Collaborative mental health services in primary care systems in Latin America: contextualized evaluation needs and opportunities

Health Expect. 2016 Feb;19(1):152-69. doi: 10.1111/hex.12338. Epub 2015 Feb 5.

Abstract

Aim: This study examined Latin American evaluation needs regarding the development of a collaborative mental health care (CMHC) evaluation framework as seen by local key health-care leaders and professionals. Potential implementation challenges and opportunities were also identified.

Methods: This multisite research study used an embedded mixed methods approach in three public health networks in Mexico, Nicaragua and Chile. Local stakeholders participated: decision-makers in key informant interviews, front-line clinicians in focus groups and other stakeholders through a survey. The analysis was conducted within site and then across sites.

Results: A total of 22 semi-structured interviews, three focus groups and 27 questionnaires (52% response rate) were conducted. Participants recognized a strong need to evaluate different areas of CMHC in Latin America, including access, types and quality of services, human resources and outcomes related to mental disorders, including addiction. A priority was to evaluate collaboration within the health system, including the referral system. Issues of feasibility, including the weaknesses of information systems, were also identified.

Conclusion: Local stakeholders strongly supported the development of a comprehensive evaluation framework for CMHC in Latin America and cited several dimensions and contextual factors critical for inclusion. Implementation must allow flexibility and adaptation to the local context.

Keywords: Latin America; addiction; collaborative mental health care; evaluation; health services research; mental health; mixed methods; primary care.

Publication types

  • Multicenter Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Cooperative Behavior*
  • Health Services Accessibility / organization & administration
  • Health Services Research
  • Humans
  • Latin America
  • Mental Disorders / diagnosis*
  • Mental Disorders / therapy*
  • Mental Health Services / organization & administration*
  • Needs Assessment
  • Primary Health Care / organization & administration*
  • Quality of Health Care / organization & administration