Barriers and facilitators to the diagnosis and treatment of depression in Primary Care in Colombia: Perspectives of providers, healthcare administrators, patients and community representatives

Carlos Gomez Restrepo; Sophia M. Bartels; Maria Paula Cardenas Charry; Jose Miguel Ignacio Uribe Restrepo; Leonardo Cubillos; William C. Torrey; Sergio Mario Castro Diaz; Makeda J. Williams; Diana Goretty Oviedo-Manrique; Lisa Marsch

doi:10.1016/j.rcp.2021.01.001

Barriers and facilitators to the diagnosis and treatment of depression in Primary Care in Colombia: Perspectives of providers, healthcare administrators, patients and community representatives

Título traducido de la contribución: Barreras y facilitadores para el diagnóstico y tratamiento de la depresión en atención primaria en Colombia: Perspectivas de los proveedores, administradores de atención médica, pacientes y representantes de la comunidad

Carlos Gomez Restrepo, Sophia M. Bartels, Maria Paula Cardenas Charry, Jose Miguel Ignacio Uribe Restrepo, Leonardo Cubillos, William C. Torrey, Sergio Mario Castro Diaz, Makeda J. Williams, Diana Goretty Oviedo-Manrique, Lisa Marsch

Producción: Contribución a una revista › Artículo › revisión exhaustiva

7 Citas (Scopus)

Resumen

Introducción
La depresión representa una importante carga de enfermedad en Colombia. Para comprender mejor las oportunidades para mejorar el acceso a la atención de la salud mental en Colombia, un equipo de investigación de la Universidad Javeriana realizó una investigación cualitativa formativa para explorar las experiencias de las partes interesadas con la integración de la atención de la salud mental en los servicios de atención primaria.

Métodos
El equipo de investigación realizó 16 grupos focales y 4 entrevistas en profundidad con pacientes, proveedores, administradores de salud y representantes de organizaciones comunitarias en cinco clínicas de atención primaria en Colombia, y utilizó un análisis temático para analizar los datos.

Resultados
Los temas se organizaron en barreras y facilitadores al nivel de pacientes, proveedores, organizaciones y estructuras. Las barreras para el tratamiento de la depresión incluyeron estigma, falta de conocimientos sobre salud mental a nivel del paciente y del proveedor, vínculos débiles entre los niveles de atención y la necesidad continua de priorización de la salud mental a nivel nacional. Los facilitadores para el manejo de la depresión en la atención primaria incluyeron sistemas de apoyo al paciente, relaciones sólidas entre el paciente y el proveedor, la focalización de las intervenciones para la depresión y las guías nacionales de depresión.

Discusión
Este estudio aclara las barreras para la atención de la depresión en Colombia y destaca los elementos de acción para integrar aún más la atención de la depresión en el entorno de atención primaria.

Título traducido de la contribución	Barreras y facilitadores para el diagnóstico y tratamiento de la depresión en atención primaria en Colombia: Perspectivas de los proveedores, administradores de atención médica, pacientes y representantes de la comunidad
Idioma original	Inglés
Páginas (desde-hasta)	67 - 76
Número de páginas	10
Publicación	Revista Colombiana de Psiquiatria
Volumen	50
DOI	https://doi.org/10.1016/j.rcp.2021.01.001 https://doi.org/10.1016/j.rcpeng.2021.01.001
Estado	Publicada - jun. 2021

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Gomez Restrepo, C., Bartels, S. M., Cardenas Charry, M. P., Uribe Restrepo, J. M. I., Cubillos, L., Torrey, W. C., Castro Diaz, S. M., Williams, M. J., Oviedo-Manrique, D. G., & Marsch, L. (2021). Barriers and facilitators to the diagnosis and treatment of depression in Primary Care in Colombia: Perspectives of providers, healthcare administrators, patients and community representatives. Revista Colombiana de Psiquiatria, 50, 67 - 76. https://doi.org/10.1016/j.rcp.2021.01.001, https://doi.org/10.1016/j.rcpeng.2021.01.001

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title = "Barriers and facilitators to the diagnosis and treatment of depression in Primary Care in Colombia: Perspectives of providers, healthcare administrators, patients and community representatives",

abstract = "IntroductionDepression represents a major disease burden in Colombia. To better understand opportunities to improve access to mental healthcare in Colombia, a research team at Javeriana University conducted formative qualitative research to explore stakeholders{\textquoteright} experiences with the integration of mental healthcare into the primary care system.MethodsThe research team conducted 16 focus groups and 4 in-depth interviews with patients, providers, health administrators and representatives of community organisations at five primary care clinics in Colombia, and used thematic analysis to study the data.ResultsThemes were organised into barriers and facilitators at the level of patients, providers, organisations and facilities. Barriers to the treatment of depression included stigma, lack of mental health literacy at the patient and provider level, weak links between care levels, and continued need for mental health prioritization at the national level. Facilitators to the management of depression in primary care included patient support systems, strong patient-provider relationships, the targeting of depression interventions and national depression guidelines.DiscussionThis study elucidates the barriers to depression care in Colombia, and highlights action items for further integrating depression care into the primary care setting.",

keywords = "Depression, Global mental health, Integrated care models, Primary care",

author = "{Gomez Restrepo}, Carlos and Bartels, {Sophia M.} and {Cardenas Charry}, {Maria Paula} and {Uribe Restrepo}, {Jose Miguel Ignacio} and Leonardo Cubillos and Torrey, {William C.} and {Castro Diaz}, {Sergio Mario} and Williams, {Makeda J.} and Oviedo-Manrique, {Diana Goretty} and Lisa Marsch",

note = "Publisher Copyright: {\textcopyright} 2021 Asociaci{\'o}n Colombiana de Psiquiatr{\'i}a",

year = "2021",

month = jun,

doi = "10.1016/j.rcp.2021.01.001",

language = "English",

volume = "50",

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Gomez Restrepo, C, Bartels, SM, Cardenas Charry, MP, Uribe Restrepo, JMI, Cubillos, L, Torrey, WC, Castro Diaz, SM, Williams, MJ, Oviedo-Manrique, DG & Marsch, L 2021, 'Barriers and facilitators to the diagnosis and treatment of depression in Primary Care in Colombia: Perspectives of providers, healthcare administrators, patients and community representatives', Revista Colombiana de Psiquiatria, vol. 50, pp. 67 - 76. https://doi.org/10.1016/j.rcp.2021.01.001, https://doi.org/10.1016/j.rcpeng.2021.01.001

Barriers and facilitators to the diagnosis and treatment of depression in Primary Care in Colombia: Perspectives of providers, healthcare administrators, patients and community representatives. / Gomez Restrepo, Carlos; Bartels, Sophia M.; Cardenas Charry, Maria Paula et al.
En: Revista Colombiana de Psiquiatria, Vol. 50, 06.2021, p. 67 - 76.

Producción: Contribución a una revista › Artículo › revisión exhaustiva

TY - JOUR

T1 - Barriers and facilitators to the diagnosis and treatment of depression in Primary Care in Colombia

T2 - Perspectives of providers, healthcare administrators, patients and community representatives

AU - Gomez Restrepo, Carlos

AU - Bartels, Sophia M.

AU - Cardenas Charry, Maria Paula

AU - Uribe Restrepo, Jose Miguel Ignacio

AU - Cubillos, Leonardo

AU - Torrey, William C.

AU - Castro Diaz, Sergio Mario

AU - Williams, Makeda J.

AU - Oviedo-Manrique, Diana Goretty

AU - Marsch, Lisa

PY - 2021/6

Y1 - 2021/6

N2 - IntroductionDepression represents a major disease burden in Colombia. To better understand opportunities to improve access to mental healthcare in Colombia, a research team at Javeriana University conducted formative qualitative research to explore stakeholders’ experiences with the integration of mental healthcare into the primary care system.MethodsThe research team conducted 16 focus groups and 4 in-depth interviews with patients, providers, health administrators and representatives of community organisations at five primary care clinics in Colombia, and used thematic analysis to study the data.ResultsThemes were organised into barriers and facilitators at the level of patients, providers, organisations and facilities. Barriers to the treatment of depression included stigma, lack of mental health literacy at the patient and provider level, weak links between care levels, and continued need for mental health prioritization at the national level. Facilitators to the management of depression in primary care included patient support systems, strong patient-provider relationships, the targeting of depression interventions and national depression guidelines.DiscussionThis study elucidates the barriers to depression care in Colombia, and highlights action items for further integrating depression care into the primary care setting.

AB - IntroductionDepression represents a major disease burden in Colombia. To better understand opportunities to improve access to mental healthcare in Colombia, a research team at Javeriana University conducted formative qualitative research to explore stakeholders’ experiences with the integration of mental healthcare into the primary care system.MethodsThe research team conducted 16 focus groups and 4 in-depth interviews with patients, providers, health administrators and representatives of community organisations at five primary care clinics in Colombia, and used thematic analysis to study the data.ResultsThemes were organised into barriers and facilitators at the level of patients, providers, organisations and facilities. Barriers to the treatment of depression included stigma, lack of mental health literacy at the patient and provider level, weak links between care levels, and continued need for mental health prioritization at the national level. Facilitators to the management of depression in primary care included patient support systems, strong patient-provider relationships, the targeting of depression interventions and national depression guidelines.DiscussionThis study elucidates the barriers to depression care in Colombia, and highlights action items for further integrating depression care into the primary care setting.

KW - Depression

KW - Global mental health

KW - Integrated care models

KW - Primary care

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U2 - 10.1016/j.rcp.2021.01.001

DO - 10.1016/j.rcp.2021.01.001

M3 - Article

AN - SCOPUS:85103035496

SN - 0034-7450

VL - 50

SP - 67

EP - 76

JO - Revista Colombiana de Psiquiatria

JF - Revista Colombiana de Psiquiatria

ER -

Gomez Restrepo C, Bartels SM, Cardenas Charry MP, Uribe Restrepo JMI, Cubillos L, Torrey WC et al. Barriers and facilitators to the diagnosis and treatment of depression in Primary Care in Colombia: Perspectives of providers, healthcare administrators, patients and community representatives. Revista Colombiana de Psiquiatria. 2021 jun.;50:67 - 76. doi: 10.1016/j.rcp.2021.01.001, 10.1016/j.rcpeng.2021.01.001