Berenzon Gorn Shoshana, Saavedra Solano Nayelhi, Medina-Mora Icaza María Elena, Aparicio Basaurí Víctor, Galván Reyes Jorge
Instituto Nacional de Psiquiatría Ramón de la Fuente Muñiz, México D.F., México.
Rev Panam Salud Publica. 2013 Apr;33(4):252-8. doi: 10.1590/s1020-49892013000400003.
Evaluate some of the key indicators that characterize the Mexican mental health system using the World Health Organization's Assessment Instrument for Mental Health Systems (WHO-AIMS).
The strategy for examining the WHO-AIMS indicators included: (i) a review of documentary sources; (ii) application of the questionnaire; and (iii) group work with a team of experts using the consensus technique. To facilitate collection of the data, a questionnaire was prepared in which the indicators were turned into simple questions. The people gathering the data were trained, and the activity was monitored.
It was found that, of the total budget for health, only 2% is allocated for mental health, and, of that share, 80% is used in the operation of psychiatric hospitals. The pivotal point for mental health care is in the psychiatric hospital; there are very few psychiatric units in the general hospitals, few residential establishments, and few services targeted specifically to care for children and adolescents. Access is limited because of the centralized health care system, with the majority of establishments located in the large cities. Only 30% of primary care services have protocols for the evaluation and treatment of mental disorders. Finally, in the mental health facilities, the ratios of psychiatrists, other physicians, nurses, and psychologists per 100 000 population are 1.6, 1.3, 3.4, and 1.5, respectively.
More funding will be needed in order to bridge the gap between the mental health burden and the budget allocated for its care, and resources will need to be used more rationally, with the first level of care becoming the pivot. In addition, it will be necessary to increase the number of specialists, offer periodic in-service training for personnel at the first level of care, and enlist greater participation by the rest of society.
使用世界卫生组织精神卫生系统评估工具（WHO-AIMS）评估墨西哥精神卫生系统的一些关键指标。
审查WHO-AIMS指标的策略包括：（i）查阅文献资料；（ii）应用调查问卷；（iii）与一组专家采用共识技术开展小组工作。为便于收集数据，编制了一份调查问卷，将指标转化为简单问题。对数据收集人员进行了培训，并对活动进行了监测。
发现，在卫生总预算中，仅2%分配给精神卫生领域，而在这一比例中，80%用于精神病医院的运营。精神卫生保健的关键点在于精神病医院；综合医院中的精神科单元很少，寄宿机构很少，专门针对儿童和青少年护理的服务也很少。由于医疗保健系统集中化，获取服务受到限制，大多数机构位于大城市。只有30%的初级保健服务有精神障碍评估和治疗方案。最后，在精神卫生机构中，每10万人口的精神科医生、其他医生、护士和心理学家的比例分别为1.6、1.3、3.4和1.5。
为弥合精神卫生负担与用于其护理的预算之间的差距，将需要更多资金，并且需要更合理地使用资源，将初级保健作为重点。此外，有必要增加专科医生数量，为初级保健人员提供定期在职培训，并争取社会其他方面更多的参与。
