2016, Number 1
<< Back Next >>
Salud Mental 2016; 39 (1)
La salud mental y la atención primaria en México. Experiencias de un modelo de atención colaborativa
Vargas TBE, Villamil SV
Language: Spanish
References: 20
Page: 3-9
PDF size: 190.92 Kb.
ABSTRACT
Introduction
In Mexico, there is scarce experience on the development of mental
health primary care models.
Objective
The goal of this work was to structure and apply a collaborative care
model in mental health based on scientific evidence proven in other
countries.
Method
A model complying with the characteristics of Mexico City’s health
system was designed. The model was composed of: training sessions
for the health team to detect possible cases, application of a screening
instrument (K-10), diagnostics of depression and anxiety, and collaborative
care meetings, among general practitioners and the specialist
(psychiatrist) to oversee cases. An opinion interview about the model
was applied to general practitioners.
Results
One hundred and four professionals were trained. During the three
years, 830 (50.5%) possible cases were detected; 38% of them were
evaluated in collaborative care sessions between the general practitioners
and the psychiatrist. Half the sessions were cancelled, mainly
for administrative reasons. The assistance of medical practitioners and
pregraduate medical education was regular.
Discussion and conclusion
A collaborative care model between the general practitioner and the
specialist is feasible in this context. However, some administrative barriers
–such as the organization of services and the number of programs
developed at the primary care– should be solved, because there are
other programs demanding from them the exclusiveness of time. In the
light of this limitation, and given the collaboration in the project, it is
proposed that pregraduate medical education students involve themselves
in this type of models with the support of general practitioners.
REFERENCES
Ivbijaro G, Kolkiewicz L, Lioni, C, Svab I et al. Primary care mental health and Alma-Ata: from evidence to action. Ment Health Fam Med 2008;5:67-69.
Saxena, Thornicof, Whiteford. Resources for mental health: scarcity, inequity, and inefficiency. Global Mental Health 2(internet. 2007;370:878-89(fecha de consulta:5 junio 2014) Disponible en: www.thelancet.com
Ustum TB, Sartorius N. Mental illness in general health care. An international study. New York: John Wiley and Sons Ltd.; 1995; pp.19-36.
Gask L, Sibbald B, Creed F. Evaluating models of working at the interface between mental health services and primary care. Br J Psychiatry 1997;170:6-11.
Kramer T, Garralda E. Psychiatric disorders in adolescents in primary care. Br J Psychiatry 1998;173:508-513.
Paolo D. Alcance y límites en la actuación del médico de atención primaria en los trastornos psiquiátricos. Psiq Prim 2003;4(2):4-12.
Bower P, Gilbody S. Managing common mental health disorders in primary care: conceptual models and evidence base. BMJ 2005;330:839- 842.
Araya R, Rojas G, Fritsch R, Gaete J et al. Treating depression in primary care in low income women in Santiago, Chile: a randomized controlled trial. Lancet 2003;361:995-1000.
Patel V, Araya R, Chatterjee S, Chisholm D et al. Global mental health 3 (internet).2007;370:991-1005. (fecha de consulta: 9 junio 2014) Disponible en: www.thelancet.com
Lara C, Medina-Mora ME, Borges G. Social cost of mental disorders: Disability and work days lost. Results from the Mexican survey of psychiatric epidemiology. Salud Ment 2007;30(5):4-11,13.
Medina-Mora ME, Borges G, Lara C, Benjet C et al. Prevalence, service use, and demographic correlates of 12-month DSM-IV psychiatric disorders in Mexico: Results from the Mexican National Comorbidity Survey. Psychol Med 2005;35(12):1773-1783.
Borges G, Wang P, Medina-Mora M, Lara C et al. Delay of first treatment of mental and substance use disorders in Mexico. Am J Public Health [Internet]. 2007 Sep [citado 2013 5 de diciembre 97(9):1638–43. Available from: http://www.pubmedcentral.nih.gov/articlerender.fcgi? artid=1963297&tool=pmcentrez&rendertype=abstract
WHO World Mental Health Consortium. Prevalence, severity and unmet need for treatment of mental disorders In the World Mental Health Organization world mental health surveys. JAMA 2004;291:2581- 2590.
Heinze G, Chapa C, Santisteban JA, Vargas I. Los especialistas en psiquiatría en México: su distribución, ejercicio profesional y certificación. Salud Ment 2012;35(4):279-285.
Katon W, Von Korff M, Lin E et al. Collaborative management to achieve treatment guidelines. Impact on depression in primary care. JAMA 1995;273(13):1026-1031.
Vargas Terrez BE, Villamil Salcedo V, Rodríguez Estrada C, Pérez Romero J et al. Validación de la escala Kessler 10 (K-10) en la detección de depresión y ansiedad en el primer nivel de atención. Propiedades psicométricas. Salud Ment 2011;34:323-331.
Saraceno B et al. Barriers to the improvement of mental health services in low-income and middle-income countries. Lancet 2007;370:1164- 1174.
Bronfman M, Castro R, Zuñiga E, Miranda C et al. Hacemos lo que podemos: los prestadores de servicios frente a la utilización. Salud Publica Mex 1987;39(6):1-8.
Gómez-Dantés H, Castro MV, Franco-Marina F, Bedregal P et al. La carga de la enfermedad en países de América Latina. Salud Publica Mex 2011;53(supl 2):S72-S77.
Gómez-Dantés O, Sesma S, Becerril VM, Knaul FM et al. Sistema de salud de México. Salud Publica Mex 2011;53(supl 2):S220-S232.