Barriers to access to mental health services among Colombia outpatients

Campo‐Arias, Adalberto; Ospino, Guillermo Augusto Ceballos; Herazo, Edwin

doi:10.1177/0020764020925105

Cited by 29 publications

(19 citation statements)

References 46 publications

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“…The main reason for not using mental health services was "not necessary" (39.1% among the displaced and 71.6% among the non-displaced); this is consistent with the national survey where 47% to 56% of people with mental health issues considered that they did not need any consultation [23]. Attitudinal barriers towards resorting to mental health services have been frequently associated with the stigma generated by mental illness [39,40].…”

Section: Context and Circumstancessupporting

confidence: 72%

Mental health among displaced and non-displaced populations in Valledupar, Colombia: do inequalities continue?

Monsalve

Vargas-Monroy

Ariza

et al. 2021

Pathogens and Global Health

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Background: During the long-lasting civil war in Colombia, the year 2002 marked a peak of violent activities displacing thousands of people mainly from rural to urban areas, causing social disruption and prolonged poverty. In 2015, the Colombian national survey on mental health included a rst overview of mental health problems of victimized families. The here presented study aimed at analysing the traumatic experience many years ago on the current psycho-emotional status of displaced families as well as the ongoing inequalities regarding displaced and non-displaced populations in one of the most affected areas by the armed con ict.Methods: An interview survey was conducted among 211 displaced families and 181 non-displaced families in 2 adjacent compounds with several ve-storey buildings in the outskirts of Valledupar, the capital of Cesar State in Colombia. The questionnaires were developed together with and applied by staff of the health and social services of the departmental secretary of health. The 15 interviewers conducted additionally in-depth interviews and participant observations. Results: The living conditions of the displaced community were precarious (lack of security, noise, drug tra cking, poor public transport). As a consequence of the past traumatic events about 16 to 18 years ago and current di cult living conditions, psycho-emotional problems were more frequent among the displaced compared to the non-displaced neighbourhood. The displaced had experienced more violent acts (intended murder, threat, murder of a family member and kidnapping) and had subsequently a larger number of emotional symptoms (fright, headache, nervousness, depression, sleeplessness). Other stress factors like economic problems, severe disease or death of family members and unemployment prevailed among displaced persons compared to the non-displaced. The non-displaced lived in a more protected environment with less exposure to violence and stress, although belonging to a similarly low socioeconomic stratum. Those previously displaced respondents now living in the non-displaced community still suffered similar emotional symptoms as the displaced respondents living in the displaced community. It is recommended to take measures for a better protection of the displaced community, improve their access to the job market, offer different leisure activities (sports club, art, women's club) and facilitate public transport.

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Section: Context and Circumstancessupporting

confidence: 72%

Mental health among displaced and non-displaced populations in Valledupar, Colombia: do inequalities continue?

Monsalve

Vargas-Monroy

Ariza

et al. 2021

Pathogens and Global Health

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“…Mental health and digital literacy levels are common obstacles in the implementation of HITs; it is well known that many people around the world are unable to recognize mental disorders [89,90] and that this lack of knowledge associated with stigma could prevent people from seeking help and providing treatment to those in need. These problems are a particular concern in low-and middle-income countries where health services are already limited [91].…”

Section: Principal Findingsmentioning

confidence: 99%

Involving End Users in Adapting a Spanish Version of a Web-Based Mental Health Clinic for Young People in Colombia: Exploratory Study Using Participatory Design Methodologies

Ospina-Pinillos¹,

Davenport²,

Navarro-Mancilla³

et al. 2020

JMIR Ment Health

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Background Health information technologies (HITs) hold enormous promise for improving access to and providing better quality of mental health care. However, despite the spread of such technologies in high-income countries, these technologies have not yet been commonly adopted in low- and middle-income countries. People living in these parts of the world are at risk of experiencing physical, technological, and social health inequalities. A possible solution is to utilize the currently available HITs developed in other counties. Objective Using participatory design methodologies with Colombian end users (young people, their supportive others, and health professionals), this study aimed to conduct co-design workshops to culturally adapt a Web-based Mental Health eClinic (MHeC) for young people, perform one-on-one user-testing sessions to evaluate an alpha prototype of a Spanish version of the MHeC and adapt it to the Colombian context, and inform the development of a skeletal framework and alpha prototype for a Colombian version of the MHeC (MHeC-C). Methods This study involved the utilization of a research and development (R&D) cycle including 4 iterative phases: co-design workshops; knowledge translation; tailoring to language, culture, and place (or context); and one-on-one user-testing sessions. Results A total of 2 co-design workshops were held with 18 users—young people (n=7) and health professionals (n=11). Moreover, 10 users participated in one-on-one user-testing sessions—young people (n=5), supportive others (n=2), and health professionals (n=3). A total of 204 source documents were collected and 605 annotations were coded. A thematic analysis resulted in 6 themes (ie, opinions about the MHeC-C, Colombian context, functionality, content, user interface, and technology platforms). Participants liked the idea of having an MHeC designed and adapted for Colombian young people, and its 5 key elements were acceptable in this context (home page and triage system, self-report assessment, dashboard of results, booking and video-visit system, and personalized well-being plan). However, to be relevant in Colombia, participants stressed the need to develop additional functionality (eg, phone network backup; chat; geolocation; and integration with electronic medical records, apps, or electronic tools) as well as an adaptation of the self-report assessment. Importantly, the latter not only included language but also culture and context. Conclusions The application of an R&D cycle that also included processes for adaptation to Colombia (language, culture, and context) resulted in the development of an evidence-based, language-appropriate, culturally sensitive, and context-adapted HIT that is relevant, applicable, engaging, and usable in both the short and long term. The resultant R&D cycle allowed for the adaptation of an already available HIT (ie, MHeC) to the MHeC-C—a low-cost and scalable technology solution for low- and middle-income countries like Colombia, which has the potential to provide young people with accessible, available, affordable, and integrated mental health care at the right time.

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“…In Chile and Colombia some studies have shown a high presence of stigmatizing beliefs and attitudes toward mental disorders, which have been associated with a reduction in seeking help and accessing to health services (Uribe Restrepo et al, 2007;Álvarez Ramírez and Almeida Salinas, 2008;Yang et al, 2013;Mascayano et al, 2016;Hernández Holguín and Sanmartín Rueda, 2018;Sapag et al, 2018;Campo-Arias et al, 2020). In Chile, one of the specific objectives of the 2017-2025 National Mental Health Plan is "to reduce the stigma associated with mental health problems" (MINSAL, 2017, p. 75), which includes initiatives such as an evaluation of mental health-related stigma in primary health care.…”

Section: Introductionmentioning

confidence: 99%

Stigmatizing Beliefs and Attitudes to Depression in Adolescent School Students in Chile and Colombia

et al. 2020

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Barriers to access to mental health services among Colombia outpatients

Cited by 29 publications

References 46 publications

Mental health among displaced and non-displaced populations in Valledupar, Colombia: do inequalities continue?

Mental health among displaced and non-displaced populations in Valledupar, Colombia: do inequalities continue?

Involving End Users in Adapting a Spanish Version of a Web-Based Mental Health Clinic for Young People in Colombia: Exploratory Study Using Participatory Design Methodologies

Stigmatizing Beliefs and Attitudes to Depression in Adolescent School Students in Chile and Colombia

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