Perceptions on healthcare in people with self-identified mental health problems in the rural areas of Peru

Abstract

Person-centered health and community health perspectives on its needs and resources are mandatory in healthcare policies in highly cultural diverse contexts. From this point of view, epidemiology needs to be centered not only on the disease, but also on the health diagnosis and its context, including the points of view of people and the community about their problems and needs. This article describes and qualitatively analyzes the views of adults with self-identified mental health disorders (MHD) in rural regions on the coast, highlands, and jungle of Peru, as causal factors, personal resources, and healthcare expectations from health facilities, using the narrative approach of ideographic formulation proposed by the World Psychiatric Association. The database of mental health epidemiological studies from the National Mental Health Institute was used. The qualitative analysis on answers from 235 people reveals that a large part of MHD is linked to the dynamics of troubled families and to the loss of loved ones. The presence of scarce community resources that help overcome these problems is noted. Counseling is stressed among the expectations of healthcare at facilities; nevertheless, many people do not know what to expect from such healthcare. We believe that the narrative approach is an important tool as regards to community- and person-centered medicine and intervention strategy planning.