title: Mental health services in the Dominican Republic from the perspective of health care providers.
abstract: This study examines mental health services in five different regions of the Dominican Republic (DR) from the perspectives of health care providers. The purpose of this research was to (1) examine existing mental health care services; (2) identify barriers to treatment and mental health services delivery; and (3) explore potential strategies to improve mental health services delivery. Thirty-seven health care workers including physicians, nurses, psychologists, governmental administrators, and non-governmental community health workers were part of five focus groups and subsequent follow-up interviews. Transcripts were coded and analysed to obtain the most parsimonious categories of themes. Results indicated that there is insufficient funding allocated to mental health. The unreliable distribution of psychiatric medications precludes care for patients with severe chronic mental illness. Stigmatising attitudes among health care providers influences the quality of care. The prevalence of domestic violence is a significant public health problem contributing to mental illness. In conclusion, our study findings call for a re-examination of priority public health foci, with special attention to mental health and domestic violence in the DR. From a policy perspective, mental health care should be integrated into primary care and coupled with provider and patient education to reduce stigma. A social determinants approach could ameliorate systemic factors contributing to mental illness.
authors: a School of Nursing, Rutgers, The State University of New Jersey , New Brunswick , NJ , USA.
authors: Susan
authors: S
authors: Caplan
authors: b College of Liberal Arts , University of Massachusetts Boston , Boston , MA , USA.
authors: Tariana V
authors: TV
authors: Little
authors: c Department of Mental Health , Ministry of Public Health , Santo Domingo , Dominican Republic.
authors: Patricia
authors: P
authors: Reyna
authors: c Department of Mental Health , Ministry of Public Health , Santo Domingo , Dominican Republic.
authors: Angelina
authors: A
authors: Sosa Lovera
authors: d New Jersey Trauma Center, University Hospital , Newark , NJ , USA.
authors: Jasmine
authors: J
authors: Garces-King
authors: e Rutgers Robert Wood Johnson Medical School , New Brunswick , NJ , USA.
authors: Kaila
authors: K
authors: Queen
authors: e Rutgers Robert Wood Johnson Medical School , New Brunswick , NJ , USA.
authors: Ritu
authors: R
authors: Nahar
mesh_terms: D001291:Attitude of Health Personnel; D004293:Dominican Republic; D005260:Female; D017144:Focus Groups; D006282:Health Personnel / Q000523:psychology*; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D008605:Mental Health Services; D011634:Public Health; D036301:Qualitative Research; D057545:Social Stigma
keywords: Dominican Republic; Mental health services; domestic violence; policy; stigma