Gaps in the Implementation of Mental Health Policies and Clinical-Psychosocial Support in the Prevention of Relapse in Schizophrenia: A Qualitative Study
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Abstract
Schizophrenia is considered one of the leading disabling mental disorders due to its chronic nature, high relapse rates, and detrimental impact on quality of life and social functioning. Although community mental health public policies (CMHPPs) have promoted models centered on clinical-psychosocial support (CPS), significant gaps persist in their implementation, particularly in rural settings. The aim of this study was to understand the gaps in the implementation of public policies and clinical-psychosocial support aimed at preventing relapse among patients with schizophrenia in Apurímac, Peru. A qualitative study with an interpretive orientation and hermeneutic phenomenological design was conducted. Ten community mental health professionals were purposively selected to participate. Data were collected through semi-structured in-depth interviews and analyzed using reflexive thematic analysis supported by Atlas.ti software. The findings revealed discontinuity of care, institutional fragmentation, weak intersectoral coordination, and territorial inequalities in access to specialized services. In addition, CPS was implemented heterogeneously and largely dependent on local capacities. The study concludes that gaps in the implementation of public policies limit continuity of care and undermine the sustainability of relapse prevention strategies for patients with schizophrenia
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