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Title: Reducing excess mortality of people with mental disorders: A policy-document analysis of the Peruvian Mental Health Reform
Other Titles: Reduciendo el exceso de mortalidad en personas con trastornos mentales: un análisis documentario de políticas sobre la reforma de salud mental peruana
Advisor(s): Avendano, Mauricio
OCDE field: https://purl.org/pe-repo/ocde/ford#3.00.00; https://purl.org/pe-repo/ocde/ford#3.02.24
Issue Date: Sep-2020
Institution: University of London (London School of Hygiene and Tropical Medicine)
Abstract: Introducción: Las personas con trastornos mentales mueren hasta 30 años antes que la población general. Este estudio exploró hasta qué punto se reconoce este exceso de mortalidad como un tema relevante en la reforma de salud mental peruana. Método: Usando documentos de políticas, se analizó mediante análisis de contenido el rol de los actores, ideas, contextos políticos y características de los problemas siguiendo el marco de Shiffman y Smith (2007). Hallazgos: Se analizaron 25 documentos (políticas gubernamentales, artículos científicos, informes de sociedad civil). Los actores principales fueron los decisores de políticas y los investigadores, quienes indicaban que el exceso de mortalidad era un problema importante de abordar. 2014-2018 apareció como un contexto político favorable, cuando se publicaron la mayoría de documentos en los que se expresaba el tema. Sin embargo, los documentos principalmente declaraban la relevancia y necesidad de reducir el exceso de mortalidad, pero no mencionaban estrategias explícitas para hacerlo. Conclusiones: El exceso de mortalidad ha ido ganando lugar en la agenda de la reforma de salud mental, en el que algunos determinantes propuestos por Shiffman y Smith's (2007) ayudaron a su posicionamiento, pero algunos otros aún serían necesarios para expandir este posicionamiento.

Aim: People with mental disorders (PMD) die up to 30 years earlier than the general population. This policy report explored the extent in which excess mortality of PMD was recognised as a relevant issue in the Peruvian Mental Health Reform (MHR) agenda, by analysing the role of actors, ideas, political contexts, and issue characteristics proposed by the Shiffman and Smith’s (2007) framework. Findings: A total of 25 documents were analysed, including government policies, research articles and civil society’s reports. Main actors were policymakers and researchers, who portrayed the idea that excess mortality was an important problem to address; and 2014-2018 appeared as a favourable Political context, when most documents stating the issue were published. Nonetheless, excess mortality’s characteristics were not entirely considered, since documents mainly declared its relevance and the need to reduce it; but did not explicitly mention strategies to do so. Recommendations: 1) Expand the agenda setting of excess mortality, by involving professional associations and users-led organisations; framing it in a way that resonates with political leaders; and explicitly present interventions to reduce it. 2) Define which effective interventions to reduce excess mortality will be implemented, by updating legislation to incorporate the goal of reducing excess mortality and tailoring effective interventions to the local context. 3) Strengthen the role of research to set excess mortality into MHR agendas, through conducting local research to inform policy guidelines; building research-capacities in policy communities; enhancing partnerships among policymakers and researchers; and positioning excess mortality into global funders’ priorities. Conclusions: The study found that excess mortality has been gaining position into the Peruvian MHR agenda; in which some determinants proposed by Shiffman and Smith’s (2007) helped its positioning, and some others would still be needed to expand the agenda setting.
Discipline: Salud Mental Global
Grade or title grantor: University of London (London School of Hygiene and Tropical Medicine)
Grade or title: Maestra en Ciencias en Salud Mental Global
Register date: 26-Jul-2021

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