Mental health care in Mexico has experienced precarious conditions for three decades. Substance use and the pandemic increased demand and made shortages more evident; the urgency of taking action to solve it is undeniable.
It is, in principle, a positive sign that the health authorities are looking for a rearrangement for better coverage. The message was diverted when it became known that psychiatric hospitals wanted to disappear. The reality is that they will not be closed overnight, but that there will be a process to gradually convert the 35 existing psychiatric hospitals into specialized mental health centers where there will be practically no admissions.
The most important thing is that they are seeking to move towards a new community model focused on the first and second level of care, that is, in health centers and general hospitals with specific areas. The entire demand for mental health care will be shared between the two, and staff training has already begun.
The model focused on hospitalization – which were more like asylums – was built in the last century: those with a mental illness were confined and were a source of shame due to the stigma with which society pointed them out. The patients lived in terrible conditions. Those were the times of La Castañeda where there was even a pavilion called “of the stupid” where coercive practices were common and the violation of the human rights of patients was systematic; It is something that, although less, continues to happen.
Today that model overloaded in psychiatric hospitals no longer makes sense and has been outdated for years.
Dr. Juan Manuel Quijada Gaytán, general director of the Psychiatric Care Services (SAP), explains that the idea with the new model is for care to come down to the community level where patients are not subjected and their families can decide and have the will early: migrating from one asylum system to another where respect for human rights is paramount; This has been recommended by the WHO for two decades, and in fact PAHO endorses and accompanies this process in Mexico, anticipating turning it into a model for the Americas.
Three areas are pooling resources and efforts: the SAP led by Dr. Quijada, the National Commission Against Addictions (Conadic) headed by Gady Sabicky and the Technical Secretariat of the National Mental Health Council (STConsame). With the recent reform to the General Health Law, the Legislature gave it legal support; the bad thing is that they did not give him an additional budget weight.
It is unfair because since the 1980s the demand for mental disorders and substance use has been increasing, but Mexico has never invested more than 2% of the Health budget for mental health, when the international recommendation is 5 to 10%. In 2021, that 2% was equivalent to 3,031 million pesos -according to CIEP-, and it was almost completely absorbed by psychiatric hospitals. This reflects that the gap due to lack of attention has been widening in unquantifiable dimensions.
Dr. Quijada tells us that the 340 primary care centers for addictions that exist throughout the country will become community centers for mental health and addictions (Cecosamas). There are 15 general hospitals with psychiatric services and of the 35 psychiatric hospitals, three are operated by the Federation: the Fray Bernardino, the Juan N. Navarro and the Samuel Ramírez Moreno Hospital, in addition to three community mental health centers located in the city halls. of Cuauhtémoc, Iztapalapa and Zacatenco in CDMX.
The remaining 32 hospitals are operated by each state according to its health system. The point is that the Federation will standardize everything, human resources and facilities, to integrate a system under a community model operated from the Center.
Journalist on economics and health issues
Health and Business
Communicator specialized in public health and the health industry. She is studying a master’s degree in Health Systems Administration at FCA of UNAM.
Founder in 2004 of www.Plenilunia.com, a concept on women’s health. I am passionate about researching and reporting on health, innovation, the industry related to science, and finding the objective business approach to each topic.