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The Research Study 3

2.1. Background of the Study

2. The Research Study

Mental disorders account for 22% of diseases within Latin America

and the Caribbean, as noted in the World Health Organization’s (WHO)

recent mental health assessment in 2009 (“WHO-AIMS,” pg. 9). In 1990,

rough estimations showed that neurological and mental disorders within

these regions were reported at 8.8% (pg. 11). This shows a dramatic

increase in the rate of occurrences for countries located in this region. The

Pan-American Health Organization (PAHO) states in their 2005 study on

community-based mental disorders that there is a 1% annual increase for

affective psychoses, 4.9% for major depression, and 5.7% for alcohol abuse

and substance dependence (pg. 11).

Within this framework the majority of services available to

populations in need are located within capital cities and urban areas (pg.

37; Santana and Rathe, pg. 93). Though most servicing is centralized,

the current most affected areas are rural. Of the six countries evaluated

by the who, the Dominican Republic reported that rural users are

substantially underrepresented in their use of inpatient and outpatient

services (“WHO-AIMS,” pg. 22). Given this situation, it is of extreme

importance to identify what services are available to rural users and

the rates of occurrence in order to provide servicing and highlight any

links that may occur with other national problems such as drug usage


While servicing is limited in rural populations, providers have

managed to persevere with the resources at their disposal. Primary care

health providers are the main purveyors of mental health servicing in rural

areas, though they are poorly trained to handle psychosocial problems.

Data collected on mental health training for physicians and nurses in

the Dominican Republic shows that 4% of training hours are devoted to

mental health in nursing schools and 3% in medical schools or faculties

("WHO-AIMS,” pg. 25, Table 9).

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