Collaborative Medication Management: A research and participatory action project in mental health

Collaborative Medication Management (CMM), also known as Gestión Autonome de la Medication (GAM), is an initiative developed in the early 1990s in Quebec (Canada) by research teams in collaboration with civil society and, especially, with users of mental health services and their advocacy groups. In recent years, it has received a boost due the transfer of this experience in Brazil under the framework of the International Alliance of Recherche Universités – communautés, Santé mentale et Citoyenneté (ARUCI-SMC). The CCM starts from an approach of empowerment of the participation of the consumer of psychoactive drugs, especially of antipsychotic medication. The aim is to enable these consumers, who are generally at risk of exclusion, to have access to all the necessary information about medicines and their alternatives, since several studies show that between 25 and 50% of users with a diagnosis of Schizophrenia do not get the expected outcome of treatment, despite complying regularly. This situation has not changed ostensibly with the appearance of second-generation antipsychotics.

Unwanted physical and psychological effects (increased body weight, risk of metabolic syndrome, concentration difficulties, effect on self-esteem, etc.), as well as related social meanings (stigmatization, discrimination, etc.) which may be more important for users than the tangible effects of the drugs, are factors that cause an inequality in the access to health and make difficult the therapeutic alliance and the autonomy of this group.

The aim of this project is to adapt the experience of Collaborative Medication Management (CMM) in the Catalan area and to develop it through the publication of a specific GCM Guide that, through intense ethnographic and qualitative research, will be designed by an interdisciplinary team – together with a group of users, caregivers and mental health professionals, as well as disseminating the results of the initiative using the potential of Radio Nikosia (www.radionikosia.org) and other channels of communication. It is a research oriented to the implementation of integrative and sustainable health policies within the field of mental health that allow the promotion of participation between this group and the achievement of a full level of citizenship.

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To Analyse CMM experiences in developed areas by reviewing literature, and exchanges with teams from Canada and Brazil.
To study the management of medicines in Catalonia through a qualitative and ethnographic analysis in two public mental health care centres in Catalonia (CSMA Badalona and CSMA Nou Barris).
To develop a CMM Guide adapted for the social and cultural reality of Catalonia.
To disseminate results in scientific circuits and also in the field of users, professionals and relatives.
To self-evaluate the project through qualitative techniques such as self-observation and self- ethnography.