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Healthy minds

Nobody says mental health services are inexpensive, but they should be considered a public health priority and they could do much for people who need them without neglecting spending in other health areas, according to a study by IDB public health expert Mark Homonoff, M.D.

In his study Models for Mental Health Intervention, Homonoff notes that long-term institutionalization is a remedy of the past and that mental health illnesses could be treated effectively and rapidly by adapting the basic health care system.

To a large extent, primary care is already dealing with basic mental health issues. The study reports that an average of 24 percent of all primary care health referrals are linked to emotional or behavioral needs in developed and underdeveloped countries, and World Health Organization research suggests that these figures may range as high as 58 percent in some physicians’ practices. Hence, government’s intervention shouldn’t be postponed any longer.

The study suggests such an intervention on mental health programs in El Salvador, a country with historically high rates of violence. Through expansion of basic services and community participation, the status of the mentally ill and the disabled could be improved. “Community support from families, educators and the clergy could compensate for the lack of basic personnel to respond to mental health demands in those countries that have a minimal allocation of financial resources for mental health services,” he said, presenting his study at IDB headquarters.

Homonoff’s findings suggest three small-scale measures that could be adopted by the Bank under this new approach.

First, he proposes setting low-cost branch clinics to operate alongside with a central mental hospital that would provide these clinics with mental health professionals and reach the more vulnerable segments in the community. Second, mental health for physicians and nurses already engaged in primary care could be trained. Third, a training program could also be put in place for school counselors and teachers, enabling them to identify behavioral and cognitive disorders as well as issues of domestic strife.

*The study was focused in the Bank’s Operational Region 2, which includes Mexico and the countries in Central America.

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