Twelve-month utilization rates and adequacy of treatment for mental health and substance use disorders in Argentina

Objective: To estimate the 12-month prevalence of mental health services utilization (overall and by type of service sector), the adequacy of treatment provided, and sociodemographic correlates in the Argentinean Study of Mental Health Epidemiology (ASMHE). Methods: The ASMHE is a multistage probability household sample representative of adults in urban areas of Argentina. The World Health Organization World Mental Health Composite International Diagnostic Interview (WMH-CIDI) was used to evaluate psychiatric diagnosis and service utilization. Results: Among those with a disorder, 27.6% received any treatment in the prior 12 months. Of these, 78.3% received minimally adequate treatment using a broad definition and only 43.6% using a stringent definition. For individuals with a disorder, more services were provided by mental health professionals (17.7%) than by general medical professionals (11.5%) or non-healthcare sectors (2.6%). Younger individuals with low education and income were less likely to receive treatment; those never married and those with an anxiety or mood disorder were more likely to receive treatment. Among those in treatment, treatment was least adequate among younger individuals with low education and low income. Conclusions: Policies to increase access to services for mental health disorders in Argentina are needed, as is training for primary care practitioners in the early detection and treatment of psychiatric disorders.

La formación actual de especialistas en psiquiatría: un desafío epistemológico / [Present training for specialists in psychiatry: an epistemological challenge].

Teaching theoretical-technical knowledge aimed at training specialists in psychiatry at postgraduate level requires the explicitness of the theoretical model to which the curricula presented to students should be ordered. First, said model should be coherent with the general curricula for the medical training from which candidates to obtain the specialist degree graduate; second, it should serve to transmit theoretical elements, attitudes and skills that allow their work of excellence, which means acquiring the qualities considered relevant and necessary by the consensus among the members of a specialty, discipline or science (in our case, medical specialty in psychiatry) in the present historical moment. Reference points to meet them in the light of the present data concerning medical and psychiatric paradigms are developed. This article refers to those particular aspects with special emphasis on certain epistemological issues, from whose effects the same specialists do not escape, and which also condition their teaching practice, trying to show that an integrative pedagogical model is the one that best fits the contemporary historical conditions.