[The state of mental health primary care in the social services of El Alto, La Paz, Bolivia].
OBJECTIVE
To determine the mental health and behavioral disorders (MHBD) treated by a Bolivian health network; and to gauge the perspective of the health professionals, community members, and care-providers in order to identify ways to better handle the issues.


METHODS
A descriptive cross-sectional study was conducted from January to December 2005 in 15 public health centers in districts 2 and 3 of the Corea Network, one of four urban networks in the municipality of El Alto, province of Murillo, department of La Paz, Bolivia. The research and active participation methodology was employed through interviews, focus group sessions, review of external consultation logs and clinical histories, and active observation.


RESULTS
Only 0.05% of primary care visits were for MHBD. Among the barriers identified by doctors were: lack of a specialized reference center (60.0%), not enough time (40.0%), a shortage of specialized personnel (33.3%), the drug supply (20.0%), and undertrained staff (16.6%). The departmental and federal programs have limited human resources training, standards of care are nonexistent, and the information system does not collect data on MHBD. Community members amply identified the mental health problems and care needs that, to date, have not been met by the social services. Conclusiones: Training and development of primary care services staff must be expanded so as to provide the proper care for mental health disorders. Improvements must be made in the management of health care services and the reporting of behavioral and mental health disorders. Another recommendation is to incorporate community participation in the model approach to mental health within the framework of primary health care.
Camacho-Arce
Carmen
C
Instituto de Investigación de Psicología, Universidad Mayor de San Andrés, La Paz, Bolivia. ccamachot@gmail.com
Caballero-Baldivieso
Dora
D
Venegas-Arzabe
Francis
F
D000293:Adolescent; D000328:Adult; D001838:Bolivia; D002648:Child; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D008605:Mental Health Services / Q000592:standards*; D008875:Middle Aged; D011320:Primary Health Care; D014504:Urban Health; D055815:Young Adult