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Salud mental y apoyo psicosocial en entornos humanitarios: vinculando la práctica y la investigación
Wietse A Tol1, Corrado Barbui, Ananda Galappatti
1Global Health Initiative, MacMillan Center, Yale University, New Haven, CT 06520-8206, USA. wietse.tol@yale.edu
Lancet (London, England)
|October 20, 2011
Resumen
La salud mental y el apoyo psicosocial en entornos humanitarios a menudo ocurren fuera de los sistemas nacionales. Si bien algunas intervenciones son prometedoras para adultos con TEPT y niños con síntomas de internalización, las prácticas comúnmente utilizadas carecen de evidencia rigurosa.
Área de la Ciencia:
- Salud global La salud global.
- La psiquiatría es la psiquiatría.
- Salud Pública La salud pública.
Sus antecedentes:
- Las intervenciones de salud mental y bienestar psicosocial son críticas en entornos humanitarios.
- Las prácticas actuales, la financiación y la evidencia para estas intervenciones requieren una revisión exhaustiva.
Objetivo del estudio:
- Para vincular la práctica, la financiación y la base de evidencia de las intervenciones de salud mental y apoyo psicosocial en contextos humanitarios.
- Identificar las intervenciones comúnmente implementadas y evaluar su efectividad a través de la revisión sistemática y el metanálisis.
Principales métodos:
- Revisión de 160 informes sobre salud mental y actividades de apoyo psicosocial (2007-2010).
- Análisis de los datos de financiación del Servicio de Seguimiento Financiero y el Sistema de Información de Acreedores (2007-2009).
- Revisión sistemática y metanálisis de 32 estudios controlados, incluidos 13 ensayos controlados aleatorios (ECA).
Principales resultados:
- Las actividades comúnmente reportadas incluyen asesoramiento básico, facilitación de apoyo comunitario y espacios amigables con los niños, a menudo fuera de los sistemas nacionales.
- El metanálisis de 7 ECA mostró efectos beneficiosos para los síntomas de TEPT en adultos (SMD -0.38).
- El metanálisis de 6 ECA indicó efectos beneficiosos para los síntomas de internalización de los niños (SMD -0.24), pero no para los síntomas de TEPT infantil.
Conclusiones:
- Existe una brecha significativa entre las intervenciones más frecuentemente implementadas y aquellas con evidencia científica sólida.
- Se necesita más investigación para evaluar rigurosamente las prácticas de salud mental y apoyo psicosocial ampliamente utilizadas en entornos humanitarios.
- Los hallazgos destacan la necesidad de alinear los esfuerzos de investigación con la implementación práctica y las prioridades de financiación.
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