The program is based on four principles:
CES clinics are staffed by pasantes, young Ministry of Health (MOH) generalist physicians completing a year of service, who provide pharmacologic and non-pharmacologic treatments and are equipped with antidepressant and antipsychotic medications. Within the community, acompañantes (community health workers) provide basic psychoeducation and monitor treatment adherence, and refer patients to care. CES, in collaboration with Instituto Tecnologico de Estudios Superiores de Monterrey (ITESM) medical students, conducts active-case finding for patients with chronic diseases, including depression.
In partnership with the ITESM, CES pasantes receive a diploma in Social Medicine and Global Health in Mexico. This involves monthly trainings on best clinical practices, how to diagnose and treat mental health problems, and social subjects. CES acompañantes complete a psychoeducation course focusing on working with patients with depression and that features expert patients describing what it is like to live with depression, so that acompañantes can give the most empathetic care possible.
As a private organization partnering with the government, CES is committed to advocating for mental health care throughout Mexico. The staff work to improve the reliability of the supply chain and encourage the MOH to increase the amount of mental health medication purchased. Aggregate patient data can also be used to demonstrate the burden of disease related to mental health to government officials.
Like all Partners in Health (PIH) sister organizations, CES is committed to research informed by service delivery needs. A recent project assessed the validity of the PHQ-21 and the PHQ-92 for screening and diagnosis of depression in rural Chiapas. A second project determined the prevalence of depression in rural communities and primary care clinics in Chiapas.
Ongoing projects include: Chronic Psychosis Case Series – Treatment of Psychosis in Rural Primary Care Clinics3-6.