Individual placement and support in Mexico: barriers and facilitators

Area of Science:

• Mental Health Services Research
• Supported Employment Models
• Global Mental Health

Background:

• The Individual Placement and Support (IPS) model is effective in high-income nations.
• Implementing IPS in low- and middle-income countries (LMICs) requires understanding local contexts.
• Guadalajara, Mexico, was selected as a site for an upcoming IPS clinical trial.

Purpose of the Study:

• To identify barriers and facilitators for IPS implementation in Guadalajara, Mexico.
• To inform the design of a future clinical trial for IPS supported employment.
• To gather perspectives from diverse mental health stakeholders.

Main Methods:

• Qualitative interviews and structured questionnaires were used.
• 61 stakeholders were interviewed, including policymakers, providers, service users, and employers.
• Data collection was tailored to participant roles and perspectives.

Main Results:

• Key barriers included stigma, treatment limitations for serious mental illness, user-related difficulties, and system-level issues.
• Facilitators identified were program effectiveness, institutional collaboration, and a patient-centered approach.
• Stakeholder insights provided crucial context for IPS adaptation.

Conclusions:

• This study offers vital insights into challenges and strategies for implementing IPS in a large LMIC.
• Findings will guide the upcoming clinical trial of IPS supported employment services.
• Understanding local barriers is critical for successful global adaptation of evidence-based practices.