Individual Placement and Support (IPS) for serious mental illness in Jalisco, Mexico

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Project Summary Substantial data indicate that the Individual Placement and Support (IPS) model, a well-know, evidence-practice, can help mental illness (PSMI) to succeed in competitive employment (i.e., average 55%, but over 60% in credible studies). However, not a single country offers IPS services in Latin America. Moreover, services to support employment and education other tend to be ad hoc, low intensity, and not well assessed, because most clinicians are not trained in evidence-based approaches and do not provide high-fidelity services. The overarching goal of this project is to pilot IPS for PSMI in the Center for Comprehensive Care in Long-Stay Mental Health (CAISAME-EB, in Spanish), the largest mental health clinic in Jalisco, Mexico. CAISAME-EB integrates primary care and provides medication and psychosocial rehabilitation services to a large population of PSMI (n=~5,000). This team serves marginalized communities resembling other urban areas of low-and- middle-income countries (LMICs) in Latin America and elsewhere. We will use the Dynamic Adaptation Process model to first inform the adaptation of IPS in Mexico, using our prior experiences adapting IPS and deep understanding of the local context (e.g., the nature of the job market in Mexico) to inform the adaptations. We will then evaluate the implementation and impact of the adapted IPS in a pilot RCT (N = 200). This pilot RCT will include quantitative and qualitative assessments at baseline, 6, and 12 months, conducted with clients, providers, and other key stakeholders. We aim to refine implementation processes, understand outcomes and instruments, and estimate power for a future, regional trial in Latin America.