Hacia una atención comunitaria en salud mental para personas con esquizofrenia en Colombia

Zaraza-Morales, Daniel Ricardo; Hernández-Holguín, Dora María

doi:10.1590/1413-81232015218.14732015

Cited by 7 publications

(1 citation statement)

References 32 publications

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“…1 153 results were imported on Rayyan for the title and abstract screening, of which 32 studies were selected for a full-text review, applying the full inclusion and exclusion criteria. 15 studies were excluded due to the lack of description of mental health services [12,24,[42][43][44][45][46][47][48][49][50][51][52][53][54], two because of their focus on characterising mental health disorders [55,56], two were only recommendations and were not implemented [57,58], and 1 due to the type of publication [15]. In the end, 12 studies were selected for data extraction.…”

Section: Study Selectionmentioning

confidence: 99%

Mental health services implementation in Colombia–A systematic review

Alarcón Garavito,

Burgess,

Dedios Sanguinetti

et al. 2023

PLOS Glob Public Health

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Colombia’s mental health services have a complex history shaped by 60 years of armed conflict, a predominantly clinical approach to mental health, and social factors such as inequities and stigma. The 1990 Caracas declaration proposed a shift towards decentralised community mental health services and interventions based on the recovery approach and emphasis on social determinants of mental health in the Americas. Colombia has adopted these approaches in its legal and practical framework in recent years, but implementation has been uneven. This systematic review aims to contribute to mental health services understanding in Colombia by examining the barriers and facilitators to the implementation of mental health services in Colombia. A search was conducted to explore available peer-reviewed studies on Colombian mental health services across five databases (Medline, PubMed, Scopus, Scielo and BVS) on quantitative and qualitative research papers published in the last ten years and without language restrictions. The Consolidated Framework for Implementation Research (CFIR) was used to structure the analysis and identify barriers and facilitators during the implementation of mental health services. We adapted the CFIR to attend to gender, race and age informed by the Socio-Political Economy of Global Mental Health framework, given the importance of these factors to the Colombian health landscape. Finally, narrative synthesis was used to summarise the data. 1 530 records were identified, and 12 articles met all inclusion criteria and were included in the analysis. 8 papers described substance use disorders services, 11 involved multidisciplinary healthcare professionals, and 7 were implemented at a local scale. The primary barriers to implementation were the lack of coordination, high workloads, and low funding. Facilitators included the use of protocols, and the involvement of communities, stakeholders, users, and external champions. Findings suggest the continued importance of community and recovery approaches and efforts to improve coordination between multi-sector actors involved in the mental health spaces (e.g., public, and private organisations, users and their families).

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