Peruvian National Survey of Mental Health and Service Utilization in the third year of the COVID-19 pandemic: Protocol for a nationally representative multistage survey

ABSTRACT Background Peru is the worst affected country by the COVID-19 pandemic showing the world highest mortality rate, thus triggering an increased mental health burden. Nevertheless, there are few population-based epidemiologic surveys of mental disorders in Peru; Therefore, nationally representative research is needed to understand the underlying population-based mental health burden and identify unmet care needs. Objective The present study aims to estimate the prevalence and patterns of psychiatric disorders, mental health service use, and unmet mental health care needs Methods This cross-sectional study will collect information from a multistage random sample of 19,500 households. A child, an adolescent, an adult, and an older adult will be interviewed in the household. Trained staff will conduct face-to-face diagnostic interviews via the Preschool Age Psychiatric Assessment, the Child and Adolescent Psychiatric Assessment, the WHO’s Composite International Diagnostic Interview, and the Alzheimer Disease 8 Scale. In addition, descriptive and inferential analysis for complex sampling will be performed to estimate the prevalence and correlates. Ethics and dissemination IRB will approve the research protocol before the commencement of the study. Only respondents who signed their informed consents or assents will participate in the study; The parent or guardian will sign the consent for the participation of preschool children. The research findings will be disseminated in peer-reviewed publications, scientific reports, and presentations at national, and international meetings. In addition, de-identified data and study results will be posted on the Peruvian National Institute of Mental Health (PNIMH) website to be freely available to policymakers, researchers, and the general public. Strengths and Limitations This will be the first national survey on mental health and services use with a large probabilistic sample size, allowing to estimate the prevalence of psychiatric disorders and service use for the rural and urban areas of each of the 25 Peruvian regions. At the national level, this survey will have enough power to estimate the prevalence of rare psychiatric disorders with a prevalence closest to one percent. Researchers aim to conduct a second interview among the participants after at least one year of performing the first evaluation to estimate the incidence of psychiatric disorders. Researchers are advocating among the Peruvian Ministry of Economics and Finance officers to conduct a national survey each year to evaluate the impact of mental health policies via the analysis of trends. The principal limitation of this study is its cross-sectional design which does not allow to infer the temporality of associations.