Community Mental Health Care In Mexico: A Look At The State Of Jalisco, Mexico

Abstract

Background: Access to mental health care is a worldwide public health challenge. In Mexico an unacceptably high percentage of the population with mental disorders does not receive the necessary treatment, which is mainly due to the lack of access to mental health care. The community mental health care model was created and has been implemented to improve this situation. In order to properly plan and implement this model a precise situational diagnosis of the mental health care network is required, thus this is a first approach to evaluate the community mental health networks in the state of Jalisco. Methods: Two components from the EvaRedCom–TMS instrument were used including a general description and accessibility of the community mental health care network. A geographic and economic accessibility evaluation was carried out for the different regions of the state ranging from scattered rural to urban communities using information gathered from health institutions, telephone interviews and computer applications. Results: Jalisco’s community mental health network includes a total of 31 centers and 0.64 mental health workers for every 10,000 inhabitants >15 years of age. The mean transportation cost required to access mental health care was 16.25 USD. The time needed to reach the closest mental health center in 7 of the 13 analyzed regions was more than 30 minutes and the mean time required to reach a prolonged stay center was 172.7 minutes with transportation cost of 22.3 USD. Some marginalized regions in the state have a mean 114 minutes required to reach the closest mental health care center and 386 minutes to reach a prolonged stay center. Conclusions: This first approach to evaluate the mental health networks in Mexico showed that there are multiple barriers to access its care including an unfavorable number of human resources, long distances and high costs. The identification of Jalisco’s mental health network deficiencies is the first step towards establishing a properly planned community mental health care model within the country.

Mental health help-seeking in Mexico

“…Yet, only 24% of those in need of psychiatric care utilize any mental health services (3). Most people with severe mental health diagnoses (76.2%), such as schizophrenia or bipolar disorder, 77.9% of those with more moderate mental health disorders, and 87.4% of those with mild disorders, receive no mental health treatment (4). These grave mental health challenges do not exist in isolation; rather, they exist against a backdrop of significant health disparities and barriers to effective health promotion exacerbated by the unequal distribution of healthcare resources and limited health education in general, and especially in marginalized communities.…”

“…Once a decision is made to seek help, individuals with mental health disorders are required to overcome additional, non-logistical barriers to access mental health care, including social stigma, discrimination, comorbidity of mental health disorders and non-communicable diseases, and the presence of additional mental health disorders (4,14). Mental health stigma is widely present in Mexico (15,16).…”