Mental health and primary care in mexico. Experience of a collaborative care model

Abstract

Introduction. In Mexico, there is scarce experience on the development of mental health primary care models.

Objective. The goal of this work was to structure and apply a collaborative care model in mental health based on scientific evidence proven in other countries.

Method. A model complying with the characteristics of Mexico City’s health system was designed. The model was composed of: training sessions for the health team to detect possible cases, application of a screening instrument (K-10), diagnostics of depression and anxiety, and collaborative care meetings, among general practitioners and the specialist (psychiatrist) to oversee cases. An opinion interview about the model was applied to general practitioners.

Results. One hundred and four professionals were trained. During the three years, 830 (50.5%) possible cases were detected; 38% of them were evaluated in collaborative care sessions between the general practitioners and the psychiatrist. Half the sessions were cancelled, mainly for administrative reasons. The assistance of medical practitioners and pregraduate medical education was regular.

Discussion and conclusion. A collaborative care model between the general practitioner and the specialist is feasible in this context. However, some administrative barriers –such as the organization of services and the number of programs developed at the primary care– should be solved, because there are other programs demanding from them the exclusiveness of time. In the light of this limitation, and given the collaboration in the project, it is proposed that pregraduate medical education students involve themselves in this type of models with the support of general practitioners.