The challenge of inclusion in mental health: an analysis of a community center and its work with social bonds

Social inclusion is a key component of transformations in mental health care, because it takes into account the benefits of community life for both those with mental illness and the other members of the community. In order to understand the scope of inclusion within mental health, 45 participants of a community center linked to a psychiatric hospital discharge program which explicitly seeks to provide social inclusion were interviewed. The possible changes in social relationships between users and other community members based in their sustained daily interactions in the community center were explored. Results suggest that the building of social bonds, as part of informal support networks, is one of the benefits of attending the community center. Positive changes in ideas regarding people with “mental illness” were also observed, although these ideas seemed to be more connected to the notion of integration than to social inclusion

El desafío de la inclusión en salud mental: análisis de un centro comunitario y su trabajo sobre los vínculos sociales

Social inclusion is a key component of transformations in mental health care, because it takes into account the benefits of community life for both those with mental illness and the other members of the community. In order to understand the scope of inclusion within mental health, 45 participants of a community center linked to a psychiatric hospital discharge program which explicitly seeks to provide social inclusion were interviewed. The possible changes in social relationships between users and other community members based in their sustained daily interactions in the community center were explored. Results suggest that the building of social bonds, as part of informal support networks, is one of the benefits of attending the community center. Positive changes in ideas regarding people with “mental illness” were also observed, although these ideas seemed to be more connected to the notion of integration than to social inclusion.La transformación de la atención en salud mental supone tomar como eje de trabajo la inclusión social, considerando tanto los beneficios que la vida comunitaria trae para las personas con trastorno mental, como los que podría tener para las demás personas de la comunidad. Con el fin de analizar los alcances de la inclusión en salud mental, se entrevistó a 45 asistentes a un centro comunitario vinculado a un programa de externación de un hospital psiquiátrico, el cual busca explícitamente propiciar la inclusión social. Se indagó sobre las posibles transformaciones en las relaciones sociales entre personas externadas y otros miembros de la población, a partir de la interacción cotidiana y sostenida en dicho centro. Los resultados sugieren que uno de los beneficios que encuentran los asistentes es el establecimiento de vínculos, ligados al apoyo informal. A su vez, se observan transformaciones positivas en las ideas respecto a las personas con “enfermedad mental”, aunque las mismas parecieran estar más del lado de la integración que de la inclusión social

Neighborhood living with psychiatric patients and its impact on community attitudes: study in the Province of Buenos Aires, Argentina. 2012-2013

Objetivo: Analizar las transformaciones producidas en la comunidad de vecinos al tener entre sus miembros a personas externadas de hospitales psiquiátricos. Métodos: Estudio observacional analítico en el que se compararon zonas de vecinos de casas de convivencia en las que habitan personas externadas de un hospital psiquiátrico y zonas equivalentes pero sin casas de convivencia. Se elaboró y aplicó un cuestionario a 236 personas (grupo de estudio n=117; grupo control n=119), que indagaba por características del barrio, actitudes frente a poblaciones específicas e ideas frente a la enfermedad mental y su tratamiento. También se analizó una sub-muestra de vecinos (n=9) con otro cuestionario que exploraba por la convivencia barrial con las personas externadas y sus efectos. El análisis de los datos fue cuantitativo (SPSS 18.0) y cualitativo. Resultados: Se destaca la asociación estadísticamente significativa entre ser vecino y el grado de aceptación hacia personas con "enfermedad mental", y entre el grado de cohesión social y la aceptación de la "enfermedad mental". Conclusiones: La convivencia barrial con personas externadas tendría efectos en la salud mental de la comunidad, entendida ésta en términos psicosociales. Indexada en: Latindex Catálogo, Latindex Directorio.Objective: To analyze the effects on the neighbors’ attitudes related with the community living with people discharged from a psychiatric hospital. Methodology: Observational analytical study where two groups were compared: one composed by neighbors of group homes for discharged patients from a psychiatric hospital (study group, n = 117) and the other composed by an equivalent area but without group homes nearby (control group, n = 119). A questionnaire was administered to both groups and it explored: neighborhood features, attitudes toward certain groups, attitudes toward mental illness and its treatment. A sub-sample of the study group (n = 9) was re-contacted and a new questionnaire was administered with the purpose to analyzed in depth the community life with the group home tenants and its effects on the neighborhood and the neighbors. Data was analyzed quantitatively (SPSS 18.0) and qualitatively. Results: It was found a statistically significant difference between the study and the control group regarding acceptance toward people with mental illness. Also, and association between the level of social cohesion and the acceptance toward people with mental illness, was found. Conclusions: Community life with people discharged form psychiatric hospital would have an effect on the neighbors’ attitudes, which could be seen as a dimension of the community mental health.Fil: Ardila Gómez, Sara Elena. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Universidad Nacional de Lanus. Departamento de Salud Comunitaria; Argentina. Universidad de Buenos Aires. Facultad de Psicología; ArgentinaFil: Fernández, Marina. Universidad de Buenos Aires. Facultad de Psicología; ArgentinaFil: Hartfiel, María Isabel. Universidad Nacional Arturo Jauretche; ArgentinaFil: Guadalupe, Ares Lavalle. Universidad de Buenos Aires. Facultad de Psicología; Argentina. Universidad Nacional de Lanus. Departamento de Salud Comunitaria; ArgentinaFil: Borelli, Mariana. Universidad Nacional de Lanus. Departamento de Salud Comunitaria; ArgentinaFil: Canales, Valeria. Universidad Nacional de Lanus. Departamento de Salud Comunitaria; ArgentinaFil: Stolkiner, Alicia Ines. Universidad Nacional de Lanus. Departamento de Salud Comunitaria; Argentin

‘Now you will understand what it is like to be confined’: Did COVID-19 lockdowns affect perceptions about long-term psychiatric hospitalizations? A report from Argentina

Background: Lockdowns have been one of the government’s primary measures to control COVID-19, especially during the initial waves of the pandemic, but there is concern on the impact of lockdowns on people’s mental health. Confinement is still today the reality of many people with severe mental illness in many places of the world. Objective: Given that the general population experienced confinement during the COVID-19 pandemic, we sought to explore if that affected perceptions about long-term psychiatric hospitalizations. Methods: About 134 residents from middle-class neighborhoods in urban settings in the Province of Buenos Aires, Argentina, were surveyed. Participants were asked if they felt emotionally affected by the pandemic and lockdown, and about their perceptions of long-term psychiatric hospitalizations. Association between personal emotional impact by the pandemic or lockdown with perceptions about long-term psychiatric hospitalization were analyzed using chi-square test. Qualitative analysis of pandemic and lockdown effects was held. Results: Respondents tended to overlap the emotional effects of the pandemic and the lockdown. Some responses explicitly referred to confinement. No association was observed between emotional impact by the pandemic or lockdown and perceptions about long-term psychiatric hospitalization among the sample. The general population’s perceptions of long-term psychiatric hospitalization do not appear to be affected by the first-hand experience of confinement, which suggest persistence of stigma, and the need to reconsider public policies and actions that attempt to impact on it.Fil: Fernandez, Marina Ayelen. Universidad de Buenos Aires. Facultad de Psicología. Instituto de Investigaciones; ArgentinaFil: Guadalupe, Ares Lavalle. Universidad de Buenos Aires. Facultad de Psicología. Instituto de Investigaciones; ArgentinaFil: Murlender, Liza Inés. Universidad de Buenos Aires. Facultad de Psicología. Instituto de Investigaciones; ArgentinaFil: Agudo Agresti, Martin Ricardo. Proyecto Suma; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; ArgentinaFil: Ardila Gómez, Sara Elena. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Universidad de Buenos Aires. Facultad de Psicología. Instituto de Investigaciones; Argentin

Convivencia barrial con pacientes psiquiátricos y sus efectos en las actitudes de la comunidad: estudio en la Provincia de Buenos Aires, Argentina. 2012-2013

Objetivo: Analizar las transformaciones producidas en las actitudes de la comunidad de vecinos al tener entre sus miembros a pacientes psiquiátricos. Metodología: estudio observacional analítico en el que se compararon zonas de vecinos de casas de convivencia en las que habitan pacientes psiquiátricos atendidos ambulatoriamente y zonas equivalentes pero sin casas de convivencia. Se elaboró y aplicó un cuestionario a 236 personas (grupo de estudio n = 117; grupo control n = 119), que indagaba por características del barrio, actitudes frente a poblaciones específicas e ideas frente a la enfermedad mental y su tratamiento. También se analizó una sub-muestra de vecinos (n = 9) con otro cuestionario que exploraba por la convivencia barrial con los pacientes psiquiátricos y sus efectos. El análisis de los datos fue cuantitativo (SPSS 18.0) y cualitativo. Resultados: se destaca la asociación estadísticamente significativa entre ser vecino y el grado de aceptación hacia personas con “enfermedad mental”, y entre el grado de cohesión social y la aceptación de la “enfermedad mental”. Conclusiones: la convivencia barrial con pacientes psiquiátricos tendría efectos en las actitudes de los vecinos, las cuales podrían ser vistas como una dimensión de su salud mental, entendida ésta en términos psicosociales

Social Perceptions About Community Life with People with Mental Illness: Study of a Discharge Program in Buenos Aires Province, Argentina

Effects of living near people with mental illness in community settings have been researched as part of psychiatric reform evaluation. However, these studies have been carried out mostly in industrialized countries, where social contexts differ from those in which psychiatric reform is now being implemented. To analyze the effects of community life with people with mental illness in the neighborhoods in which they live, in Buenos Aires, Argentina. A questionnaire was administered to randomly-selected neighbors of group homes of a discharge program and an equivalent control area (n = 236). Data was analyzed both quantitatively and qualitatively. Significant differences were found between being a neighbor and having a high degree of acceptance toward people with mental illness. In addition, significant associations were found between neighbors having a high-perceived social cohesion and having a high level of acceptance toward the mentally ill. Living near people with mental illness is associated with better acceptance toward them; these results are congruent with those results found in other cultural contexts.Fil: Ardila Gómez, Sara Elena. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Universidad de Buenos Aires. Facultad de Psicología. Área de Salud Pública y Salud Mental; Argentina. Universidad Nacional de Lanus. Departamento de Salud Comunitaria; ArgentinaFil: Guadalupe, Ares Lavalle. Universidad de Buenos Aires. Facultad de Psicología. Área de Salud Pública y Salud Mental; Argentina. Universidad Nacional de Lanus. Departamento de Salud Comunitaria; ArgentinaFil: Fernández, Marina. Universidad Nacional de Lanus. Departamento de Salud Comunitaria; ArgentinaFil: Hartfiel, María Isabel. Universidad Nacional de Lanus. Departamento de Salud Comunitaria; ArgentinaFil: Borelli, Mariana. Universidad Nacional de Lanus. Departamento de Salud Comunitaria; Argentina. Programa de Rehabilitación y Externación Asistida; ArgentinaFil: Canales, Valeria. Universidad Nacional de Lanus. Departamento de Salud Comunitaria; ArgentinaFil: Stolkiner, Alicia Ines. Universidad Nacional de Lanus. Departamento de Salud Comunitaria; Argentin

The mental health users’ movement in Argentina from the perspective of Latin American Collective Health

The mental health users’ movement is a worldwide phenomenon that seeks to resist disempowerment and marginalisation of people living with mental illness. The Latin American Collective Health movement sees the mental health users’ movement as an opportunity for power redistribution and for autonomous participation. The present paper aims to analyze the users’ movement in Argentina from a Collective Health perspective, by tracing the history of users’ movement in the Country. A heterogeneous research team used a qualitative approach to study mental health users’ associations in Argentina. The local impact of the Convention on the Rights of Persons with Disabilities and the regulations of Argentina’s National Mental Health Law are taken as fundamental milestones. A strong tradition of social activism in Argentina ensured that the mental health care reforms included users’ involvement. However, the resulting growth of users’ associations after 2006, mainly to promote their participation through institutional channels, has not been followed by a more radical power distribution. Associations dedicated to the self-advocacy include a combination of actors with different motives. Despite the need for users to form alliances with other actors to gain ground, professional power struggles and the historical disempowerment of ‘patients’ stand as obstacles for users’ autonomous participation