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Transformación de los sistemas de salud mental a nivel mundial: principios y recomendaciones políticas
Vikram Patel1, Shekhar Saxena2, Crick Lund3
1Department of Global Health and Social Medicine, Harvard Medical School, Boston, MA, USA; Department of Global Health and Population, Harvard T H Chan School of Public Health, Boston, MA, USA.
Lancet (London, England)
|August 19, 2023
Resumen
La crisis mundial de salud mental requiere un cambio de paradigma más allá de las categorías de diagnóstico. Empoderar a las comunidades y a los diversos proveedores con enfoques basados en los derechos puede transformar la atención utilizando los recursos existentes.
Área de la Ciencia:
- Salud global
- Investigación en servicios de salud mental
- Política de salud pública
Sus antecedentes:
- Una importante crisis mundial de salud mental está aumentando, independientemente de los recursos nacionales.
- Los enfoques actuales, centrados en categorías de diagnóstico, limitan las intervenciones especializadas y descuidan las estrategias de promoción y prevención basadas en la comunidad.
Objetivo del estudio:
- Proponer un marco transformador para responder a la crisis mundial de salud mental.
- Identificar principios aplicables y recomendaciones de políticas para mejorar la prestación de atención de salud mental.
Principales métodos:
- Síntesis de la evidencia para identificar los principios clave para la transformación de la práctica.
- Desarrollo de recomendaciones políticas para el cambio sistémico en la atención de la salud mental.
Principales resultados:
- Cinco principios básicos para transformar las prácticas de salud mental: abordar los determinantes sociales, alinear la atención con la estadificación de la enfermedad, capacitar a diversos proveedores, adoptar enfoques basados en los derechos y centrar la experiencia vivida.
- Cuatro acciones políticas: un enfoque de toda la sociedad, rediseño de la arquitectura de atención, inversión en intervenciones basadas en la evidencia y rendición de cuentas a través del monitoreo.
Conclusiones:
- La transformación de la atención de la salud mental se puede lograr aprovechando los recursos comunitarios y nacionales existentes.
- Un cambio de "negocios como de costumbre" a enfoques integrados, centrados en la comunidad y basados en los derechos es esencial para abordar efectivamente la crisis de salud mental.
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