Summary of Keynote Address |
Mr. Jesús Cabrera Solís
Mr. Cabrera described his program and its outcomes. He explained that the Youth Integration Centers are primarily state-sponsored civilian organizations, whose primary objective is to provide health care through offering such social services as prevention, treatment, rehabilitation, training, and research concerning the problem of drug addiction in the Mexican communities.
According to Mr. Cabrera, the Centers' 29 years of experience in this area have allowed them to develop and consolidate a holistic approach to the drug problem. As he pointed out, there are currently 52 regional centers, 10 offices, 2 training units, and 4 clinical projects located at strategic points throughout Mexico. The staff of 1,131 consists mainly of mental health professionals who provide interdisciplinary services and who are supported by a network of more than 10,000 volunteers. During 1997, Mr. Cabrera noted, the Centers provided 246,000 sessions to more than two million people. More than half of those (56 percent) were provided primary prevention services; 43 percent received awareness and direct promotion of services; and the remaining 1 percent received treatment and rehabilitation services. Professional staff saw about half of those served, he noted; the other half were seen by volunteers who mostly work in primary prevention and promotion. Most clients (92 percent) received information, 7 percent received guidance, and the remaining 1 percent received training. The Centers' community participation components involved more than 900,000 people who collaborated in activities designed to promote public health. The Centers placed a great deal of emphasis on reports to the community; presentation of research, books, and forums; and meetings of volunteers and health workers.
Mr. Cabrera stated that some 28,000 people have received therapeutic services through the Youth Integration Centers, almost all (99 percent) on an outpatient basis. The remaining 1 percent were hospitalized and received a range of treatment services. Nearly half (46 percent) of those assisted on an outpatient basis were substance abusers; the remainder were family members of substance abusers. A preconsultation visit was used to determine motivation for treatment, treatment expectations, and to promote awareness of clients' problems as well as ensure active participation in treatment, he pointed out. Two-thirds of the more than 12,000 drug users seen were classified as drug-dependent abusers, 28 percent as experimental or social users, and only 3 percent as repeat offenders. Four out of five were assisted in individual therapy; 30 percent participated in family therapy, while 20 percent were involved in group therapy. As appropriate, Mr. Cabrera explained, some cases received pharmacotherapy. Of the 2,700 Center "graduates," half (52 percent) reported being improved and cut short their treatment, a third obtained partial discharge, and 15 percent were discharged following improvement.
Lastly, Mr. Cabrera pointed out that of the 308 Center patients who were hospitalized, two-thirds were admitted to residential treatment. Of these, two-thirds experienced a total remission of drug abuse-related symptoms, a fifth had partial remission, and the remainder (16 percent) voluntarily withdrew from treatment. The other third of the patients who were hospitalized received treatment for drug overdoses and withdrawal and were then seen on an outpatient basis. Forty-four percent of those achieved full remission of symptoms, 47 percent achieved partial remission; and the remaining 9 percent did not complete treatment because of rule violations.
