+ Primary health care in Peru is able to incorporate mental health care. PDF
Preview + Primary health care in Peru is able to incorporate mental health care.
d e z ri o h S ut A e ,r u s o Scl E s Di c bli u P D V d e z ri o Nh I ut A e L r u s o cl s Di Ic bli u P G M d e z ri o h ut N A MOVEMENT FOR A e r Gsu COMMUNITY–BASED o cl s Di MENTAL HEALTH CARE c I bli u IN PERU P NG Delivery Innovations in a d Low-Income Community, 2013–2016 e z ori N Ih ut A Le r u s o cl s Di A Ac bli u P H E H C H E A L IN G M IN D S , C H A N HEALING MINDS, G IN G L IV E S CHANGING LIVES E X E C U T IV E S U M M A R Y A MOVEMENT FOR COMMUNITY–BASED MENTAL HEALTH CARE 3 IN PERU Delivery Innovations in a Low-Income Community, 2013–2016 TABLE OF CON TENTS Acknowledgments HH VII EAEA LL ININ GG M M Executive Summary INDIND IX SS , C, C HH AA NN GG 01 Introduction ININ GG LIV LIV EE 03 Changing Mental Health Care: What is at Stake? SS EXTA 04 Community-Based Reforms: A Proven Approach, Poised to Deliver ECUBLE 04 What this Report Contributes TIV OF E C 05 The Peruvian Context SO UN MT 0077 LPiemrua’s a Mnde nCtaarl aHbeaayltllho Challenge MARYENTS 11 Research Methods 12 Road Map of this Report 02 Delivering Community-Based III Mental Health Reforms in Carabayllo: What was Achieved? 15 Background 16 1. The Community Mental Health Center 20 2. Strengthening Mental Health Care in Primary Care 25 3. Creating a Mental Health Hospitalization Unit within a General Hospital 27 4. A Women’s Mental Health Halfway House 30 Can Community-Based Mental Health Care Save Money? 34 Conclusions 03 Mental Health Reform and Peru’s Psychiatric Hospitals 37 Background 38 Comprehensive Health Insurance for Mental Health: Making Care Affordable for the Poor 44 Bringing Community Care Strategies into the Hospital: the “Short-Term Intervention Module” 45 Innovation in Service Coordination: Lima’s Mental Health Network 47 The Future of Specialized Hospitals as Reforms Advance 48 Conclusions 04 Mental Health Reform as a Political Process 51 Background 53 Factors that Enabled Political Momentum for Reform 60 Factors that Weakened Mental Health as a Policy Issue 63 Conclusion 05 Choosing the Future 67 Milestones and Persistent Challenges 71 Sustaining Momentum 79 Conclusion: Mental Health Reform and Development 06 Conclusions 80 07 Recommendations 86 Appendix A HH 93 EE AA LL ININ Methodological Considerations G MG M ININ DD SS Appendix B , C, C HH 99 AA NN GG Budget Program PP 131, “Mental Health Prevention INGING LIV LIV and Control”: its importance for the reform and EE recommendations to further strengthen its impact SS EXTA ECUBLE Appendix C TIV OF 102 E C SO UN MT Ecostmimmautninitgy umneitn ctoasl thse faolrt hse cleenctteerd a snedrv hicaelfsw aat yth heo Cusaer aabs aayltlelor natives MARYENTS to traditional hospital-based care: complete study Appendix D 122 Participation of the communications media in Peru’s V mental health care reform, 2013–2016 Endnotes 140 ACK NOWLEDG MENTS LIMA AND WASHINGTON, DC FEBRUARY 2018 This report was prepared under the overall coordination of HH EE AA Patricio V. Marquez, Lead Public Health Specialist, Jaime LINLIN GG Bayona, Senior Health Specialist, and Sheila Dutta, Health, M M ININ DD Nutrition and Population Global Practice, World Bank Group SS , C, C HH (WBG), by a team from the Cayetano Heredia Peruvian AA NN GG University (UPCH) in Lima, Peru, led by Humberto Castillo ININ GG Martell, Principal Investigator, and including: Julio Ríos Peña, LIV LIV EE María Mendoza Vilca, Kelly Méndez Polo, Martha Mitrani S S EXAC GAloenxzaánldeezr, IVrawniens ssear vHeedr raesr par Linócpipeza,l awnrdit eRr/oecdiioto Vr aolfv tehred efi nAalli aregpao. rt. ECUTIVKNOWL EE SD UG ME MM The report team gratefully acknowledges the comments and suggestions of AREN YT peer reviewers: Daniel Chisholm (World Health Organization EURO Region), S Jill Farrington (World Health Organization EURO Region), Chloë Fevre (World Bank Group), Julian Jamison (World Bank Group), Devora Kestel (Pan American Health Organization), Iryna Postolovska (World Bank Group), Beverly Pringle (United States National Institute of Mental Health), Giuseppe Raviola (Partners In Health), Shekhar Saxena (World Health Organization), Mark van Ommeren VII VII (World Health Organization), Inka Weissbecker (International Medical Corps), and Ann Marie Willhoite (USAID). Akosua Dakwa (WBG) provided administrative support to the project. Funding for this report was provided under a grant from the Rockefeller Foundation managed by the World Bank Group Global Mental Health Initiative Team to help prepare country case studies on mental health reform in various countries. The findings, interpretations, and conclusions in this report are entirely those of the authors. They do not necessarily represent the views of the World Bank Group, its Executive Directors, or the countries they represent, nor of the Rockefeller Foundation, or the Cayetano Heredia Peruvian University (UPCH). EXEC UTIVE SUMM ARY WHAT WILL THIS GREAT VICTORY LOOK LIKE?
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