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Table 2 Schedule of response to harmful practices

From: COllaborative Shared care to IMprove Psychosis Outcome (COSIMPO): study protocol for a randomized controlled trial

Practice observed Thresholds of harm Responses control arm Responses intervention arm
Shackling 1. Short-term (hours)
2. Infections due to long-term shackling
1. Continued monitoring
2. Study team works with CAP to treat infections (by facilitating access to medical care)
1. PHCP consultation and study team consultation to employ alternative measures
2. PHCP will treat the infection; if more medical or specialist care is required, PHCP will initiate referral to such care
Beating 1. Evidence of beating – equipment for beating present at site
2. Evidence of beating particular patient (marks, scars)
1. Continued monitoring
2. Continued monitoring
1. PHCP consultation and study team consultation not to beat patients
2. PHCP to reinforce the need to avoid practice
Scarification 1. Wounds have healed
2. Wounds are yet to heal
1. Continued monitoring
2. Study team works with CAP to treat infections(by facilitating referral to hospital)
1. PHCP to reinforce the need to avoid practice
2. PHCP will treat infection and reinforce the need to avoid practice (and if necessary, initiate referral to medical care)
Herbs 1. Patient shows non- serious signs of side effects or drug reaction (e.g., vomiting, skin rash, etc.)
2. Patient is seriously unwell as a reaction to herbs
1. Continued monitoring
2. Work with CAP to treat illness (by facilitating referral to hospital)
1. PHCP monitors the situation and offers suggestions about avoiding herbs
2. PHCP will assess and treat the condition; if more medical or specialist care is required, PHCP and study team will facilitate access to such care
Sexual abuse 1. Any report or other evidence of sexual abuse 1. Study team reports to legal authorities 1. Study team reports to legal authorities
  1. CAP complementary alternative health provider,PHCP primary health care provider