Contextos y desafíos para la atención de la salud mental en el primer nivel.  Una aproximación socioecológica

Berenzon-Gorn, Shoshana; Saavedra-Solano, Nayelhi; Galván-Reyes, Jorge

doi:10.21149/8673

Cited by 11 publications

(10 citation statements)

References 12 publications

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“…Similarly, a study in Japan mentions that a low proportion of patients (17%) prefer to leave decisions to their relatives or their doctors [ 48 ]. In multiple scenarios, patients report that they need to feel that their doctors care about them and listen to them [ 49 – 51 ] and that they are interested in participating in decisions because it makes them feel valued as humans [ 50 ]; even in clinical settings involving palliative care, patients prefer a communication style in which respect for autonomy prevails [ 52 ]. In this sense, in our study of mental healthcare professionals, we observed that open communication was associated with low paternalism/autonomy.…”

Section: Discussionmentioning

confidence: 99%

Communication patterns in the doctor–patient relationship: evaluating determinants associated with low paternalism in Mexico

et al. 2020

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Background Paternalism/overprotection limits communication between healthcare professionals and patients and does not promote shared therapeutic decision-making. In the global north, communication patterns have been regulated to promote autonomy, whereas in the global south, they reflect the physician’s personal choices. The goal of this study was to contribute to knowledge on the communication patterns used in clinical practice in Mexico and to identify the determinants that favour a doctor–patient relationship characterized by low paternalism/autonomy. Methods A self-report study on communication patterns in a sample of 761 mental healthcare professionals in Central and Western Mexico was conducted. Multiple ordinal logistic regression models were used to analyse paternalism and associated factors. Results A high prevalence (68.7% [95% CI 60.0–70.5]) of paternalism was observed among mental health professionals in Mexico. The main determinants of low paternalism/autonomy were medical specialty (OR 1.67 [95% CI 1.16–2.40]) and gender, with female physicians being more likely to explicitly share diagnoses and therapeutic strategies with patients and their families (OR 1.57 [95% CI 1.11–2.22]). A pattern of highly explicit communication was strongly associated with low paternalism/autonomy (OR 12.13 [95% CI 7.71–19.05]). Finally, a modifying effect of age strata on the association between communication pattern or specialty and low paternalism/autonomy was observed. Conclusions Among mental health professionals in Mexico, high paternalism prevailed. Gender, specialty, and a pattern of open communication were closely associated with low paternalism/autonomy. Strengthening health professionals’ competencies and promoting explicit communication could contribute to the transition towards more autonomist communication in clinical practice in Mexico. The ethical implications will need to be resolved in the near future.

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Section: Discussionmentioning

confidence: 99%

Communication patterns in the doctor–patient relationship: evaluating determinants associated with low paternalism in Mexico

et al. 2020

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“…The Mexican National Development Plan (2019-2024) [ 37 ], includes a strong component of social policy matters, for various underprivileged populations in Mexico, with the purpose of generating welfare. Regarding the health system and access to mental health attention, we consider it necessary and urgent to strengthen the current health reform, in such way that it influences the reorganization of public health services, and an increase to the allocated budget [ 38 ]. Specifically, in order to generate actions aimed at preventing suicide, it is necessary to create a Mental Health Law in Mexico.…”

Section: Discussionmentioning

confidence: 99%

Living Conditions of Adolescents Who Have Attempted Suicide in Mexico

Valdez‐Santiago

Cruz-Bañares

Rojas-Carmona

et al. 2020

IJERPH

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Suicidal behavior represents a complex public health problem, with a rising number of suicide attempts registered among Mexican adolescents. We undertook a qualitative study in order to understand the living conditions of adolescents who had attempted to take their lives in five Mexican states. We interviewed 37 adolescents who had engaged in suicide attempts in the year prior to our study. To code and analyze the information, we defined the following three categories of living conditions as social determinants of health for adolescents: poverty and vulnerability, education, and health care. To this end, we followed the methodology proposed by Taylor and Bogdan, and used Atlas.ti 7.5.18 software for analyses. Among our findings, we noted that poverty, manifested primarily as material deprivation, rendered the daily lives of our interviewees precarious, compromising even their basic needs. All the young people analyzed had either received medical, psychological, and/or psychiatric care as outpatients or had been hospitalized. School played a positive role in referring adolescents with suicidal behavior to health services; however, it also represented a high-risk environment. Our findings highlight the urgent need to implement a national intersectoral strategy as part of comprehensive public policy aimed at improving the health of adolescents in Mexico.

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“…2. p. 190 Mundial de la Salud, 2013b). Según otros estudios, cuando la salud mental no es considerada un programa prioritario se produce un impacto negativo en las características de la atención (Berenzon-Gorn et al, 2018). En relación a esto, se deben realizar más investigaciones que apunten a la gobernanza en el área.…”

Section: Discussionunclassified

“…Por otro lado, los países de ingresos mayores gastan una proporción superior de sus presupuestos, y se alejan de los hospitales neuropsiquiátricos tomando como base la integración de la salud mental Ejemplo de la relación entre el presupuesto y la atención en salud mental es lo expuesto por un estudio en México, en el que los programas que no son considerados prioritarios, como salud mental, fueron los que recibieron un mayor impacto negativo. Esto se traduce en recortes presupuestarios, personal insuficiente y escasez de medicamentos (Berenzon-Gorn et al, 2018).…”

Section: Sistemas De Salud Mentalunclassified

Una mirada al sistema de salud mental en Paraguay

Centurión¹,

Mereles²

2020

Academo (Asunción)

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Contextos y desafíos para la atención de la salud mental en el primer nivel. Una aproximación socioecológica

Abstract: Improving MH care at the primary care level requires reflective work from a variety of perspectives.

Cited by 11 publications

References 12 publications

Communication patterns in the doctor–patient relationship: evaluating determinants associated with low paternalism in Mexico

Communication patterns in the doctor–patient relationship: evaluating determinants associated with low paternalism in Mexico

Living Conditions of Adolescents Who Have Attempted Suicide in Mexico

Una mirada al sistema de salud mental en Paraguay

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