Fundación Santa Fe de Bogotá,Colombia.
Health Economist & Policy Analyst,Independent,Alexandria, VA,USA.
Epidemiol Psychiatr Sci. 2017 Jun;26(3):211-215. doi: 10.1017/S2045796016000846. Epub 2016 Nov 17.
Comprehensive psychiatric rehabilitation programs in Latin America have been designed across several countries in the region without yet achieving full implementation. Facing an increasing burden of disease due to mental disorders, including alcohol and substance use disorders, the region has responded unevenly to the challenge. Moreover, low priority for mental health in national policies and insufficient funding for mental health services are common barriers for the much-needed mental health services reforms. Reestablishing a primary care community-based model of care has been a shared aspiration for most countries during the last two decades. Comprehensive models of psychiatric rehabilitation developed predominantly in high-income countries need to be culturally adapted to local contexts, while strengthening health systems research will provide evidence on the efficiency of locally designed interventions and on the critical milestones to succeed in the scaling up strategies. Increasing participation of patients and their families in the mental health delivery system is another key factor in order to ensure comprehensive patient-centred psychosocial rehabilitation programs in Latin America.
拉丁美洲的综合性精神康复项目已在该地区的多个国家设计完成,但尚未全面实施。由于精神障碍(包括酒精和物质使用障碍)导致疾病负担不断增加,该地区对这一挑战的应对参差不齐。此外,精神卫生在国家政策中未被优先重视,精神卫生服务资金不足,这是精神卫生服务改革急需解决的常见障碍。在过去二十年中,大多数国家都渴望重新建立以初级保健为基础的社区护理模式。在高收入国家制定的综合性精神康复模式需要适应当地文化,同时加强卫生系统研究,为当地设计的干预措施的效率以及在扩大规模战略中取得成功的关键里程碑提供证据。增加患者及其家属参与精神卫生服务系统是另一个关键因素,以便确保在拉丁美洲实施全面以患者为中心的心理社会康复计划。