Protecting vulnerable communities and health professionals from COVID-19 associated mental health distress: a comprehensive approach led by a public-civil partnership in rural Chiapas, Mexico

Abstract

Background The COVID-19 pandemic has stricken mental health worldwide. Marginalized populations in low- and middle-income countries have been the most affected, as they were already experiencing barriers to accessing mental health care prior to the pandemic and are unequally exposed to the stressors associated with the health emergency, such as economic ravages or increased risk of complicated disease outcomes. Objective The aim of this paper is to describe a comprehensive initiative resulting from a public-civil partnership to address the increased burden of mental health illness associated with the COVID-19 pandemic in rural Chiapas, Mexico. Methods To address the emerging health needs of the general population and health professionals resulting from the pandemic, Compañeros En Salud (CES), a non-profit civil society organization based in Chiapas, implemented a comprehensive strategy to compensate for the shortage of mental health services in the region in collaboration with the Chiapas Ministry of Health. The strategy included three components: capacity building in mental health care delivery, psychosocial support to the general population, and provision of mental health care to CES collaborating staff. In this capacity building article, implementers from CES and the government share descriptive information on the specific interventions carried out and their beneficiaries, as well as a critical discussion of the strategy followed. Results Through this strategy, we have been successful in filling the gaps in the public health system to ensure that CES-served populations and CES-collaborating health professionals have access to mental health care. However, further studies to quantify the impact of this intervention in alleviating the burden of mental health illnesses associated with the pandemic are needed. Conclusions The current situation represents an opportunity to reimagine global mental health. Only through the promotion of community-based initiatives and the development of integrated approaches will we ensure the well-being of marginalized populations.

Task shifting healthcare services in the post-COVID world: A scoping review

“…COVID-19 widened MH needs and service gaps. Ortega et al [42] described Mexican non-profit Compañeros En Salud and the Chiapas health ministry building MH capacity through TS and skilling of non-specialist providers. Primary care physicians, CHW and non-clinical staff were trained in psychological first aid, referrals and self-care and were given pocket guides to extend psychosocial support to community members.…”

“…Furthermore, they provided MH to patients grieving and in need of palliative MH due to COVID-19. Depending on severity, providers referred to higher care [42]. TS expanded coverage of MH during the pandemic and incorporated instruments to address pandemic-induced stressors.…”

“…modified standard operating procedures to protect HRH through the pandemic. Compañeros En Salud trains non-specialists in MH as discussed previously [42].…”

A comprehensive and healthcare equity promoting response by a civil society–public partnership to COVID-19 in Chiapas, Mexico

“…The well-being of healthcare professionals was addressed by securing enough supplies, staff and training, providing a point of contact from the mental health team at CES, debriefing and defusing groups and virtual well-being groups. 34 …”

Salud mental infantil y la brecha de tratamiento en México

“…En 2014, CES inició un programa de salud mental en respuesta a la elevada carga de los servicios mentales, el cual se basa en el cambio de tareas, cuidados escalonados y modelos de atención colaborativa. Durante la pandemia de COVID-19, esta organización tuvo como propósito disminuir dicha carga en el área rural del estado de Chiapas, para lo cual psicólogos y psiquiatras profesionales entrenaron y asesoraron voluntarios por para poner en práctica primeros auxilios psicológicos y técnicas como ejercicios de mindfulness, psicoeducación orientada a la toma de decisiones respecto a transferencias y altas hospitalarias, cuidados posteriores al COVID-19 y adherencia al tratamiento (Ortega et al, 2021).…”