2023, Number 3
<< Back Next >>
salud publica mex 2023; 65 (3)
Role of community health workers in addressing mental health in rural areas of Chiapas
González-Robledo MC, González-Robledo LM, Nudel-Ontiveros A, Agudelo-Botero M, Rodríguez-Cuevas FG, Reyes-Morales H
Language: Spanish
References: 34
Page: 275-284
PDF size: 336.94 Kb.
ABSTRACT
Objective. To analyze, from the perspective of community
health workers (CHW), the knowledge and experiences in
mental health care (MH), in rural communities in Chiapas.
Materials and methods. The descriptive phenomenological
approach was used. Eighteen semi-structured
interviews were conducted with CHW, which were audiorecorded,
transcribed, codified and analyzed using qualitative
content analysis with the help of Atlas ti.
Results. Mental
CHW have a broad understanding of the culture, language
and problems of their communities, allowing them to act as
liaisons between health services and the population. They
identify that there is good MH when a “person is in the
mood to do their daily work” and illness when “people are
suffering or have wicked thoughts”. Their work experiences
are linked to individual accompaniment (psycho-education)
and the support of activities carried out by professionals
of
Compañeros En Salud (CES).
Conclusion. The mental
CHW who work with CES, develop an important role in the
promotion of mental health, of risks and accompaniment of
patients with mental disorders. These findings contribute to
strengthen the evidence on the importance of developing
community interventions in MH through these personnel, in
contexts of scarce availability of health services.
REFERENCES
Racine N, McArthur BA, Cooke JE, Eirich R, Zhu J, Madigan S.Global prevalence of depressive and anxiety symptoms in childrenand adolescents during COVID-19: a meta-analysis. JAMA Pediatr. 2021;175(11):1142-50. https://doi.org/10.1001/jamapediatrics.2021.2482
Berenzon S, Lara MA, Robles R, Medina-Mora ME. Depresión: estadodel conocimiento y la necesidad de políticas públicas y planes de acciónen México. Salud Publica Mex. 2013;55(1):74-80. https://doi.org/10.1590/S0036-36342013000100011
Carreño-García S, Medina-Mora ME. Panorama epidemiológico de lostrastornos mentales, su impacto entre el balance trabajo familia, 2018[citado junio 25, 2022]. Disponible en: https://www.imss.gob.mx/sites/all/statics/salud/estreslaboral/1erjornada/07-Panorama-Trastornos-Mentales.pdf
Serván-Mori E, Gonzalez-Robledo LM, Nigenda G, Quezada AD,González-Robledo MC, Rodríguez-Cuevas FG. Prevalence of depressionand generalized anxiety disorder among mexican indigenous adolescentsand young adults: challenges for healthcare. Child Psychiatry Hum Dev.2021;52:179-89. https://doi.org/10.1007/s10578-020-01001-9
Leiva-Peña V, Rubí-González P, Vicente-Parada B. Determinantes socialesde la salud mental: políticas públicas desde el modelo biopsicosocial enpaíses latinoamericanos. Rev Panam Salud Publica. 2021;45:e158. https://doi.org/10.26633/RPSP.2021.158
Organización Mundial de la Salud. Salud mental del adolescente. Ginebra:OMS, 2021 [citado noviembre 17, 2021]. Disponible en: https://www.who.int/es/news-room/fact-sheets/detail/adolescent-mental-health
Organización Mundial de la Salud. Global Health Observatory datarepository. Human resources Data by country, c2014. Ginebra: OMS, 2018[citado noviembre 15, 2018]. Disponible en: https://apps.who.int/gho/data/node.main.MHHR?lang=en
Díaz-Castro L, Cabello-Rangel H, Medina-Mora ME, Berenzon-Gorn S,Robles-García R, Madrigal-de León EA. Necesidades de atención en saludmental y uso de servicios en población mexicana con trastornos mentalesgraves. Salud Publ Mex. 2020;62(1):72-9. https://doi.org/10.21149/10323
Kohrt BA, Asher L, Bhardwaj A, Fazel M, Jordans M, Mutamba BB, etal. The role of communities in mental health care in low- and middleincomecountries: a meta-review of components and competencies. IntJ Environ Res Public Health. 2018;15(6):1279. https://doi.org/10.3390/ijerph15061279
Hoeft TJ, Fortney JC, Patel V, Unützer J. Task-Sharing approachesto improve mental health care in rural and other low-resource settings:a systematic review. J Rural Health. 2018;34(1):48-62. https://doi.org/10.1111/jrh.12229
Funk M, Saraceno B, Drew N, Faydi E. Integrating mental health intoprimary healthcare. Ment Health Fam Med. 2008;5(1):5-8 [citado noviembre15, 2018]. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2777555/
Pérez LM, Martinez J. Community health workers: social justice andpolicy advocates for community health and Well-Being. Am J Public Health.2008;98(1):11-4. https://doi.org/10.2105/AJPH.2006.100842
Barnett ML, Gonzalez A, Miranda J, Chavira DA, Lau AS. Mobilizingcommunity health workers to address mental health disparities forunderserved populations: a systematic review. Adm Policy Ment Health.2018;45:195-11. https://doi.org/10.1007/s10488-017-0815-0
Olaniran A, Smith H, Unkels R, Bar-Zeev S, van den Broek N. Who isa community health worker? - a systematic review of definitions. GlobHealth Action. 2017;10(1):1272223. https://doi.org/10.1080/16549716.2017.1272223
WestRasmus EK, Pineda-Reyes F, Tamez M, Westfall JM. “Promotoresde Salud” and community health workers: an annotated bibliography.Fam Community Health. 2012;35(2):172-82 [citado noviembre 15, 2018].Disponible en: https://www.jstor.org/stable/44953456
Scott K, Beckham SW, Gross M, Pariyo G, Rao KD, Cometto G,Perry HB. What do we know about community-based health workerprograms? A systematic review of existing reviews on community healthworkers. Hum Resour Health. 2018;16:1-17. https://doi.org/10.1186/s12960-018-0304-x
Organización Panamericana de la Salud, USAID, CONAPRA.Salud Mental. Guía del promotor comunitario. México: OPS, 2013[citado noviembre 15, 2018]. Disponible en: https://iris.paho.org/bitstream/handle/10665.2/31342/salud-mental-guia-promotor.pdf?sequence=1&isAllowed=y
Newman PM, Franke MF, Arrieta J, Carrasco H, Elliott P, Flores H, etal. Community health workers improve disease control and medicationadherence among patients with diabetes and/or hypertension in Chiapas,Mexico: an observational stepped-wedge study. BMJ Glob Health. 2018;3:e000566. https://doi.org/10.1136/bmjgh-2017-000566
Rodríguez-Cuevas FG, Valtierra-Gutiérrez ES, Roblero-Castro JL,Guzmán-Roblero C. Living six hours away from mental health specialists:Enabling access to psychosocial mental health services through the implementationof problem management plus delivered by community healthworkers in rural Chiapas, Mexico. Intervention. 2021;19(1):75-83. https://doi.org/10.4103/INTV.INTV_28_20
Compañeros en Salud. ¿Qué hacemos? México: CES, 2021 [citadojunio 24, 2022]. Disponible en: https://companerosensalud.mx/
Consejo Nacional de Población. Índice de marginación por entidadfederativa y municipio 2020. Nota técnico-metodológica. México: Conapo,2021 [citado junio 25, 2022]. Disponible en: https://www.gob.mx/cms/uploads/attachment/file/685354/Nota_te_cnica_IMEyM_2020.pdf
Guest G, Namey E, Chen M. A simple method to assess andreport thematic saturation in qualitative research. PLoS One.2020;15(5):e0232076. https://doi.org/10.1371/journal.pone.0232076
Gray LM, Wong-Wylie G, Rempel GR, Cook K. Expanding qualitativeresearch interviewing strategies: Zoom video communications.The Qual Rep. 2020;25(5):1292-1301. https://doi.org/10.46743/2160-3715/2020.4212
Retamal S. Entrevista cualitativa mediante videoconferencia: característicasy recomendaciones. Apuntes MIDE. 2020 [citado agosto 1, 2022].Disponible en: https://www.evalperu.org/wp-content/uploads/2021/04/APUNTES-MIDE-UC_Entrevistas-cualitativas-1.pdf
Lopez KA, Willis DG. Descriptive versus interpretive phenomenology:Their contributions to nursing knowledge. QualitativeHealth Research, 2004;14(5):726-735. https://doi.org/10.1177/1049732304263638
Cáceres P. Análisis cualitativo de contenido: una alternativa metodológicaalcanzable. Psicopersp. Indiv. Soc. 2003;2(1):53-82. https://doi.org/10.5027/psicoperspectivas-vol2-issue1-fulltext-3
Harvard Magazine. Paul Farmer: “Accompaniment” as Policy. HarvardMagazine. 25 de mayo de 2011 [citado abril 17, 2022]. Disponible en: https://www.harvardmagazine.com/2011/05/paul-farmer-accompaniment-as-policy
Arrieta J, Aguerrebere M, Raviola G, Flores H, Elliott P, Espinosa A, etal. Validity and utility of the patient health questionnaire (PHQ)-2 andPHQ-9 for screening and diagnosis of depression in rural Chiapas, Mexico:a cross-sectional study. J Clin Psychol. 2017;73(9):1076-1090. https://doi.org/10.1002/jclp.22390
García-Campayo J, Zamorano E, Ruiz MA, Pardo A, Pérez-Páramo M,López-Gómez V, et al. Cultural adaptation into Spanish of the generalizedanxiety disorder-7 (GAD-7) scale as a screening tool. Health Qual LifeOutcomes. 2010;8(1):1-11. https://doi.org/10.1186/1477-7525-8-8
Perry HB, Zulliger R, Rogers MM. Community health workersin low-, middle-, and high-income countries: An overview of theirhistory, recent evolution, and current effectiveness. Annu Rev PublicHealth. 2014;35:399-421. https://doi.org/10.1146/annurev-publhealth-032013-182354
Balcazar H, Perez-Lizaur AB, Izeta EE, Villanueva MA. Community healthworkers-promotores de salud in Mexico. History and potential for buildingeffective community actions. J Ambul Care Manage. 2016;39(1):12-22.https://doi.org/10.1097/JAC.0000000000000096
Oliveira-Pinheiro PM, de Souza-Medeiros AE, Jardsom-Moura F, MendesG, Colares J, de Lucena G, et al. Knowledge of community health agentsabout visually impaired people. Acta Paul Enferm. 2022;35:eAPE03372.https://doi.org/10.37689/acta-ape/2022AO03372
Monteiro NM, Balogun SK. Perceptions of mental illness in Ethiopia:a profile of attitudes, beliefs and practices among community members,healthcare workers and traditional healers. Int J Cult Ment Health.2014;7(3):259-72. https://doi.org/10.1080/17542863.2013.784344
Sibeko G, Milligan PD, Roelofse M, Mofele L, Jonker D, et al. Piloting amental health training programme for community health workers in SouthAfrica: an exploration of changes in knowledge, confidence and attitudes.BMC Psychiatry. 2018;18:1-10. https://doi.org/10.1186/s12888-018-1772-1