Collaborative care for depression and suicide prevention: a feasible intervention within the Mexican health system

Abstract

Mexico faces an enormous challenge in attending mental health disorders with depression rising as one of the five main contributors to disability adjusted life years (DALYs) and increasing suicide rates. These challenges are coupled with a dearth of resources and an inefficient allocation of the meager funds. While no magical bullet is available to ameliorate this situation in the short term, here we discuss current concepts and experiences that could be used in Mexico to deliver better primary mental health care. We focus on depression and suicidal behavior and argue that collaborative care is a feasible and replicable model, emphasizing the importance of training non-specialized primary care personnel to become case managers and provide primary mental health care. Mexi­co is currently undergoing a process of changes, including the emergence of universal health care. The time seems right to make mental health care more transversal, widely available and scientifically proven.

A State Level Analyses of Suicide and the COVID-19 Pandemic in Mexico

“…Such environments may have been particularly stressful in the context of a generational infectious disease outbreak and accompanying lockdown measures. Residents of cities may also adhere to morenon-traditional family roles and experience less family cohesion.On the other hand, mental health resources in Mexico are much more available in urban areas [15]. Although we were not able to identify speci c mechanisms by which population density acts on the RR of suicide with our current data, this study suggests rich material for future work in Mexico.…”

“…Decisive actions by governments and society as a whole are nevertheless needed. As Mexico struggles to deal with the pandemic, we need to expand primary health care services and include suicide prevention and treatment in primary care settings [15].Although the overall results of this study suggest that in most states in Mexico the pandemic had no net effects or was even associated with reductions in suicide mortality, this should not lead to complacency regarding effects in sub-populations or in the states that showed increase trends. As the pandemic continues to evolve, so there is a need to monitor and not be complacent in all states.…”

A state level analyses of suicide and the COVID-19 pandemic in Mexico

“…Residents of cities may also adhere to more non-traditional family roles and experience less family cohesion. On the other hand, mental health resources in Mexico are much more available in urban areas [ 18 ]. Although we were not able to identify specific mechanisms by which population density acts on the RR of suicide with our current data, this study suggests rich material for future work in Mexico.…”

“…Decisive actions by governments and society as a whole are nevertheless needed. As Mexico struggles to deal with the pandemic, we need to expand primary health care services and include suicide prevention and treatment in primary care settings [ 18 ]. Although the overall results of this study suggest that in most states in Mexico the pandemic had no net effects or was even associated with reductions in suicide mortality, this should not lead to complacency regarding effects in sub-populations or in the states that showed increase trends.…”

Impacto del COVID-19 en México: Un análisis de las respuestas ante la Pandemia.

“…A pesar de que la depresión es el padecimiento más común y el principal contribuyente al suicidio, en México no hay una suficiente y adecuada asignación presupuestal, lo que implica insuficiencia y baja calidad de la atención primaria en salud mental 20 . Por consiguiente, el personal de salud y los propios usuarios del sistema reconocen la escasez presupuestal y denuncian la baja calidad de estos servicios 21.…”