[Design and implementation of an epidemiological surveillance system for mental health]

To design and test a surveillance system to detect and rank the most significant mental health problems in a community and to establish their association with the living conditions in that community.

The system was designed and tested at a primary health care center in the community of La Florida, which is in the metropolitan region of Santiago, the capital of Chile. The health problems that were under surveillance, with monthly monitoring, were: addiction (to alcohol, tobacco, and benzodiazepines or other drugs), violence (domestic violence and sexual abuse, real or suspected), and disorders in children (attention deficit and behavioral disorders). By means of a computerized geographical information system (GIS), those surveillance data were combined with other data. These other data included sociodemographic information on the persons who went to the health center for care as well as data on local risk factors and protective factors for health problems, some of which are indicators of the local residents' living conditions.

The proposed epidemiological surveillance system, which takes into account local living conditions and environmental variables, is a good tool for health action. The proposed system also complements the incomplete perspective of monitoring systems, which do not include variables describing the local context and that focus only on health problems. The information synthesized in the GIS maps makes it possible to simultaneously display different layers of information on factors related to the health problems studied, linked to a specific area and all its environmental variables, in an easy-to-read, self-explanatory format.

These results and the concurring opinions of the participating physicians show that the experimental system effectively met the basic requirements of an epidemiological surveillance system of this kind.