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智利的全球精神卫生行动计划(mhGAP):拉丁美洲和加勒比地区的经验教训与挑战 智利减少精神卫生差距全球行动计划(mhGAP):拉丁美洲和加勒比地区的经验教训与挑战

[Mental Health Global Action Programme (mhGAP) in Chile: Lessons Learned and Challenges for Latin America and the CaribbeanPrograma de ação mundial para reduzir as lacunas em saúde mental (mhGAP) no Chile: aprendizados e desafios para América Latina e Caribe].

作者信息

Sapag Jaime C, Álvarez Huenchulaf Cinthia, Campos Álvaro, Corona Francisca, Pereira Milena, Véliz Verónica, Soto-Brandt Gonzalo, Irarrazaval Matias, Gómez Mauricio, Abaakouk Zohra

机构信息

Departamentos de Salud Pública y Medicina Familiar, Escuela de Medicina, Facultad de Medicina, Pontificia Universidad Católica de Chile Santiago Chile Departamentos de Salud Pública y Medicina Familiar, Escuela de Medicina, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile.

Departamento de Gestión del Cuidado, División de Atención Primaria, Subsecretaría de Redes Asistenciales, Ministerio de Salud Santiago Chile Departamento de Gestión del Cuidado, División de Atención Primaria, Subsecretaría de Redes Asistenciales, Ministerio de Salud, Santiago, Chile.

出版信息

Rev Panam Salud Publica. 2021 Apr 6;45:e32. doi: 10.26633/RPSP.2021.32. eCollection 2021.

Abstract

OBJECTIVES

Present the methodology for comprehensive evaluation of the implementation of the Mental Health Global Action Programme (mhGAP) in Chile and describe the program's results.

METHODS

Cross-sectional evaluative study based on a survey of key program informants deployed in 29 public health services in the country, as well as individual interviews and focus groups with key actors and experts. The evaluation was focused on the relevance and impact of mhGAP on the provision of mental health services and on the implementation of the program.

RESULTS

The participants gave a positive evaluation of the progressive implementation of mhGAP in Chile. In particular: 1) They reported having better tools for detecting, diagnosing, and treating common disorders, and efficient referral strategies; (2) They rated all modules as important, the most relevant being self-harm/suicide (x¯ = 4.77) and mental and behavioral disorders in children and adolescents (x¯ = 4.58); (3) They favorably assessed the National Mental Health Day training courses and the subsequent courses repeated at the local level, indicating that these courses contributed to successful implementation of mhGAP; (4) They agreed on the need to incorporate new actors, strengthen certain aspects, and expand information on the program.

CONCLUSIONS

The implementation of mhGAP in Chile is an emblematic example of learning supported by the development of community mental health and family health, among other factors. These accomplishments offer a unique opportunity to continue advancing the implementation of this program in the country and to implement this experience in other contexts in Latin America and the Caribbean.

摘要

目标

介绍智利对《全球精神卫生行动计划》(mhGAP)实施情况进行全面评估的方法,并描述该计划的成果。

方法

基于对该国29个公共卫生服务机构的关键项目信息提供者进行的调查开展横断面评估研究,同时对关键行为者和专家进行个人访谈及焦点小组访谈。评估聚焦于mhGAP对精神卫生服务提供的相关性和影响以及该计划的实施情况。

结果

参与者对mhGAP在智利的逐步实施给予了积极评价。具体而言:1)他们报告称拥有了更好的工具来检测、诊断和治疗常见疾病,以及有效的转诊策略;(2)他们认为所有模块都很重要,其中最相关的是自我伤害/自杀(x¯ = 4.77)以及儿童和青少年的精神与行为障碍(x¯ = 4.58);(3)他们对全国精神卫生日培训课程以及随后在地方层面重复开展的课程给予了积极评价,表明这些课程有助于mhGAP的成功实施;(4)他们一致认为有必要纳入新的行为者、加强某些方面并扩大该计划的宣传。

结论

智利实施mhGAP是社区精神卫生和家庭卫生发展等因素支持下学习的一个典型例子。这些成果为在该国继续推进该计划的实施以及在拉丁美洲和加勒比地区的其他背景下推广这一经验提供了独特机遇。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d703/8021207/27693e3f21a6/rpsp-45-e32_Figure1.jpg

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