The number of specialists is lower than that internationally recommended and insufficient to cover the health needs of the country. Gender distribution is shifting towards a more equitable one. Specialists are mainly grouped in urban areas. This is the first census of specialists based on total verifiable number of physicians, which will allow the design of policies for human resources planning in health.
BackgroundClassification of Psychiatric Emergency Presentations (PEP) is not sufficiently clear due to their inherent high inter-subjectivity and lack of validated triage instruments. In order to improve current classification of psychiatric emergency presentations (PEP) at Emergency Departments, we implemented and validated the Color-Risk Psychiatric Triage (CRPT), an instrument for classifying PEP risk by sorting one to five color/risk levels and one to thirty-two possible conditions arranged by risk.MethodsUsers who visited the Emergency Department (ED) of a Mexican psychiatric hospital from Dec 1st, 2008 to Dec 1st, 2009 were included. One CRPT was assessed by an ED psychiatrist to each patient upon their arrival to ED. Some patients were randomly assessed simultaneously with an additional CRPT and a Crisis and Triage Rating Scale (CTRS) to test validity and reliability of the CRPT.ResultsA total of 7,631 CRPT assessments were included. The majority of PEP were non-urgent (74.28 %). For the validation phase n = 158 patients were included. CRPT score showed higher concurrent validity than CRPT color/risk. CRPT level/risk and score showed highest concurrent validity within dangerousness domain of CTRS (r = 0.703, p < 0.0001). CRPT and CTRS scores showed similar predictive validity (p < 0.0001). High intraclass correlation coefficient (0.982) and Cohen’s Kappa (0.89) were observed for CRPT score (r = 0.982, p < 0.0001).ConclusionsCRPT appeared to be a useful instrument for PEP classification due to its concurrent validity, predictive validity and reliability. CRPT score showed higher correlations than the CRPT color/risk. The five levels of risk provided by the CRPT appear to represent a simple and specific method for classifying PEP. This approach considers actual or potential risk, rather than severity, as the main factor for sorting PEP, which improves upon the current approach to emergency classification that is mainly based on the criterion of severity. Regardless of the triage procedure, emergency assessments should no longer classify PEP as “not real emergencies.”Electronic supplementary materialThe online version of this article (doi:10.1186/s12888-016-0727-7) contains supplementary material, which is available to authorized users.
Introduction.In 2016, there were 4,393 psychiatrists in Mexico, with an estimated rate of 3.68 per 100,000 inhabitants. It is essential to keep this information updated in order to achieve the overall objectives of mental health care. Objective. Estimate the total number of psychiatrists and paidopsychiatrists in Mexico in 2018; identify their geographical distribution, and compare the results with those obtained in 2011 and 2016. Method. Comparative, longitudinal study. Various sources were consulted to update the number of psychiatrists and paidopsychiatrists in 2018 and to determine their sociodemographic characteristics. These characteristics were compared with those found in 2011 and 2016. Results. A total of 4,999 specialists in psychiatry practiced their specialty in Mexico in 2018, 365 of whom are child and adolescent psychiatrists. A rate of 3.71 psychiatrists per 100,000 inhabitants was obtained for a population of 124,737,789. Regarding pedopsychiatric specialists, if we consider a population of 37,714,991 inhabitants under 16, the corresponding rate is .96 child and adolescent psychiatrists per 100,000 minors. These specialists are unevenly distributed throughout the country. Approximately 60% of all psychiatrists and child and adolescent psychiatrists practice in the three largest cities in Mexico. Discussion and conclusion. Although the national rate of psychiatrists was increased in comparison with 2016, it is still lower than that recommended by the World Health Organization (WHO). The geographical distribution of psychiatrists is uneven due to centralization and economic factors as happens in many countries in the world.
Methods A systematic analysis was performed of the medical specialization academic programs of 20 different countries to establish which medical specialties take into account mental health issues in the specialty curricular design and which mental health content these programs address. The criteria that were explored in the educational programs include: 1) name of the medical specialties that take into account mental health content in curriculum design, 2) name of the mental health issues addressed by these programs. After independent review and data extraction, paired investigators compared the findings and reached consensus on all discrepancies before the final presentation of the data. Descriptive statistics evaluated the frequency of the data presented. Results Internal medicine, family medicine, neurology, pediatrics and geriatrics were the specialties that included mental health topics in their programs. In four countries: Bangladesh, Serbia, the Netherlands and France, 50%of all graduate specialty training programs include mental health content. In ten countries: Germany, Sweden, the United Kingdom, Mexico, Belgium, India, Russia, Canada, Israel and Spain, between 20% and 49% of all graduate specialty training programs include mental health content. In six countries - Brazil, Chile, Colombia, Croatia, Kenya, and the United States-less than 20% of all graduate specialty training programs include mental health content. Discussion The proposal that we have made in this article should be taken into account by decision-makers, in order to complement the different postgraduate training programs with mental health issues that are frequently present with other physical symptoms. It is not our intention that the different specialists know how to treat psychiatric comorbidities, but rather pay attention to their existence and implications in the diagnosis, evolution and prognosis of many other diseases. The current fragmentation of medicine into ever finer specialties makes the management of comorbidity ever more difficult: a reorientation of post- graduate training might improve the situation.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.