Community-Based Mental-Health Services in Mexico

Objective :  This article describes the general characteristics of community-based mental health care in Mexico. Method: It uses data from national surveys, special studies and statistics from the national information system for the period 2001-2017 . It reviews available information on health systems, new regulations and innovations implemented and research on psychosocial interventions conducted in the country. Results: Data show a fragmented health system with services for workers, people without social security or private care; a treatment system still heavily based on tertiary health care and not integrated into the general health system with a significant treatment gap and delay in first treatment. At the same time, a slow but steady increase in care provided at the primary health care level and in specialized community services is observed. This trend has been accompanied by an increase in the number of medical doctors, psychologists and to a lesser extent psychiatrist incorporated into primary care health services. At the same time, no new psychiatric hospitals have been built and there has been a proportional reduction in psychiatric beds but no increase in mental health services or beds allocated in first contact hospitals. Research initiatives have analyzed the barriers to a reform and efficient interventions have been developed and tested for the community and primary health care level, special interventions are available for populations in vulnerable conditions with no formal efforts for their implementation. Conclusions : Evidence is available for implementing the transition from reliance on tertiary health care to a reinforced primary care. At the same time, parity, financial protection, quality and continuity of care remain major challenges.