Access to mental health care is a worldwide public health challenge. In Mexico, an unacceptably high percentage of the population with mental disorders does not receive the necessary treatment, which is mainly due to the lack of access to mental health care. The community mental health care model was created and has been implemented to improve this situation. In order to properly plan and implement this model a precise situational diagnosis of the mental health care network is required, thus this is a first approach to evaluate the community mental health networks in the state of Jalisco. Two components from the EvaRedCom–TMS instrument were used including a general description and accessibility of the community mental health care network. A geographic and economic accessibility evaluation was carried out for the different regions of the state ranging from scattered rural to urban communities using information gathered from health institutions, telephone interviews and computer applications. Jalisco’s community mental health network includes a total of 31 centers and 0.64 mental health workers for every 10,000 inhabitants > 15 years of age. The mean transportation cost required to access mental health care was 16.25 USD per visit. The time needed to reach the closest mental health center in 7 of the 13 analyzed regions was more than 30 min and the mean time required to reach a prolonged stay center was 172.7 min with transportation cost (taxi, private and public transport) of 22.3 USD. Some marginalized regions in the state have a mean 114 min required to reach the closest mental health care center and 386 min to reach a prolonged stay center. This first approach to evaluate the mental health networks in Mexico showed that there are multiple barriers to access its care including an unfavorable number of human resources, long distances, and high costs. The identification of Jalisco’s mental health network deficiencies is the first step towards establishing a properly planned community mental health care model within the country.

中文翻译：

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墨西哥的社区精神卫生保健：中等收入国家的区域视角

获得精神卫生保健是一项全球性的公共卫生挑战。在墨西哥，精神障碍患者没有得到必要治疗的比例高得令人无法接受，这主要是由于缺乏精神卫生保健。社区精神卫生保健模式的创建和实施就是为了改善这一状况。为了正确规划和实施该模型，需要对精神卫生保健网络进行精确的情境诊断，因此这是评估哈利斯科州社区精神卫生网络的第一种方法。使用了 EvaRedCom-TMS 仪器的两个组件，包括社区精神卫生保健网络的一般描述和可访问性。利用从卫生机构、电话访谈和计算机应用程序收集的信息，对该州不同地区（从分散的农村到城市社区）进行了地理和经济可达性评估。哈利斯科州的社区心理健康网络共有 31 个中心，每 10,000 名 15 岁以上居民有 0.64 名心理健康工作者。每次就诊所需的平均交通费用为 16.25 美元。在 13 个分析区域中，有 7 个区域到达最近的精神健康中心所需的时间超过 30 分钟，到达长期停留中心所需的平均时间为 172.7 分钟，交通成本（出租车、私人和公共交通）为 22.3 美元。该州一些边缘化地区到达最近的精神卫生保健中心平均需要 114 分钟，到达长期停留中心需要 386 分钟。评估墨西哥心理健康网络的第一种方法表明，获得其护理存在多重障碍，包括人力资源数量不足、距离远和成本高。查明哈利斯科州精神卫生网络的缺陷是在该国建立适当规划的社区精神卫生保健模式的第一步。