Collaborative mental health services in primary care systems in Latin America: contextualized evaluation needs and opportunities.

AIM

This study examined Latin American evaluation needs regarding the development of a collaborative mental health care (CMHC) evaluation framework as seen by local key health-care leaders and professionals. Potential implementation challenges and opportunities were also identified.

METHODS

This multisite research study used an embedded mixed methods approach in three public health networks in Mexico, Nicaragua and Chile. Local stakeholders participated: decision-makers in key informant interviews, front-line clinicians in focus groups and other stakeholders through a survey. The analysis was conducted within site and then across sites.

RESULTS

A total of 22 semi-structured interviews, three focus groups and 27 questionnaires (52% response rate) were conducted. Participants recognized a strong need to evaluate different areas of CMHC in Latin America, including access, types and quality of services, human resources and outcomes related to mental disorders, including addiction. A priority was to evaluate collaboration within the health system, including the referral system. Issues of feasibility, including the weaknesses of information systems, were also identified.

CONCLUSION

Local stakeholders strongly supported the development of a comprehensive evaluation framework for CMHC in Latin America and cited several dimensions and contextual factors critical for inclusion. Implementation must allow flexibility and adaptation to the local context.