Community-Based Mental Health Services in Mexico

Martha Cordero Oropeza,Shoshana Berenzon,Rebeca Robles,Tania Real,María Elena Medina Mora

doi:10.17816/cp86

Martha Cordero Oropeza, Shoshana Berenzon + Show 3 more

Open Access

https://doi.org/10.17816/cp86

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Abstract

AIM: This article describes the general characteristics of community-based mental healthcare in Mexico. METHODS: Data from national surveys, special studies and statistics from the national information system during the period 20012017 are used. Available information on health systems, new regulations and the innovations implemented are reviewed, as well as research on psychosocial interventions conducted within the country. RESULTS: Data show a fragmented health system with services for workers and those without social security or private care. This is a treatment system essentially based on tertiary healthcare and not integrated into the general health system, with a significant treatment gap and delay in relation to the first treatment. At the same time, a slow but steady increase in the level of care provided at primary healthcare level and in specialized community services has been observed. This trend has been accompanied by an increase in the number of medical doctors, psychologists and, to a lesser extent, psychiatrists, incorporated into the primary healthcare services. At the same time, no new psychiatric hospitals have been built; there has been a proportional reduction in psychiatric beds but no increase in mental health services or beds allocated to first contact hospitals. Research initiatives have analysed the barriers to reform, and efficient interventions have been developed and tested for the community and for primary healthcare; special interventions are available for the most vulnerable but no formal efforts have been to facilitate their implementation. CONCLUSIONS: Evidence is available regarding the implementation of the transition from reliance on tertiary healthcare to reinforced primary care. At the same time, parity, financial protection, quality and continuity of care remain major challenges.

Highlights

The inclusion of mental health in the UN Sustainable Development Goals and the universal health coverage commitment adopted by countries, re-opened the debate on best practices in terms of closing the treatment gap between needs and the demand covered
A small but steady increase in services and human resources in primary healthcare and specialized community services was observed. This shift is an important step towards reducing the treatment gap
We are convinced that Mexico can build a mental healthcare model that will improve the quality of life of the population, by integrating mental healthcare across the lifespan into the health system, with coordinated actions in various sectors, including civil society organizations

Summary

Introduction

The inclusion of mental health in the UN Sustainable Development Goals and the universal health coverage commitment adopted by countries, re-opened the debate on best practices in terms of closing the treatment gap between needs and the demand covered. This challenge posed in Alma Ata in 1978, namely, universal health coverage through primary care,[1] has not been met around the globe[2] and Mexico is no exception. GENERAL HEALTHCARE SYSTEM IN MEXICO The Mexican healthcare system comprises two sectors: public and private. The private sector provides services for those with the capacity to pay

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