[Design and implementation of an epidemiological surveillance system for mental health]. / Diseño y puesta en marcha de un sistema de vigilancia epidemiológica en salud mental.

OBJECTIVE: To design and test a surveillance system to detect and rank the most significant mental health problems in a community and to establish their association with the living conditions in that community. METHODS: The system was designed and tested at a primary health care center in the community of La Florida, which is in the metropolitan region of Santiago, the capital of Chile. The health problems that were under surveillance, with monthly monitoring, were: addiction (to alcohol, tobacco, and benzodiazepines or other drugs), violence (domestic violence and sexual abuse, real or suspected), and disorders in children (attention deficit and behavioral disorders). By means of a computerized geographical information system (GIS), those surveillance data were combined with other data. These other data included sociodemographic information on the persons who went to the health center for care as well as data on local risk factors and protective factors for health problems, some of which are indicators of the local residents' living conditions. RESULTS: The proposed epidemiological surveillance system, which takes into account local living conditions and environmental variables, is a good tool for health action. The proposed system also complements the incomplete perspective of monitoring systems, which do not include variables describing the local context and that focus only on health problems. The information synthesized in the GIS maps makes it possible to simultaneously display different layers of information on factors related to the health problems studied, linked to a specific area and all its environmental variables, in an easy-to-read, self-explanatory format. CONCLUSIONS: These results and the concurring opinions of the participating physicians show that the experimental system effectively met the basic requirements of an epidemiological surveillance system of this kind.

Diseño y puesta en marcha de un sistema de vigilancia epidemiológica en salud mental / Design and implementation of an epidemiological surveillance system for mental health

Objetivos. Diseñar y poner a prueba un sistema de vigilancia que permita detectar y jerarquizar los problemas más relevantes de salud mental y establecer su asociación con las condiciones de vida de la comunidad estudiada. Métodos. El sistema se diseñó y puso a prueba en un centro de salud de la comuna La Florida, región metropolitana de Chile. Los problemas de salud que se sometieron a vigilancia con seguimiento mensual fueron: adicción (al alcohol, tabaco, drogas y benzodiazepinas), violencia (violencia o sospecha de violencia intrafamiliar y abuso sexual) y trastornos en niños (déficit de atención y trastornos de conducta). Mediante un sistema computacional de información geográfica se combinaron estos elementos con datos sociodemográficos de las personas que acudieron a consulta y con datos territoriales que pueden considerarse factores protectores o de riesgo de los problemas de salud, y algunos de los cuales constituyen indicadores de las condiciones de vida de las personas. Resultados. Se probó que el sistema de vigilancia epidemiológica propuesto ­que incorpora las condiciones de vida y las variables ambientales­ es una buena herramienta para la acción en salud y complementa la visión parcial de los sistemas de seguimiento, que no incluyen variables de contexto y se centran sólo en los problemas de salud. La información sintetizada en mapas permite visualizar simultáneamente diferentes capas de información sobre los factores relacionados con los problemas de salud estudiados, asociados a un territorio específico, con todas las variables ambientales que implican, en un formato de lectura ágil y evidente por sí mismo. Conclusiones. Estos resultados y la opinión convergente de los médicos participantes y usuarios permiten afirmar que el sistema de vigilancia epidemiológica puesto a prueba en fase experimental logró cumplir los requerimientos básicos de un método de esta naturaleza

Objective. To design and test a surveillance system to detect and rank the most significant mental health problems in a community and to establish their association with the living conditions in that community. Methods. The system was designed and tested at a primary health care center in the community of La Florida, which is in the metropolitan region of Santiago, the capital of Chile. The health problems that were under surveillance, with monthly monitoring, drugs), violence (domestic violence and sexual abuse, real or suspected), and disorders in children (attention deficit and behavioral disorders). By means of a computerized geographical information system (GIS), those surveillance data were combined with other data. These other data included sociodemographic information on the persons who went to the health center for care as well as data on local risk factors and protective factors for health problems, some of which are indicators of the local residents' living conditions. Results. The proposed epidemiological surveillance system, which takes into account local living conditions and environmental variables, is a good tool for health action. The proposed system also complements the incomplete perspective of monitoring systems, which do not include variables describing the local context and that focus only on health problems. The information synthesized in the GIS maps makes it possible to simultaneously display different layers of information on factors related to the health problems studied, linked to a specific area and all its environmental variables, in an easy-to-read, self-explanatory format. Conclusions. These results and the concurring opinions of the participating physicians show that the experimental system effectively met the basic requirements of an epidemiological surveillance system of this kind