Title
Perceptions of community involvement in the peruvian mental health reform process among clinicians and policy-makers: A qualitative study
Date Issued
01 December 2019
Access level
open access
Resource Type
journal article
Author(s)
Arriola-Vigo J.A.
Stovall J.G.
Moon T.D.
Audet C.M.
Publisher(s)
Kerman University of Medical Sciences
Abstract
Background: The global burden of mental health conditions has led to the implementation of new models of care for persons with mental illness. Recent mental health reforms in Peru include the implementation of a community mental health model (CMHM) that, among its core objectives, aims to provide care in the community through specialized facilities, the community mental health centers (CMHCs). Community involvement is a key component of this model. This study aims to describe perceptions of community engagement activities in the current model of care in three CMHCs and identify barriers and potential solutions to implementation. Methods: A qualitative research study using in-depth semi-structured interviews with clinicians from three CMHCs and with policy-makers involved in the implementation of the mental health reforms was conducted in two regions of Peru. The interviews, conducted in Spanish, were digitally recorded with consent, transcribed and analyzed using principles of grounded theory applying a framework approach. Community engagement activities are described at different stages of patient care. Results: Twenty-five full-time employees (17 women, 8 men) were interviewed, of which 21 were clinicians (diverse health professions) from CMHCs, and 4 were policy-makers. Interviews elucidated community engagement activities currently being utilized including: (1) employing community mental health workers (CMHWs); (2) home visits; (3) psychosocial clubs; (4) mental health workshops and campaigns; and (5) peer support groups. Inadequate infrastructure and financial resources, lack of knowledge about the CMHM, poorly defined catchment areas, stigma, and inadequate productivity approach were identified as barriers to program implementation. Solutions suggested by participants included increasing knowledge and awareness about mental health and the new model, implementation of peer-training, and improving productivity evaluation and research initiatives. Conclusion: Community engagement activities are being conducted in Peru as part of a new model of care. However, their structure, frequency, and content are perceived by clinicians and policy-makers as highly variable due to a lack of consistent training and resources across CMHCs. Barriers to implementation should be quickly addressed and potential solutions executed, so that scale-up best optimizes the utilization of resources in the implementation process.
Start page
711
End page
722
Volume
8
Issue
12
Language
English
OCDE Knowledge area
Salud pública, Salud ambiental
Scopus EID
2-s2.0-85074770398
PubMed ID
Source
International Journal of Health Policy and Management
Source funding
School of Medicine, Vanderbilt University
Sponsor(s)
This paper presents independent research supported by Vanderbilt Institute for Clinical and Translational Research (VICTR): #VR51884. JAV was supported by the Overall Family Fellowship for International Research and Vanderbilt University School of Medicine MPH scholarships.
Sources of information: Directorio de Producción Científica Scopus