Protocolo para la Implementación de Grupos de Apoyo Emocional en México

Objectives

The protocol establishes open weekly emotional-support groups to improve mental-health literacy in Mexico, providing accessible information and practical wellbeing tools through online or face-to-face sessions. It frames mental health as a public-health priority, particularly in the context of the COVID-19 pandemic, and emphasises promotion, prevention, early detection and care.[1][2]The intended outcome is to help people develop their abilities, manage everyday stress, remain productive and contribute to their communities.[3]

• Create safe, trustworthy spaces for dialogue between mental-health and addiction professionals and the public, using directive, explanatory and educational psychoeducation.[1]
• Improve understanding of mental health and recovery, distinguish illness from non-illness, and encourage timely help-seeking and early identification of biopsychosocial risk and protective factors.[4][5]
• Reduce stigma and the pathologisation of mental-health experiences, while promoting participation, mutual support, personal development and constructive relationships with care teams.[1][4]
• Prevent and address harmful substance use through motivational support for behavioural change and accessible information.[1][5]
• Develop coping, communication and problem-solving skills, particularly within families, so that participants can discuss conflict and tension more constructively.[4]
• Address interpersonal difficulties by helping participants recognise distorted perceptions, relationship patterns and behavioural problems, and supporting them to make changes.[4][6]
• Target the general population aged over 14, principally through first-level care units, while allowing delivery in general and specialist hospitals, educational settings, workplaces and other sectors.[3]
• Cover priority subjects including anxiety, self-care, caregiving, child and adolescent mental health, substance use, depression, self-harm and suicide, violence, post-traumatic stress, psychosis, grief and burnout.[7]

Implementation

The delivery model centres on weekly psychoeducational support groups, primarily conducted virtually but available face-to-face when health circumstances permit.[3]Groups combine accessible professional guidance, participant interaction and practical reflection on everyday life, using interpersonal group-work principles to promote hope, information-sharing, social learning, emotional expression and exploration of family conflict.[4]The Secretariat for the Technical Council for Mental Health within Mexico’s Ministry of Health is identified as the responsible technical body, with contributions and review involving federal health institutions and the Government of Yucatán.[8]

• Deliver a standard programme of 12 weekly sessions lasting approximately 60 to 120 minutes, with flexibility to expand the programme in response to population needs.[3]
• Assign two mental-health professionals to each group: an experienced therapist to coordinate the session and present the subject, and a co-therapist to explain rules, manage questions and provide available referral contacts.[3]
• Invite subject specialists where appropriate, provided that they can communicate complex issues in clear and accessible language.[3]
• Maintain groups at a size that enables participation, preferably 10 to 12 people; the guidance notes that fewer than four or five participants may not provide sufficient group interaction, while more than 24 may leave some participants marginalised.[7]
• Use dynamic psychoeducation based on open questions, reflective listening, positive reframing, concise summaries and self-motivation statements, adapting content to participants’ educational level, intellectual circumstances and life experience.[5]
• Position the group as a social microcosm in which participants can identify, examine and modify interpersonal patterns, with group therapy able to complement other therapeutic approaches.[6]
• Provide direct guidance during emotionally engaged discussion to clarify concepts, connect them with daily life, support personal reflection and encourage bio-psycho-social development.[6]
• Establish the digital conditions for virtual delivery, including stable internet access, an appropriate computer or mobile device, videoconferencing software and a platform able to host at least 30 people.[7]
• Protect orderly participation by giving the session host control of participant audio and video, and using passwords and participant-identification functions where available.[7]
• Promote the programme three or four weeks before launch through a poster listing the full session schedule, then circulate topic-specific posters one week before each session.[7]
• Link mental-health and addiction services with institutions, sectors, programmes and strategies to strengthen an integrated service network and engage society in prevention and mental-health protection.[6]
• Use supporting initiatives and materials, including the National Strategy for Addiction Prevention, Mental Health Support Brigades, the National Telementoring Programme, Code 100 for suicidal behaviour in general hospitals, Clubs for Peace, Contacto Joven, reading clubs and topic-specific information booklets.[6][9]
• Record participant names in the chat as a basic measure of group productivity; the available text does not specify a wider evaluation framework, formal indicators, reporting schedule or accountability mechanism.[7]
• Provide the required operational resources, although no budget, financing source, implementation cost or resource-allocation arrangement is specified.[7]

Monitoring & Evaluation

Monitoring and accountability provisions are limited. The protocol identifies a basic participation-based reporting practice, but does not establish a comprehensive monitoring, evaluation, surveillance or formal accountability framework.[7]

• Record participant names entered in the session chat as a means of reporting group productivity.[7]
• Use the delivery model to support early detection, help-seeking, stigma reduction, identification of biopsychosocial risk and protective factors, and motivational support for change, although no corresponding outcome indicators or measurement methods are specified.[5]
• Operate weekly groups, normally through a 12-session structure that may be expanded according to population needs; however, the protocol does not define attendance targets, completion measures, quality standards or thresholds for expansion.[3]
• Maintain group sizes that enable participation, preferably 10 to 12 people, while recognising that groups below four or five participants may lack critical mass and groups above 24 may marginalise participants. This is operational guidance rather than a formal performance indicator.[7]
• Facilitate sessions through a lead therapist and co-therapist, with the latter managing questions and referral contacts where available, but without specifying supervisory processes, referral tracking, incident reporting or provider accountability arrangements.[3]
• Use secure virtual-delivery features, including host control of audio and video, passwords and participant identification where possible, but without setting requirements for data collection, confidentiality auditing or information-governance reporting.[7]
• Recognise that the responsible technical body is the Secretariat for the Technical Council for Mental Health in Mexico’s Ministry of Health, with input from federal health institutions and the Government of Yucatán; the excerpts do not assign monitoring responsibilities, reporting lines or enforcement powers to these bodies.[8]
• Note that the introduction positions mental health as a public-health priority requiring promotion, prevention, early detection and care, but it does not provide a results framework for assessing progress in these areas.[2]
• Link services with institutions, sectors, programmes and strategies to form an integrated health-service network, but do not specify indicators for intersectoral coordination, coverage, referrals or service outcomes.[6]
• Provide psychoeducation on a broad range of priority issues, including substance use, depression, self-harm and suicide, violence, post-traumatic stress, psychosis, grief and burnout, without specifying topic-level monitoring or surveillance measures.[7]
• Leave evaluation methods, formal indicators, reporting frequency, surveillance systems and accountability mechanisms unspecified in the supplied excerpts, including the sections on group techniques, supporting materials and bibliography.[1][4][9][10]

Costing & Financing

No implementation budget, financing mechanism, funding source, resource-allocation formula, resource-mobilisation plan or funding-gap estimate is specified. The protocol nevertheless presents mental-health investment as economically beneficial and identifies several operational resources needed for delivery.[2][7]

• Identify an economic rationale in which each peso invested in mental health is associated with a return of four pesos through improved health and productivity; the excerpts do not describe the methodology, time horizon, payer or conditions underlying this estimate.[2]
• Describe mental disorders as imposing high social costs and accounting for 12% of the global burden of disease and up to 28% of years lived with disability, but do not translate these estimates into a national cost projection or programme budget.[2]
• Require practical delivery inputs including stable internet connectivity, a suitable computer or mobile device, videoconferencing software and a platform able to host at least 30 people. No unit costs, procurement arrangements or recurrent expenditure estimates are provided.[7]
• Use two mental-health professionals for group delivery, comprising an experienced coordinating therapist and a co-therapist, with possible participation by subject specialists. The protocol does not specify remuneration, staffing allocations, workload assumptions or financing for this workforce.[3]
• Plan promotional activity three or four weeks before the first session and topic-specific promotion one week before each session, but do not specify communications costs or a funding source.[7]
• Target people aged over 14 principally through first-level care units, with potential extension to hospitals, educational settings, workplaces and other sectors. No costs are provided for expansion across these settings.[3]
• Support participants through basic-information booklets on mental health and substance-use topics, but do not provide production, distribution or adaptation costs.[6][9]
• Reference linked initiatives, including the National Strategy for Addiction Prevention, Mental Health Support Brigades and the National Telementoring Programme, but do not specify their budgets, financing relationships or contributions to the support-group protocol.[6]
• Leave costs, budgets, financing sources, resource mobilisation, funding gaps and economic assumptions unspecified in the remaining supplied sections.[8][1][5][4][10]