Macro level system mapping of the provision of mental health services to young people living in a conflict context in Colombia.
Macro level system mapping of the provision of mental health services to young people living in a conflict context in Colombia.
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DOI：
10.1186/s12913-024-10602-2
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发表时间：
2024-01-25
影响因子：
2.8
通讯作者：
Romero, Juan Pablo Aranguren
中科院分区：
文献类型：
--
作者：
Fenton, Sarah-Jane;Gutierrez, Juan Roberto Rengifo;Pinilla-Roncancio, Monica;Casas, German;Carranza, Francy;Weber, Sanne;Jackson, Paul;Romero, Juan Pablo Aranguren
哥伦比亚是国内武装冲突持续时间最长的国家之一，严重影响了民众的心理健康。本文首次通过详细审查文件、采访主要利益相关者以及对心理健康和自杀方面的现有数据进行定量分析，在国家层面上绘制了向哥伦比亚年轻人提供心理健康服务的情况。它探讨了该国现有的公共精神卫生服务，重点关注精神卫生资源集中在哪里以及如何实施。我们利用这张图来了解哥伦比亚当前的心理健康系统如何与国际青年心理健康方法相适应。我们表明，虽然精神卫生政策的框架各异（生物医学、生物社会、心理或通过人权），但哥伦比亚政策显然侧重于差异化方法。这种差异化的方法将服务提供定为针对有需要的人的支持，从而忽视了整个人口层面的心理健康支持。这意味着并非所有利益相关者都明确阐述或包含在政策中，并且关键机构利益相关者（例如教育部门）与实施计划或活动没有联系。政策方法也过于集中，几乎没有跨机构合作。青年人尤其缺乏服务，对冲突的代际效应和影响的明确了解也是如此。由于精神卫生保健服务集中在远离受冲突影响地区的人口稠密的城市地区，这种情况更加严重。自杀是第二大常见死因，有 10% 的人口因暴力而死亡，或死于自杀。三角测量表明自杀与受冲突影响地区难以获得专业支持之间存在密切关系，并表明支持青少年心理健康的国际框架和政策方法尚未充分适应冲突和冲突后环境。在线版本包含可在 10.1186/s12913-024-10602-2 获取的补充材料。
Colombia has one of the longest running internal armed conflicts, which has significantly impacted the mental health of the population. This article is the first to present a national level mapping of the provision of mental health services to young people living in Colombia, through detailed review of documentation, interviews with key stakeholders and quantitative analysis of existing data on mental health and suicide. It explores the existing public mental health provision in the country, focussing on where mental health resources are concentrated and how these are implemented. We use this mapping to understand how the current mental health system in Colombia fits with international approaches to youth mental health. We show that whilst mental health policy is variously framed (biomedical, biosocial, psychologically or through human rights), Colombian policy clearly focusses on a differential approach. This differential approach shapes service provision to target support at those in need, consequently neglecting whole population level mental health support. This means that not all stakeholders were clearly articulated or included in policy and that key institutional stakeholders, such as the education sector, were not linked to implementation plans or activity. Policy approaches were also over-centralised with little cross-institutional collaboration. Youth were specifically missing from services, as was explicit understanding of the intergenerational effects and impact of conflict. This was exacerbated by unequal distribution of mental health care services concentrated in populous, urban areas away from conflict-affected regions. Suicide is the second most prevalent cause of death with 10% of population who were recorded as dying by violence, dying from completed suicide. Triangulation implies a strong relationship between suicide and poorer access to professional support in conflict-affected areas and suggests that international frameworks and policy approaches to supporting youth mental health have been insufficiently adapted for conflict and post conflict contexts. The online version contains supplementary material available at 10.1186/s12913-024-10602-2.
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DOI：
10.1016/j.rcp.2016.06.010
发表时间：
2016-12-01
期刊：
Revista Colombiana de Psiquiatría
影响因子：
--
作者：
Gómez-Restrepo, Carlos;Aulí, Javier;Casas, Germán
通讯作者：
Casas, Germán
影响因子：
2.5
作者：
Betancourt, Theresa Stichick;Speelman, Liesbeth;Bolton, Paul
通讯作者：
Bolton, Paul
影响因子：
5.4
作者：
Miller, Kenneth E.;Rasmussen, Andrew
通讯作者：
Rasmussen, Andrew
DOI：
10.1186/s13034-020-00327-5
发表时间：
2020-05-19
影响因子：
5.6
作者：
Marroquin Rivera, Arturo;Rincon Rodriguez, Carlos Javier;Gomez-Restrepo, Carlos
通讯作者：
Gomez-Restrepo, Carlos
影响因子：
1.6
作者：
Eriksson, Malin;Ghazinour, Mehdi;Hammarstrom, Anne
通讯作者：
Hammarstrom, Anne