Laws in Latin American countries are based on scientific evidence that calls for mental health services to move to the community. These care modalities have implementation problems. The objective of this article is to describe the implementation of the services proposed in Law 1616 of 2013 of Colombia (Mental Health Law): emergencies, hospitalization, community-based rehabilitation, pre-hospital care, day hospital for children and adults, Drug Addiction Care Center, groups support and mutual aid, telemedicine, and home and outpatient care. We used a mixed study, with a cross-sectional descriptive quantitative component, where an instrument was used to determine the level of implementation of these services, consisting of a scale that established the availability and use of these services, in addition to the climate of implementation of the services and community mental health strategies, in addition to a qualitative determination of barriers and facilitators of implementation. We found a low availability of all services in departments such as Amazonas, Vaupés, Putumayo, and Meta and an implementation of services in Bogotá and Caldas. The least implemented services are the community ones, and those with the greatest presence at the territorial level are emergencies and hospitalization. We conclude that low- and middle-income countries have few community models and invest a large part of their technical and economic effort in emergencies and hospitalization. There are difficulties in the implementation of most of the services proposed by Colombian legislation related to mental health.

Antecedentes: La resiliencia es una medida de la capacidad de adaptación exitosa en un ambiente cambiante. Para medirla se ha usado ampliamente la escala breve de Connor-Davidson Resilience (CD-RISC). Sin embargo, no se cuenta con una validación en población general colombiana mayor de edad, sino en grupos de personas con patologías y en adolescentes. Objetivo: evaluar las propiedades psicométricas de este instrumento para su uso con población general adulta colombiana. Método: Se realizó un muestreo incidental por conveniencia, con una muestra de 18779 personas mayores de 18 años de todas las regiones de Colombia. Resultados: Se destaca un coeficiente alfa de Cronbach de .892 que indica una confiabilidad alta, correlaciones estadísticamente significas entre todos los ítems (p<.001) y la agrupación del total de ítems en un único factor con una varianza explicada de 51.60%. Esto sugiere que hay consistencia en el agrupamiento de los ítems en torno a ese factor. Estas propiedades confirman los hallazgos de validaciones previas. Conclusiones: La presente investigación aumenta la evidencia disponible sobre los instrumentos para evaluar la resiliencia y confirma que las propiedades psicométricas de la CD-RISC-10 son adecuadas para su utilización con población general adulta colombiana, especialmente para el diseño de planes de promoción de la salud mental.

Objetivo. Describir barreras y desafíos en la implementación del Programa de Acción Mundial para Reducir las Brechas de Atención en Salud Mental mhGAP, y determinar la asociación entre facilitadores de implementación, accesibilidad, aceptabilidad y supervisión, en Chocó, Colombia. Métodos. Estudio evaluativo de corte transversal, con métodos mixtos y secuenciales. Se contó con la participación de 41 personas (30 correspondientes a personal de salud y 11 personas del área administrativa). Se conformaron cinco grupos focales, en el marco de la formación en mhGAP. Se usó la escala de impulsores de implementación, que determinó factores como: facilitadores del sistema para la implementación, accesibilidad de la estrategia, adaptación y aceptabilidad, formación y supervisión en la estrategia. También se realizaron entrevistas semiestructuradas, con un posterior análisis temático. Resultados. Se encontró una correlación estadísticamente significativa entre los componentes de la implementación, lo cual fue reafirmado con la información de las entrevistas. A nivel de las barreras seÑaladas, se destacan factores como dispersión, conflicto armado, la dificultad para cambiar la perspectiva de la zona en la que se vive y los problemas administrativos para acceder a los tratamientos. Estos factores se abordan en una propuesta de ruta de atención. Conclusiones. En mhGAP en el departamento del Chocó, pese a una adecuada aceptabilidad, acceso y supervisión, se evidencian barreras y desafíos de orden social, geográfico, político, cultural y a nivel de la administración en salud, que podrían ser superados con la implementación de rutas intersectoriales de recuperación, construidas desde el mismo territorio.

Human rights training in mental health professions is essential to reduce stigma and facilitate recovery processes. The aim of this study was to understand the relationship between engagement to human rights and stigma towards people with mental disorders, as well as attitudes towards mental illness in medical and social work students of a Latin American context. An analytical, cross-sectional study was carried out with a sample of 243 students in the last two years of study. Community Attitudes Towards the Mentally Ill (CAMI), Mental Illness Clinicians’ Attitude Scale (MICA), Human Rights Exposure in Social Work (HRXSW) and Human Rights Engagement in Social Work (HRESW) were used as instruments. To determine how the explanatory variables are related to the engagement to human rights (dependent variable) a binary logistic regression model was used. Correlations were found between the scales and their components. Economic condition, intersectional approach, authoritarianism, benevolence and mental health ideology explained 55.11% of the variance for commitment to the engagement of human rights. Some factors related to the stigma of mental disorders and the focus on human rights in future mental health professionals are highlighted that should be more visible in the training practices of these professions.

Background: Among the causes associated with suicide there are social factors such as forced displacement has been described and health factors in general that have an impact on pediatric mental health. Aims: To describe clinical and psychosocial factors, and their relationship with suicidal behavior in a Colombian indigenous community. Participants and setting: The mean age were 9.23 years old, 53.7% male and 46.3% female. Method: Mixed approach study. A thematic analysis was carried out with the youth of the community to investigate emotional aspects. A descriptive cross-sectional study was carried out and correlations between variables were made. Results: Correlations were found between suicidal behavior and medical findings. When comparing the mental health disorders and nutritional problems, statistically significant differences were found in the Suicide Risk domain (<.001). This was reaffirmed in the thematic analysis, where factors such as migration and difficulty understanding the language are highlighted as related to suicidal behavior in the pediatric population. Conclusions: Suicidal behavior should not be approached solely from psychopathology. Hunger, the weakening of one’s own culture, armed conflict, migration, and other clinical conditions are found to be associated with suicidal behavior.