What do we have here? A Systematic Review of Mental Health Policy in Colombia

Abstract

Background Colombia′s mental health policy is currently under the spotlight due to the global call of prioritising mental health services quality and innovation and the Colombian vision of having an articulated mental health system based on inclusion and community participation. Despite the interest in this topic and proliferation of policy documents, there is no clarity around mental health concepts underlying the compendium of mental health policies, plans and legislation, which are crucial for successful development and implementation of public mental health. Method This study is a novel Systematic Collaborative Policy Review which includes a structured approach to identifying and synthesising relevant institutional documents, alongside a realist approach including consultations with experts throughout the review process to increase the applicability of results. Results 295 records were screened at title and main content stage, 66 were assessed in full text and 46 were included in this review. Most documents identified were created by the Ministry of Health, the Unit for the Attention and Integral Reparation to the Victims, and regional governments. We found Colombian institutional documents had a holistic understanding of mental health, including considerations around the importance of prevention through the creation of healthy protective environments, as well as protecting right to receive a diagnosis, treatment and rehabilitation for people who require mental health care. There was a strong focus on childhood wellbeing and addressing issues related to illegal drug use. Numerous preventive programmes were listed such as specific programmes for LGTB+ and indigenous communities. Conclusion Colombia has a strong mental health legal and programmatic baseline, with ample coverage of aspects ranging from prevention and promotion to quality treatment. However, the extent to which these plans are implemented is unclear. There is a need for clear implementation paths to be included in policy plans, and identification of measurable outputs to monitor success.