"Razones para Vivir": Hybrid implementation study in Colombia for health governance and improving suicidal behavior.

OBJECTIVES

To describe the implementation of a strategy to promote reasons for living and to assess its impact on acute mental health symptoms, psychosocial disability, and perceptions of health services.

METHODS

A quasi-experimental methodology that incorporates methods from a Type I hybrid implementation study. The Caldas Scale, Self-Reporting Questionnaire (SRQ-20), and the Zarit Caregiver Burden Scale were applied to people with a history of mental disorder and suicidal ideation, before and after the implementation of the "Razones para Vivir" strategy, to determine psychosocial disability associated with mental disorders and caregiver burden.

RESULTS

The Razones para Vivir strategy has modified the relationship between the quality and perception of health services and psychosocial disability associated with mental disorders. Large effect sizes were found for the variables of occupational disability (r = 0.68), social disability (r = 0.55), therapeutic adherence (r = 0.71), and perception of services (r = 0.51), with a moderate effect size for acute mental health symptoms (r = 0.41).

CONCLUSIONS

The implementation of the strategy contributed to institutional involvement in promoting mental health, in addition to the improvement of acute mental health symptoms and some psychosocial disability variables. Mental health promotion strategies can be integrated with implementation frameworks to facilitate their development in specific sociopolitical contexts.