Barreras y facilitadores para el diagnóstico y tratamiento de la depresión en atención primaria en Colombia: Perspectivas de los proveedores, administradores de atención médica, pacientes y representantes de la comunidad

Abstract

IntroductionDepression represents a major disease burden in Colombia. To better understand opportunities to improve access to mental healthcare in Colombia, a research team at Javeriana University conducted formative qualitative research to explore stakeholders’ experiences with the integration of mental healthcare into the primary care system. MethodsThe research team conducted 16 focus groups and 4 in-depth interviews with patients, providers, health administrators and representatives of community organisations at 5 primary care clinics in Colombia, and used thematic analysis to study the data. ResultsThemes were organised into barriers and facilitators at the level of patients, providers, organisations and facilities. Barriers to the treatment of depression included stigma, lack of mental health literacy at the patient and provider level, weak links between care levels, and continued need for mental health prioritisation at the national level. Facilitators to the management of depression in primary care included patient support systems, strong patient-provider relationships, the targeting of depression interventions and national depression guidelines. DiscussionThis study elucidates the barriers to depression care in Colombia, and highlights action items for further integrating depression care into the primary care setting.