RED-EMAR - A Chilean pilot initiative of early detection and intervention in clinical high-risk subjects

ABSTRACT

The COVID-19 crisis has had a significant impact on the mental health of adolescents and young adults in South America. As a result, the appearance of a higher incidence of anxiety and depressive disorders in these countries have been documented and could lead to the appearance of severe mental health disorders. In this context, the prevention and early intervention in mental health is a current challenge in Central and South America. Since the last decade, the existence of initiatives in this field has been mapped in Mexico, Brazil, Chile and Argentina, mostly in first episode psychosis programs. However, Chile is the only country in South America with a multicentre prospective initiative for early detection and intervention in clinical high-risk subjects (called RED-EMAR). The aim of RED-EMAR is disseminate the value of the at-risk mental state concept (abbreviated to EMAR in Spanish), establish agreed therapeutic strategies in this field, and establish potential new evidence-based local interventions. The successful experiences of this network include the monitoring and discussion of clinical cases in telemedicine and the development of mental health psychoeducation guidelines. However, Insufficient resources, stigma, and the lack of mental health public policies are some of the weaknesses of this initiatives in South America. The development and access to early detection and intervention services in South America could be a window of opportunity to reduce the impact of severe mental health disorders such as psychosis and related disorders and move towards an approach aimed at prevention or delaying its onset.