Mental health and psychiatric care in Bolivia: what do we know?

International Journal of Mental Health Systems

Jair de Jesus Mari²  Jessie Whitfield¹  Wagner Silva Ribeiro²  Denisse Jaen-Varas² 

[1] Saint Louis University School of Medicine, St. Louis, Missouri, USA;Departamento de Psiquitria, Universidade Federal de São Paulo, Rua Borges Lagoa, 570, São Paulo, SP 04038-000, Brasil

关键词: Suicide;    Domestic Violence;    Alcohol Addiction;    South America;    Bolivia;    Developing countries;    Health policy;    Public policy;    Mental health service;   

Others  :  800981
DOI  :  10.1186/1752-4458-8-18

 received in 2014-03-25, accepted in 2014-05-07,  发布年份 2014

【 摘 要 】

Background

Recently Bolivia has implemented a universal health system, but their mental health policy is still emerging.

Objectives

To investigate the current state of the mental health care system in Bolivia and discuss challenges for structuring a coordinated network of services that can effectively meet the needs of the Bolivian population.

Methods

This review was conducted by searching for scholarly articles through the databases Lilacs, Medline OPS, HISA and IBECS REPIDISCA via the search portal in the Virtual Health Library - NLM (http://www.bireme.br webcite).

Results

Bolivia has a National Mental Health Plan that is intended to guide mental health promotion, prevention, treatment and rehabilitation of mental illness, but the resources for this area of health are limited. There are 1.06 psychiatrists and 0.46 psychologists per 100, 000 inhabitants. Information on psychiatric morbidity in Bolivia and the impact of mental disorders on the global burden of disease is scarce. Admission statistics reported by psychiatric hospitals in the country show that the main cause of hospitalization is substance abuse (30%). Alcohol consumption is responsible for 90% of these admissions, in addition to being a major cause of deaths in traffic and one of the main risk factors for domestic violence. Almost one in two women in Bolivia (47%) experienced some form of violence from their partner in the last year. Nineteen percent of women living with a partner reported being physically abused, while 7% were sexually abused by their partners. Isolated studies report that suicide rates are disproportionately high in Bolivia.

Conclusions

Although there is a shortage of epidemiological data in Bolivia, it is clear the impact of alcohol addiction in psychiatric admissions, domestic violence and traffic accidents. Violence against women and suicides are important issues to be tackled. Among the proposed strategies to afford human resources for mental health in Bolivia, “task shifting”, the delegation of tasks to non-specialists should be extensively adopted in the country to improve mental health care.

【 授权许可】

   
2014 Jaen-Varas et al.; licensee BioMed Central Ltd.

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