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Camagueyan Psychiatry: four decades focused on the community

 

(Psychiatric Hospital Camaguey (outside), Cuba

Hospital services generally respond to the needs of those who are hospitalized; however, all specialists at René Vallejo Psychiatric Hospital in Camagüey, Cuba, are proud of their forty years of history working with and bringing their knowledge to the community.

A novel concept of psychiatric care preceded the opening of the Hospital on April 19, 1972. In 1967, a community and outpatient care facility was already offering follow-up to patients discharged from the old Psychiatric Hospital. They were reintegrated to their family environment, medically treated and received support from social workers, as well as food on the day of the appointment, all for free.

Undoubtedly, offering graduate and undergraduate studies to Cuban and foreign medical students, using community and group techniques, being the first institution in the country to establish a day hospital for psychotic patients, -and one of the first to open a Crisis Intervention Unit (CIU)-, together with the development of other in-patient services  -such as stomatology, laboratory, imagenology and natural and traditional medicine- have placed this hospital at a leading position and as an example of quality and excellence in Cuba and Latin America. Today there are just over 300 beds, out of the 700 conceived in its beginnings; this reduction was made possible thanks to a successful psychosocial rehabilitation program.

The first community based psychiatry plan was discussed in Camagüey in 1968. In 1973, its functional structure was adapted to the primary health care network of that moment (six polyclinics in the city of Camagüey). They established a Council of Families that grouped together relatives of discharged and hospitalized patients with other groups of society involved in the process of improving services. Thus, the new concept of mental health and psychosocial rehabilitation outside the hospital walls came true as something feasible.

Agramonte Park is part of the historic center of the city of Camaguey, which was declared by the UNESCO Cultural patrimony of the humanity, on February 2, 2009

As of 1995, a new model of services was developed: the Community Mental Health Centers, which allowed to improve the quality of care for people with mental disorders and minimize the need for hospitalization. Four years later, the continuous training offered to professionals and technicians facilitated the opening of these centers in all the municipalities of Camaguey.

The Center’s Director, Dr. Jorge Balseiro Estévez, remarked that patients should receive treatment as close as possible to their natural environment and family because, through their own experiences in their milieu, mental disorders can be overcome and a real and long lasting rehabilitation can be achieved.

He also pointed out that, in keeping with the development achieved by primary care and mental health community services, the hospital has been resized. Its structure and function exclusively fulfill a secondary level role. On the other hand, due to current economic conditions, it also ensures proper and decent care for patients with serious limitations or problems in their family environment.

The current model for dealing with persons with mental health disorders in the province of Camagüey favors the community approach and outpatient care over the old hospital-asylum focused concept. The Pan American Health Organization (PAHO) has recognized the enormous progress of mental health services and programs in Cuba, Camagüey being an example.

Original contribution (in Spanish) of Olga Lilia Vilató de Varona, Cuban journalist, “Semanario Adelante.” Recognized specialist in health issues and blogger. We recommend  her blog CuquiSalud: http://cuquisalud.blogia.com/

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