Psychosocial treatment for individuals with psychotic disorders – Guide for implementation and sustainable use of DIALOG+ in healthcare systems in Southeast Europe

The combination of care, medication and psychosocial interventions helps people affected by psychotic disorders to lead productive life and be integrated in society. This approach has been widely recommended and implemented in countries with developed economies, but most of the low and middle income countries (LMIC) are still far from this goal. The reasons for underuse of psychosocial interventions span from financial and organizational issues to insufficient data about the efficacy and safety of non-pharmacological interventions in the local context. In 2018, the European Commission and Global Alliance for Chronic Diseases (GACD) invested 2.4 million Euros in the IMPULSE consortium to deliver a new research study called ‘Implementation of an effective and cost-effective intervention for patients with psychotic disorders in low and middle income countries in South Eastern Europe (IMPULSE). The main goal of the project is to improve treatment of individuals diagnosed with psychotic disorders in five low and middle income countries of Southeast Europe: Bosnia and Herzegovina, Kosovo* UN Resolution, Republic of North Macedonia, Montenegro, and Serbia. The project also focuses on bridging the gap between research and policy, facilitating community-based mental health care, facilitating user-led involvement, and building research capacity in the participating countries. The partners, coordinated by the Queen Mary University of London, conducted a longitudinal trial which involved 468 patients and 81 clinicians from the region to explore effectiveness and implementation of a digital psychosocial intervention called DIALOG+ in healthcare systems of participatingcountries. The DIALOG+ intervention was designed specifically to improve therapeutic effectivenessof routine clinical meetings. The intervention was shown to be effective, cost saving and acceptable to patients and staff in the UK. The IMPULSE study team has created this guide for all who work in the field of mental health care and who have been searching for methods which could improve routine patient-clinician meetings. This Guide offers essential advice on how to understand and to implement a psychosocial approach in order to protect and ameliorate mental health and psychosocial well-being of people with both non-affective and affective psychoses. This publication has been created for clinicians (psychiatrists, psychologists, social workers, andnurses), patients and their caregivers, but also for policy makers and service commissioners and organizers. All of them will find new information which could be used to better integrate people withpsychosis in society.