focus groups (n = 42) with health professionals (n = 29), program coordinators (n = 7) and TB patients (n = 6). The main potential barriers identified were poverty, political instability, an overburdened and under-resourced health system, high levels of distress among professionals, violence in the community and stigma related to mental health and TB. Potential facilitators included a high receptivity to, and demand for, mental health training; strong community relationships through the Community Health Workers (CHW); overall acceptability of IPC delivered by non-specialists for the treatment of depression among individuals with and without comorbid TB. Despite many challenges, integrating depression treatment into primary care in Itaboraí using IPC was perceived as an acceptable and feasible option.

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Posted

06/15/2020

How to Cite

Sweetland, A., Mann, C. G., Fernandes, M. J., Silva, F. V., Matsuzaka, C., Cavalcanti, M., Fortes, S., Kritski, A., Ambrosio, J. C., & Wainberg, M. L. (2020). Barriers and facilitators of integrating depression and tuberculosis treatment in primary care in Brazil. In SciELO Preprints. https://doi.org/10.1590/SciELOPreprints.760

Section

Health Sciences

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