Development of an alternative, efficient, low cost mental health delivery system in Cali, Colombia

Summary

A new program was developed for the delivery of mental health services in Cali, Colombia utilizing auxiliary nurses who were given special training and supervision. In order to evaluate this program, equivalent groups of 30 patients each, who came to the psychiatric emergency room, were treated over a three-month period by the auxiliary nurses or by the “traditional” service which relies mostly on interns and residents. It was found that the experimental program produced a greater decrease in symptoms as measured by psychiatric ratings and by a self-report scale. A questionnaire completed by family members also revealed a similar difference. No differences were found between the two systems on patients attitudes toward services, on a self-esteem scale, or on a social adjustment scale. The cost of the new program was somewhat less than the traditional one. The results suggest that the new system should continue to be used and evaluated.