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Órgano Oficial del Instituto Nacional de Psiquiatría Ramón de la Fuente Muñiz
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2016, Number 1

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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
Full text How to cite this article

Language: Spanish
References: 20
Page: 3-9
PDF size: 190.92 Kb.


Key words:

Collaborative care, mental health, depression, primary care.

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

  1. 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.

  2. 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

  3. Ustum TB, Sartorius N. Mental illness in general health care. An international study. New York: John Wiley and Sons Ltd.; 1995; pp.19-36.

  4. 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.

  5. Kramer T, Garralda E. Psychiatric disorders in adolescents in primary care. Br J Psychiatry 1998;173:508-513.

  6. Paolo D. Alcance y límites en la actuación del médico de atención primaria en los trastornos psiquiátricos. Psiq Prim 2003;4(2):4-12.

  7. Bower P, Gilbody S. Managing common mental health disorders in primary care: conceptual models and evidence base. BMJ 2005;330:839- 842.

  8. 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.

  9. 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

  10. 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.

  11. 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.

  12. 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

  13. 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.

  14. 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.

  15. 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.

  16. 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.

  17. Saraceno B et al. Barriers to the improvement of mental health services in low-income and middle-income countries. Lancet 2007;370:1164- 1174.

  18. 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.

  19. 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.

  20. 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.




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Salud Mental. 2016;39