Challenges in Accessibility of Public Specialized Mental Health Services for Children and Adolescents in Mexico

Abstract

Specialized mental health services (SMHS) should be accessible to all populations. This study investigated the accessibility of public SMHS for children and adolescent patients, as well as their caregivers, in Mexico. A cross-sectional survey was conducted with 400 patient–caregiver dyads receiving care at two primary SMHS facilities. The survey included indicators within four dimensions of accessibility: (1) organizational entry into SMHS; (2) organizational processes within SMHS; (3) ecological factors; (4) financial aspects. Additionally, six outcome variables were explored, including perceived health conditions and quality of care indicators. A principal component analysis (PCA) was utilized to construct four accessibility indices. Subsequently, multiple linear regression models were applied to examine the relationship between these accessibility indices and the outcome variables. Several indicators yielded notable results. The average emergency ward waiting time was 74.3 min (SD = 95.99), the post-hospitalization wait time was 1.28 weeks (SD = 1.85), and the average medical costs amounted to 962.6 Mexican pesos (SD = 2555.1). Several of the tested relationships between accessibility indices and outcome variables were statistically significant; organizational processes within SMHS and financial indices had a higher number of these significant relationships. These findings highlight the significant challenges in improving accessibility to public SMHS for children and adolescents in Mexico.