Protecting vulnerable communities and health professionals from COVID-19 associated mental health distress: a comprehensive approach led by a public-civil partnership in rural Chiapas, Mexico

ABSTRACT

Background

The COVID-19 pandemic has stricken mental health worldwide. Marginalized populations in low- and middle-income countries have been the most affected, as they were already experiencing barriers to accessing mental health care prior to the pandemic and are unequally exposed to the stressors associated with the health emergency, such as economic ravages or increased risk of complicated disease outcomes.

Objective

The aim of this paper is to describe a comprehensive initiative resulting from a public-civil partnership to address the increased burden of mental health illness associated with the COVID-19 pandemic in rural Chiapas, Mexico.

Methods

To address the emerging health needs of the general population and health professionals resulting from the pandemic, Compañeros En Salud (CES), a non-profit civil society organization based in Chiapas, implemented a comprehensive strategy to compensate for the shortage of mental health services in the region in collaboration with the Chiapas Ministry of Health. The strategy included three components: capacity building in mental health care delivery, psychosocial support to the general population, and provision of mental health care to CES collaborating staff. In this capacity building article, implementers from CES and the government share descriptive information on the specific interventions carried out and their beneficiaries, as well as a critical discussion of the strategy followed.

Results

Through this strategy, we have been successful in filling the gaps in the public health system to ensure that CES-served populations and CES-collaborating health professionals have access to mental health care. However, further studies to quantify the impact of this intervention in alleviating the burden of mental health illnesses associated with the pandemic are needed.

Conclusions

The current situation represents an opportunity to reimagine global mental health. Only through the promotion of community-based initiatives and the development of integrated approaches will we ensure the well-being of marginalized populations.

KEYWORDS:

• Psychosocial support
• capacity building
• low- and middle-income countries
• task-sharing
• community mental health

Responsible Editor

Julia Schröders

Responsible Editor

Julia Schröders

Acknowledgments

We thank Paola Rodriguez-Cuevas for her support in the design of the figures included in this manuscript. We thank Vivian Chung and specially Gerogina Miguel-Esponda and Harvey Aspelling-Jones for proofreading the manuscript prior to submission. We greatly appreciate the hard work of the community mental health workers who have made it possible to combat the mental health burden associated with the pandemic in the rural communities supported by CES.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Ethics and consent

Due to the descriptive nature of this work, institutional review board approval was not applicable in this case. Nevertheless, all interventions implemented by CES and the MoH described in the manuscript received approval from the management of the basic community hospital of Ángel Albino Corzo when applicable and from the authorities of the Health Jurisdictions IV and X of Chiapas, always within the framework of the ethical guidelines stipulated by the MoH.

Paper context

The mental health of marginalized populations has been most affected by the COVID-19 pandemic due to the limited human, economic, and social resources available. This article describes a public-civil partnership initiative to address the increased burden of mental illness in rural Mexico through capacity building and mental health care for health professionals and provision of psychosocial support for the general population. This is an opportunity to reimagine global mental health through comprehensive community-based initiatives.

Additional information

Funding

The publication was made possible by the support of The Wagner Foundation.

Notes on contributors

Ana Cecilia Ortega

FGRC, ACO, EV and ZA contributed equally in the design of the work, the drafting, review and editing of the work, and revising the article. GP and SM contributed equally to the design of the work and drafting. All co-authors are accountable for all aspects of the work.