Instituto Peruano de Orientación Psicológica, 208 Manuel Corpancho Av, Lima 15046, Peru.
CRONICAS Centre of Excellence in Chronic Diseases, Universidad Peruana Cayetano Heredia, 445 Armendáriz Av, Lima 15074, Peru.
Health Policy Plan. 2023 Nov 16;38(Supplement_2):ii3-ii13. doi: 10.1093/heapol/czad055.
Governments globally deployed various non-pharmacological public health measures to respond to the COVID-19 pandemic (i.e. lockdowns and suspension of transportation, amongst others); some of these measures had an influence on society's mental health. Specific mental health policies were therefore implemented to mitigate the potential mental health impact of the pandemic. We aimed to explore the implementation of mental health regulations adopted by the Peruvian health system by focusing on the care services at Community Mental Health Centres (CMHCs), based on the experiences of health workers. We conducted a phenomenological qualitative study to understand the implementation of mental health policies launched in Peru during the COVID-19 pandemic. Data were obtained from a document review of 15 national policy measures implemented during the pandemic (March 2020 to September 2021), and 20 interviews with health workers from CMHCs (September 2021 to February 2022). The analysis was conducted using thematic content analysis. Most implemented policies adapted CMHC care services to a virtual modality during the COVID-19 pandemic; however, various challenges and barriers were evidenced in the process, which prevented effective adaptation of services. Workers perceived that ineffective telemedicine use was attributed to a gap in access to technology at the CMHCs and also by users, ranging from limited access to technological devices to a lack of technological skills. Further, although mental health promotion and prevention policies targeting the community were proposed, CMHC staff reported temporary interruption of these services during the first wave. The disparity between what is stated in the regulations and the experiences of health workers is evident. Policies that focus on mental health need to provide practical and flexible methods taking into consideration both the needs of CMHCs and socio-cultural characteristics that may affect their implementation.
全球各国政府采取了各种非药物性公共卫生措施来应对 COVID-19 大流行（例如封锁和暂停交通等）；其中一些措施对社会心理健康产生了影响。因此，实施了特定的心理健康政策来减轻大流行对心理健康的潜在影响。我们旨在通过关注社区心理健康中心（CMHC）的护理服务，探讨秘鲁卫生系统实施的心理健康法规，以此了解秘鲁在 COVID-19 大流行期间实施的心理健康政策。我们进行了一项现象学定性研究，以了解在 COVID-19 大流行期间在秘鲁推出的心理健康政策的实施情况。数据来自对 15 项在大流行期间实施的国家政策措施（2020 年 3 月至 2021 年 9 月）的文件审查，以及对来自 CMHC 的 20 名卫生工作者的访谈（2021 年 9 月至 2022 年 2 月）。分析采用主题内容分析进行。在 COVID-19 大流行期间，大多数实施的政策使 CMHC 的护理服务适应了虚拟模式；然而，在这一过程中也出现了各种挑战和障碍，阻碍了服务的有效适应。工作人员认为，远程医疗使用效果不佳归因于 CMHC 技术获取方面存在差距，以及用户方面存在差距，从技术设备的有限获取到缺乏技术技能等。此外，尽管提出了针对社区的心理健康促进和预防政策，但 CMHC 工作人员报告说，在第一波疫情期间，这些服务暂时中断。法规中规定的内容与卫生工作者的经验之间存在明显差距。关注心理健康的政策需要提供实际和灵活的方法，既要考虑 CMHC 的需求，也要考虑可能影响其实施的社会文化特征。
