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      Necesidades de atención en salud mental y uso de servicios en población mexicana con trastornos mentales graves Translated title: Mental health care needs and use of services in Mexican population with serious mental disorders

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          Abstract

          Resumen: Objetivo: Analizar las demandas de atención de los trastornos mentales graves (TMG) y factores asociados con la utilización de servicios en México. Material y métodos: Se llevó a cabo un estudio analítico transversal en dos fases: la primera con una base de datos nacional de servicios disponibles y su utilización; la segunda, una muestra de registros médicos de un hospital psiquiátrico. Resultados: La esquizofrenia es el TMG más prevalente; más de 50% de hospitalizados fueron hombres, con edad promedio 37 años. La utilización de servicios estuvo asociada con la edad (β=1.062; p=.000), ingreso familiar (β=1.000, p=.000) y no tener ocupación (β=3.407; p=.000). La población con esquizofrenia tiene cuatro veces más la probabilidad de requerir estar exenta de pago (β=4.158; p=.000). Conclusiones: La población con TMG es más vulnerable por la discapacidad funcional y social asociada; requiere de intervenciones específicas de salud acompañadas de una política de protección financiera adaptada a sus necesidades de atención.

          Translated abstract

          Abstract: Objective: To analyze the mental health care needs of the serious mental disorders (SMD) and factors associated with the use of services in Mexico. Materials and methods: A cross-sectional analytical study was conducted in two phases, the first with a national database of available services and its utilization; the second, a sample of medical records of a psychiatric hospital. Results: Schizophrenia is the most prevalent MDS; more than 50% of those hospitalized were male, with an average age of 37 years. The use of services was associated with age (β=1.062, p=.000), family income (β=1.000, p=.000) and no laboral occupation (β=3.407, p=.000). The population with schizophrenia is four times more likely to require to be exempt from payment (β=4.158, p=.000). Conclusions: The population with SMD as schizophrenia is more vulnerable due to the associated functional and social disability and it requires specific heath interventions and a financial protection policy adapted to their mental health care needs.

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          Most cited references32

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          The Lancet Commission on global mental health and sustainable development

          The Lancet, 392(10157), 1553-1598
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            National health surveys and the behavioral model of health services use.

            National health surveys have played an important role in the development of health services research. They have contributed to the advancement of concepts, methods, and the policy relevance of the field. One product of these surveys was the Behavioral Model of Health Services Use. This article documents a 75-year legacy by reviewing the series of national studies that have given to the form and function of health services research. It further examines the Behavioral Model through 40 years of considerable application and alteration.
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              The magnitude of and health system responses to the mental health treatment gap in adults in India and China

              This Series paper describes the first systematic effort to review the unmet mental health needs of adults in China and India. The evidence shows that contact coverage for the most common mental and substance use disorders is very low. Effective coverage is even lower, even for severe disorders such as psychotic disorders and epilepsy. There are vast variations across the regions of both countries, with the highest treatment gaps in rural regions because of inequities in the distribution of mental health resources, and variable implementation of mental health policies across states and provinces. Human and financial resources for mental health are grossly inadequate with less than 1% of the national health-care budget allocated to mental health in either country. Although China and India have both shown renewed commitment through national programmes for community-oriented mental health care, progress in achieving coverage is far more substantial in China. Improvement of coverage will need to address both supply-side barriers and demand-side barriers related to stigma and varying explanatory models of mental disorders. Sharing tasks with community-based workers in a collaborative stepped-care framework is an approach that is ripe to be scaled up, in particular through integration within national priority health programmes. India and China need to invest in increasing demand for services through active engagement with the community, to strengthen service user leadership and ensure that the content and delivery of mental health programmes are culturally and contextually appropriate.
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                Author and article information

                Journal
                spm
                Salud Pública de México
                Salud pública Méx
                Instituto Nacional de Salud Pública (Cuernavaca, Morelos, Mexico )
                0036-3634
                February 2020
                : 62
                : 1
                : 72-79
                Affiliations
                [2] Ciudad de México orgnameHospital Psiquiátrico Fray Bernardino Álvarez México
                [3] Ciudad de México orgnameInstituto Nacional de Psiquiatría Ramón de la Fuente Muñiz México
                [1] Ciudad de México orgnameInstituto Nacional de Psiquiatría Ramón de la Fuente Muñiz orgdiv1Dirección de Investigaciones Epidemiológicas y Psicosociales orgdiv2Área de Concentración Sistemas de Salud México
                Article
                S0036-36342020000100072 S0036-3634(20)06200100072
                10.21149/10323
                31869563
                58902641-1565-431c-98ec-cce43dcdd50c

                This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.

                History
                : 09 May 2019
                : 21 January 2019
                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 33, Pages: 8
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                SciELO Public Health

                Categories
                Artículos originales

                mental disorders,schizophrenia,population characteristic,health infrastructure,health services,trastornos mentales,esquizofrenia,características de la población,infraestructura sanitaria,servicios de salud

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