title: Collaborative mental health services in primary care systems in Latin America: contextualized evaluation needs and opportunities.
abstract: OBJECTIVE
  This study examined Latin American evaluation needs regarding the development of a collaborative mental health care (CMHC) evaluation framework as seen by local key health-care leaders and professionals. Potential implementation challenges and opportunities were also identified.
  
  
  METHODS
  This multisite research study used an embedded mixed methods approach in three public health networks in Mexico, Nicaragua and Chile. Local stakeholders participated: decision-makers in key informant interviews, front-line clinicians in focus groups and other stakeholders through a survey. The analysis was conducted within site and then across sites.
  
  
  RESULTS
  A total of 22 semi-structured interviews, three focus groups and 27 questionnaires (52% response rate) were conducted. Participants recognized a strong need to evaluate different areas of CMHC in Latin America, including access, types and quality of services, human resources and outcomes related to mental disorders, including addiction. A priority was to evaluate collaboration within the health system, including the referral system. Issues of feasibility, including the weaknesses of information systems, were also identified.
  
  
  CONCLUSIONS
  Local stakeholders strongly supported the development of a comprehensive evaluation framework for CMHC in Latin America and cited several dimensions and contextual factors critical for inclusion. Implementation must allow flexibility and adaptation to the local context.
authors: Office of Transformative Global Health, Centre for Addiction and Mental Health (CAMH), Toronto, ON, Canada.|Division of Public Health and Family Medicine, School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile.
authors: Jaime C
authors: JC
authors: Sapag
authors: Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada.|Department of Psychiatry, University of Toronto, Toronto, ON, Canada.|Centre for Addiction and Mental Health, Toronto, ON, Canada.
authors: Brian
authors: B
authors: Rush
authors: Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada.
authors: Lorraine E
authors: LE
authors: Ferris
mesh_terms: D003299:Cooperative Behavior; D006297:Health Services Accessibility / Q000458:organization & administration; D006302:Health Services Research; D006801:Humans; D007843:Latin America; D001523:Mental Disorders / Q000175:diagnosis* / Q000628:therapy*; D008605:Mental Health Services / Q000458:organization & administration*; D020380:Needs Assessment; D011320:Primary Health Care / Q000458:organization & administration*; D011787:Quality of Health Care / Q000458:organization & administration
keywords: Latin America; addiction; collaborative mental health care; evaluation; health services research; mental health; mixed methods; primary care
references: Eval Program Plann. 2010 Aug;33(3):205-14
references: 19931908
references: Psychiatr Serv. 2009 Apr;60(4):505-11
references: 19339326
references: BMJ. 2008 Sep 29;337:a1655
references: 18824488
references: Int Rev Psychiatry. 2010;22(4):317-24
references: 20874060
references: BMJ. 2007 Mar 3;334(7591):455-9
references: 17332585
references: Rev Panam Salud Publica. 2007 Feb-Mar;21(2-3):65-72
references: 17565793
references: Cochrane Database Syst Rev. 2012 Oct 17;10:CD007825
references: 23076937
references: Rev Panam Salud Publica. 2005 Oct-Nov;18(4-5):229-40
references: 16354419
references: Health Policy Plan. 2012 Oct;27 Suppl 4:iv9-19
references: 23014156
references: Int J Ment Health Syst. 2013 Jan 23;7(1):5
references: 23343127
references: J Prim Health Care. 2012 Sep 01;4(3):242-8
references: 22946074
references: Eval Program Plann. 2012 Nov;35(4):518-22
references: 22364849
references: Healthc Policy. 2011 Dec;7(Spec Issue):13-20
references: 23205032
references: Eval Program Plann. 2011 Feb;34(1):1-12
references: 20674980
references: Adm Policy Ment Health. 2015 May;42(3):252-64
references: 24961356
references: Am J Public Health. 2006 Mar;96(3):538-46
references: 16449581
references: Aten Primaria. 2007 Aug;39(8):402-3
references: 17692226