Developing an mHealth intervention to strengthen the community mental health system in the context of the COVID-19 pandemic in Peru

COVID-19大流行和强制性社会距离措施对秘鲁卫生系统构成了挑战，该系统没有能力为患者提供远程护理。这种情况使本已脆弱的卫生系统雪上加霜，限制了民众获得适当医疗服务的机会。在这种情况下，由于大流行对精神健康的影响以及在获得精神卫生服务方面的限制，精神障碍患者尤其容易受到伤害。本提案旨在(1)评估COVID-19大流行对秘鲁精神卫生服务提供的影响；(2)确定用于解决这一情况的战略，特别是涉及移动技术的战略，以及面临的主要优势和挑战；(3)设计和测试基于移动技术（即手机、平板电脑）的干预措施，在卫生服务提供者、患者和政策制定者的投入下，提供精神卫生保健。为实现我们的目标，我们将开展一个为期两年的项目，分三个阶段：(1)第一阶段：我们将通过审查指导方针和协议，以及与患者、保健提供者和政策制定者面谈，审查大流行对公共精神卫生服务的影响，以及继续提供护理的战略；(2)第二阶段：我们将根据前一阶段收集的信息设计和发展我们的技术干预措施。在这一过程中，使用者、卫生服务提供者、管理人员和政策制定者将提供他们的意见，使干预措施可接受、可行和适应秘鲁公共精神卫生保健系统；(3)第三阶段：我们将进行一项试点研究，在秘鲁利马的3个社区精神卫生中心实地测试开发的干预措施。这个为期两年的项目的结果将帮助我们了解我们的想法的可行性，并有可能在更大的范围内实施。此外，我们将与精神卫生政策制定者定期举行会议，分享我们的发现，并讨论如何将其纳入公共卫生系统。我们的研究小组由来自秘鲁和英国的研究人员组成，他们还将通过会议和在专业期刊上发表文章，与国际听众分享项目成果。

The COVID-19 pandemic and the measures of mandatory social distancing presented a challenge to the Peruvian health system, which is not equipped to provide remote care to patients. This situation worsened an already fragile health system, limiting the population's access to adequate care. People with mental disorders are particularly vulnerable in this context, due to the impact of the pandemic on their mental health, as well as the limitations in accessing mental health services.This proposal aims to (1) assess the impact of the COVID-19 pandemic on the provision of mental health services in Peru, (2) identify the strategies used to address this situation, particularly those involving mobile technology, as well as the main advantages and challenges faced, (3) design and test an intervention based on mobile technology (i.e. mobile phones, tablets) to provide mental health care, with the input from health providers, patients, and policymakers.To achieve our objectives we will conduct a 2-year project with 3 phases: (1) Phase 1: We will examine the impact of the pandemic on the public mental health services and the strategies used to continue the provision of care, through the review of guidelines and protocols, as well as interviews with the patients, health providers and policymakers; (2) Phase 2: We will design and develop our technological intervention based on the information collected in the previous phase. In this process, users, health providers, managers and policymakers will provide their opinions to make the intervention acceptable, feasible and adaptable to the Peruvian public mental health care system; (3) Phase 3: We will perform a pilot study to field test the developed intervention in 3 community mental health centers in Lima, Peru. The results of this 2-year project will help us to understand the viability of our idea, and potentially an implementation at a larger scale. Additionally, we will organize regular meetings with mental health policymakers to share our findings and discuss how they could be integrated within the public health system. Our research team, consisting of researchers from Peru and the United Kingdom, will also share the project results with an international audience, through conferences and publications in specialized journals.