Mental Health Services in Colombia: a national implementation study and a call to the community

Abstract

Abstract Background: the laws in Latin American countries are based on scientific evidence that indicates the need for community mental health services, however, these care modalities present implementation problems. Objective: to describe the implementation of mental health services in Colombia with an emphasis on community interventions, such as support groups and mutual aid groups. Methods: descriptive cross-sectional study. An instrument was used to determine the level of implementation of these services, consisting of a Likert-type scale that established the climate of implementation, and questions about the usefulness of the services, which were completed by 31 of 35 mental health department leaders and by leaders of nationally registered mutual aid and support groups. Correlations were made between the implementation climate, the core components of community strategies and their benefits. A bivariate correlation was made between the scale of implementation and the use of services. Results: a low availability of all the services was found in four departments and an implementation of the services in only two. The least implemented services are the community ones, and those with the greatest presence at the territorial level are emergencies and hospitalization. Regarding community strategies, important barriers were identified, among the main ones a poor relationship of the groups with national organizations and the health system; the essential components of its functioning were active agency and trust. Conclusion: middle- and low-income countries have few community models and invest a large part of their technical and economic effort in emergencies and hospitalization. There are difficulties in the implementation of most of the services proposed by the Mental Health Law of Colombia. Despite the implementation difficulties that persist in the studied context, important benefits for mental health are perceived in these interventions.