Description of the state and its health regions
Mexico is divided into five mesoregions made up of several federative entities. The State of Jalisco is located in the central-western region with a territorial extension of 78,599km2 (Fig. 1). It contains the second largest Metropolitan area in the country: The Metropolitan Area of Guadalajara (ZMG, for its acronym in Spanish).
Fig. 1
Jalisco within Mexico
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Jalisco is made up of 125 municipalities, which in turn comprise 13 geographic and health regions (Fig. 2). Each health region has a main municipality or city and several municipalities, as shown in Table 1.
Fig. 2
Health regions in Jalisco
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Table 1 Description of the State of Jalisco
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The state has a population of 8,256,000 inhabitants, of which 6,057,265 are people over 15 years of age. Because the state’s mental health system is aimed at the population over 15 years old, this study considers this population as the object of study.
Mental health care in Mexico: conceptual definitions
Mental health services in Mexico are divided into different levels of care. The closest to community mental health care corresponds to the Comprehensive Mental Health Centers (CISAMEs), the second level to outpatient mental health care services in community and general hospitals, and the third level to psychiatric hospitals where outpatient care, and in some cases inpatient care, is provided. In Jalisco, the latter are the Center for Comprehensive Care in Mental Health for Short Stay (CAISAME-EB) and the Center for Comprehensive Care in Mental Health for Long Stay (CAISAME-EP).
The state of Jalisco has eight of the 54 Comprehensive Mental Health Centers (CISAMEs) in the country, being the state with most centers; the two states ranking second have four centers each. It is worth mentioning that eight states of the country do not have any CISAME, even in states with a greater geographic extension than Jalisco.
Instrument description
There are different instruments for the evaluation of community mental health networks, such as the Description and Evaluation of Services and Directories in Europe for Long-Term Care (DESDE-LTC) designed for the description and evaluation of health services for people with disabilities, being currently one of the most complete models [18]. A second instrument is the EvaRedCom–TMS, which was created in Chile to make a rapid evaluation of community mental health services in low and mid-income countries [17]. Its application is based on data that is easy to collect, such as access to care with distances, times and costs, along with information regarding resources and other specific indicators that are useful for the Assessment Instrument for Mental Health Systems (WHO- AIMS). For this reason and the fact that it has been used and validated in low and mid-income countries like Mexico, we decided to use this tool.
For this study, we have included 2 of the 4 components from the EvaRedCom instrument which include the following:
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A general description of the community care network including the institutions that make up the network, the human resources of each institution and the number of hours available to provide care considering the general population to which these services are available.
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The accessibility to the community care network which includes information on geographic accessibility, that is, travel times, expressed in minutes and hours, to mental health services and the transportation cost of the round-trip to the mental health care center, expressed in dollars (19.90$, value as of December 2019).
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The third component which includes the prevalence of people with Severe Mental Disorders within the community care network was not included due to the fact that there is a void regarding the information required to complete this section especially considering the nonurban prevalence of mental illness.
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The fourth component contains the information regarding the coordination and operation of the community network, including periodic reviews, technical advice of the network, its management, activities that are developed and a rating of the network coordination strategy [17].
Source of information
The general description of the community care network was obtained through the health centers databases, which depends on the State Health Secretariat. The main health center of each municipality was taken as a reference and starting point for the analysis of geographic and economic accessibility.
Through direct contact with health institutions, information was requested regarding the number of human resources in mental health (a rate was calculated per 10,000 inhabitants with > 15 years of age) and the hours available for clinical care per week (7.5 h/day and 37.5 h/week for each professional).
Geographic accessibility and transportation costs
The geographic and economic accessibility evaluation was carried out under three methodologies: A (from region one to nine), B (region 10 and 13) and C (region 11 and 12), which are explained below:
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Methodology A: for the health regions are located within the state. These are characterized by having a main municipality that is usually the largest and several nearby municipalities. In these regions there is great mobility in the search for resources, services (including health services) or goods, representing a significant amount of time and economic resources spent. These regions have scattered rural, semi-urban rural and intermediate urban municipalities, and may even have urban municipalities.
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Methodology B: these are the main urban cities found within the ZMG, so mobility is urban, with multiple public transport services and various private options. These concentrate the largest amount of services, goods and resources. It is made up of populations greater than 100,000 inhabitants.
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Methodology C: these two regions have large cities within the ZMG and rural municipalities outside of this area, so it was decided to use both methodologies (A and B).
Geographic accessibility
This section refers to the time it takes a user to get to the nearest mental health service center, or one with a higher level of care, from anywhere in the state, both by public transport (bus) and private transport (car). The information was collected through telephone interviews, data provided by health institutions and computer tools such as Google Maps, Waze and Rome2rio. The route from one point to another (from a health center to a mental health service) was introduced between 8 and 13hrs, obtaining an arithmetic mean of the three computer tools, the result is expressed in minutes.
Transportation costs
This section considers the traveling cost required to get from anywhere in the state to the nearest mental health service center, or to one with a higher level of care. For this section, all the mobility options that the population may have were taken into consideration, taking into account the costs of public transport (bus), private transport (taxi, Uber) and private transport (car). The information on the costs of public bus transport was collected through the experience of the workers on the different health institutions and telephone calls to bus terminals, with the information being corroborated with prices found on the internet. The information on private transport (taxi, Uber) was made through the costs referred by the taxi terminals and through the Uber mobile application at different schedules. The costs of private transportation (car) were calculated by estimating gasoline consumption per kilometer of an average car, multiplied by the kilometers traveled on a round trip. For this calculation we considered the cost of a liter of regular gasoline to be1 USD, which yields 15 km/l.
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New Mexico Behavioral Health Institute
The New Mexico Behavioral Health Institute (NMBHI) is the only state owned and operated psychiatric hospital in New Mexico. NMBHI is made up of five clinical divisions serving a wide range of public needs. Each division is separately licensed and has its own unique admission criteria.
The most familiar is the inpatient care we offer adult psychiatric patients. We provide adult psychiatric services on six units, serving approximately 1000 admissions per year.
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Overview
Our Adult Psychiatric Division is the only publicly funded psychiatric hospital in New Mexico and serves adults from throughout the state.
Our adolescent program is dedicated to treating adolescent males who have a history of sexually harmful behaviors and have been diagnosed with a co-occurring mental illness.
Our forensic division treatment to competency for adult patients who have been charged with committing a felony.
Our long term care division is a major regional licensed long-term nursing care provider for elderly and disabled residents. It is Center for Medicare & Medicaid Services certified, accredited by The Joint Commission (TJC) and provides specialty services for dementia care in both elderly and younger residents.
Community based services, through a comprehensive community mental health agency, offers many individual programs.
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Adult Psychiatric Division
The New Mexico Behavioral Health Institute – Adult Psychiatric Division is an acute inpatient psychiatric setting owned and operated by the State of New Mexico. Adult Psychiatric Division is accredited by The Joint Commission and provides voluntary, involuntary, and court-ordered behavioral health treatment to individuals, ages 18 and older, suffering from a major mental illness that severely impairs their functioning, their ability to be maintained in the community, and who present as an imminent danger to self and/or others. The governing body of the New Mexico Behavioral Health Institute assumes overall responsibility for the Adult Psychiatric Division’s operation.
Patients, when admitted, are evaluated and offered treatment by an interdisciplinary treatment team comprised of a Psychiatrist, Psychologist, Nurse, Social Worker, Treatment Plan Coordinator, and Rehabilitation Services. Other services, including Medicine and Nutrition Services also work with the patient on an as needed basis. Family, significant others, and guardian(s) are encouraged to participate and are welcome participants, under HIPAA guidelines, in the assessment and treatment planning process.
The planning for discharge and after-care for each patient begins at the time of admission by identifying family members, significant others, and community resources which might be available to support the patient’s transition back into his/her community of origin whenever possible. Whenever possible, throughout the patient’s stay, all efforts are made to keep family, significant others, guardian(s) and/or community resources involved. For those patients without family, significant others, guardian(s) and/or community resources, the treatment team will work with community agencies to assure community resources are in place at the time of discharge. At times, community resources may be non-existent in the patient’s community of origin, and at those times the treatment team will work with patient, significant others, guardian(s) and/or community resources to obtain appropriate and available aftercare placement and services.
Who Provides the Inpatient Care?
The inpatient treatment team is responsible for each patient’s individual needs and for the overall unit-specific treatment milieu. This inpatient treatment team is made up of employees from the following disciplines: Psychiatry, Nursing, Social Work, Rehabilitation Therapy Services, and Psychology. Other departments, such as Medicine and Nutrition Services are also actively working with each patient in the hospital.
An extensive admission interview occurs with the evaluating clinician and the preliminary clinical information is used to complete the initial treatment plan. Other team members complete a discipline-specific assessment within 72 hours and these assessments are then utilized in developing a master treatment plan with the participation of the patient within 7 days after the completion of the Initial Treatment Plan. This time period allows the team to become more familiar with the patient’s particular strengths and individual treatment needs while identifying discharge criteria that will continue to be assessed throughout the course of treatment.
The Psychiatrist is responsible for leading the treatment team, and identifies the interventions needed to address the patient’s psychiatric needs and concerns. The psychiatrist and medical practitioner complete an initial assessment, prescribe medication, other tests or treatment that need to be performed and review the individual’s progress in meeting treatment goals.
Nursing staff monitor the status of the patient and coordinate treatment interventions to ensure that care is provided. They maintain responsibility for a safe and therapeutic environment, supporting, supervising, and teaching patients self-care, medication education and administration as well as implementing physician orders. Nursing staff help patients process their moods and feelings, and communicate the progress of the patient to the rest of the team.
The Psychologist is responsible for facilitating the clinical discussion and assisting in the formulation of the treatment plan. The psychologist is responsible for providing individual or group therapy to address common issues that are experienced by patients with mental illness. For example, the development of coping, communication and social skills, anger management and substance abuse education are some of the more common areas covered in therapeutic groups. Psychologists perform evaluations to help clarify a diagnosis or assist in determining the treatment approach that should be used. Psychology staff may develop the individualized behavior management plans and provide necessary training to the treatment team.
The Social Worker on the unit is responsible for assuring that all family members and significant community service providers are notified of treatment team meetings, and encourage their input into the treatment/discharge plan. Family and community service providers are strongly encouraged to maintain their involvement with the patient throughout their stay in the hospital, since they are the primary link to a successful discharge. The Social Worker is charged with planning and coordinating the return of the patient to the community following discharge (discharge planning). Some of the services they work to coordinate include: case management and medication, medical care, housing, and other benefits.
The Treatment Plan Coordinators are members of the multidisciplinary treatment teams and ensure that the treatment plans developed by the treatment teams meet all standards and specifically address the behaviors which admitted the patient to the most restrictive level of psychiatric care. They assist in the timely review of treatment plans and updating the treatment process for the identification of medical necessity for continued psychiatric care. They assist the team psychologist in the development of behavior management plans and assist with staff training if deemed necessary.
Rehabilitation Services are provided by Recreational Therapists. Rehabilitation staff assist patients in learning the community living skills needed to assist them in successful community reintegration. These services focus primarily on home management, use of leisure time, fitness, and social skill development. Opportunities are provided to apply skills learned in day-to-day activities (e.g. walks, dances, art and music, exercise, etc).
The hospital Patient Advocate is available to speak with the patient and/or interested parties throughout the course of the hospitalization. The patient advocate assists in bridging communication between the patient and treatment team and provides mediation in an attempt to resolve communication and or treatment issues or concerns. The Patient Advocate is available to the patient and next of kin through discharge. At the time of discharge the Patient Advocate can assist the patient and if the patient so desires in completing a satisfaction survey. The completion of such survey is optional and is not a requirement for discharge. The survey is sent directly to NMBHI’s Standards and Compliance Division and the feedback affords NMBHI Adult Psychiatric Division Management Team in identifying opportunities for improvement.
What happens after the hospitalization?
The planning for the discharge of the patient begins at the time of admission by identifying family and community resources, which will be available to support the patient’s transition back into the community, once the illness is stabilized. Throughout the patient’s stay all efforts will be made to keep family and community involvement active. For those patients who do not have the family or community supports, the treatment team will work with community agencies to assure those supports are in place during the patients hospitalization and, in particular, at the time of discharge. At times the community supports necessary are non-existent in the community of origin, it is in those instances that the treatment team will work with the patient in obtaining the most appropriate and available local supports.
NMBHI Adult Psychiatric Division will continue be a support to the patient — even post-discharge. The patient and/or support network may elicit consultation with the treatment team or other professional staff at any time. We will be here to assist with advocacy, linkage and support as patients integrate into their community.
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Adolescent Services Center for Adolescent Relationship Exploration
The New Mexico Behavioral Health Institute – Center for Adolescent Relationship Exploration (CARE) is a residential treatment facility owned and operated by the State of New Mexico. The CARE facility is licensed as a Residential Treatment Center by the State of New Mexico and is accredited by The Joint Commission. The governing body of the New Mexico Behavioral Health Institute assumes overall responsibility for the CARE’s operation.
The CARE program is designed to provide treatment to adolescent boys, 13 – 17 years of age, who have a history of sexually harmful behaviors and have been diagnosed with a co-occurring mental illness–a mental illness that has produced a history of disturbances in behavior, age-appropriate adaptive functioning, and psychological functioning. These adolescents have frequently attempted to cope with problems by engaging in antisocial and self-destructive behaviors that has limited their ability to function appropriately and safely in a less restrictive environment. The severity of these disturbances requires 24-hour supervision within a structured positive and motivational, therapeutic setting. CARE is a secure locked facility.
CARE provides a safe, strength-based, non-punitive, structured, and supportive environment that is essential for successful treatment. The program design is based on the premise that a significant number of these adolescents have themselves been victims of abuse and/or neglect. Their sexually harmful behaviors are often the result of multiple etiologies which have created unresolved developmental issues and learned maladaptive behaviors. These behaviors can be modified through strength-based, individualized and multidisciplinary treatment interventions. The course of treatment is approximately 12 months, but may vary depending upon the level of complexity and degree of pathology exhibited at the time of admission and thereafter during treatment. Family participation, through visits and family therapy, is strongly encouraged. The CARE treatment philosophy is a team approach which includes the resident, the family or guardian, and the professional multidisciplinary team. Resident participation is vital and so the program is voluntary—the resident MUST agree to participate before admission is completed.
Treatment is provided under the direction of a clinical director, a psychiatrist, and/or a licensed psychologist. A variety of treatment modalities are utilized to help residents achieve their treatment goals. These include; group therapy, experiential therapy, recreational therapy, family therapy, cognitive behavioral therapy, mindfulness training, psychopharmacological therapy, milieu therapy and psychoeducation for the adolescent who has created sexual harm. Other physician ordered interventions, as appropriate, are also provided.
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Community Based Services
The goal of the New Mexico Behavioral Health Institute Community Based Services is to provide the highest quality of services in an outpatient setting in a three-county area. The services include Mental Health, Outpatient services, Psychosocial Rehabilitation, Comprehensive Community Support Services and Assisted Living services for the Chronically Mentally Ill.
Mental Health Services
The Mental Health Component provides an individualized, assertive and comprehensive community based treatment. The focus is on rehabilitation and improving the quality of life to adults and families in need of Mental Health Services. The following services are available to meet the individualized needs of the client:
- Psychiatry Services provides diagnosis, disease management and medication management
- Nursing Services provides medication monitoring, administration, disease education
- Behavioral Health Therapist Services offer individual therapy.
- Comprehensive Community Support Services– provides advocacy and linkage to access and use community resources.
- Psychosocial Rehabilitation Services emphasizing the development of daily living skills
- Crisis Response is available 24 hours a day, seven days a week.
- Sexual Assault Services provides a comprehensive array of advocacy and therapy services to victims.
- Special Needs Housing Local Lead Agency performs eligibility screening and referral of special needs applicants for low-income set aside housing and acts as a liaison between property management and service agencies to assist in addressing issues that may arise during an approved applicant’s tenancy.
- LLA Brochure
- Special Needs Application
- Assisted Living Services focuses on providing a highly structured, therapeutic milieu intended to increase independence in the living environment of their choice.
- Substance Abuse Counseling provides individual counseling with an emphasis on education on the addictive process.
- Education and Information Services are available for presentations and workshops upon request.
Psychiatry services provide diagnosis and medication treatment. Nursing services are offered as well as individual and group therapy and psychological testing. Comprehensive community support services provides advocacy and linkage to access and use of community resources. Psychosocial Rehabilitation emphasizing the development of daily living skills is provided daily and includes supportive employment. Crisis Response is available 24 hours a day seven days a week. Sexual Assault Services provides a comprehensive array of advocacy and therapy services to victims. Residential Services focuses on providing a highly structured, therapeutic milieu intended to increase independence in the living environment of their choice. Substance Abuse Counseling provides individual counseling with an emphasis on education on the addictive process. Education and Information Services are available for presentations and workshops upon request.
Outpatient Restorative Services
Outpatient Restorative Services offers expertly trained therapists that are knowledgeable in their field. Treatment is available to all ages from pediatrics to geriatrics. Services offered are: Physical Therapy,and Occupational Therapy.
Locations
We currently have Community Based Services offices in the following locations.
Las Vegas
700 Friedman Avenue
Las Vegas, NM 87701
505-454-5100 (Phone)
505-425-1048 (Alternate)
505-454-5172 (Fax)
Mora
Highway 518
Mora, NM 87732
575-387-2677 (Phone)
575-387-2678 (Fax)
Santa Rosa
801 Fourth Street
Santa Rosa, NM 88435
575-472-3068 (Phone)
505-472-3768 (Alternate)
575-472-3768 (Fax)
Pecos
HC 74, Box 310
Pecos, NM 87552
505-757-6112 (Phone)
505-757-6113 (Fax)
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Forensic Division
The Forensic Division is one of five divisions that comprise the New Mexico Behavioral Health Institute (NMBHI) at Las Vegas. The Forensic Division of NMBHI is a 116-licensed bed facility that is fully accredited by the Joint Commission. The primary mission of the Forensic Division is to provide competency restoration services to individuals referred by District Courts across the state. Additional services include providing risk assessments to referring District Courts all pursuant to statutory mandates. The Forensic Division is made up of four, inpatient psychiatric care units that are staffed 24 hours per day. The residential units are the Acute Care Unit, the Continuing Care Unit, and the Women’s Unit. There is also a Maximum Security Unit.
Individuals referred to the facility are charged with at least one felony-level offense, and in need of treatment to attain competency to proceed with adjudication. Upon admission, individuals are assigned a treatment team including psychologists, physicians, social workers, nursing staff and psychosocial rehabilitation personnel. A full range of treatment modalities including individual and occupational therapy are available. The physical environment is comparable to other areas of the hospital and consists of dormitory wings with patient rooms, large day room areas, and recreational courtyards. The Forensic Division differs from other areas of NMBHI, only in that it is surrounded by a perimeter fence for the purpose of maintaining security.
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Long Term Care Services Division
Meadows Home
This is a long-term care community consisting of three neighborhoods – Evergreen, Aspen and Juniper, and is located on the campus of the New Mexico Behavioral Health Institute. Each neighborhood is home to 36 people. Our community is licensed by the New Mexico Department of Health for 176 beds and is dually-certified for Medicare and Medicaid by the Centers for Medicare and Medicaide Services as a skilled nursing facility. We are accredited by the TJC and certified as a restraint-free facility.
Sunrise Village at Ponderosa
This community provides a secure home for people who are living with Alzheimer’s and other dementia diagnoses. The capacity at Ponderosa is 50.
Services
- 24-hour Nursing
- Activity Therapy
- Medicine
- Pharmacy
- Social Services
- Psychology
- Occupational Therapy
- Housekeeping
Culture Change
Culture change (also known as person-centered care or resident-directed care) transforms the long-term care medical model to one that nurtures the human spirit, as well as meeting medical needs. Culture change is a work in progress, always evolving to meet the needs of the residents.
Goals of Culture Change
- Restore control over daily living to residents of long-term care facilities, respecting the right of residents to make their own decisions.
- Involve all levels of staff in the care process, honoring those who work most closely with residents.
- Include families and friends in a comprehensive team-building approach to care.
- Provide a familiar and hospitable environment, a supportive workplace and responsive, individualized care practices that focus on the needs and preferences of people, rather than those of the facility.
Resident Benefits
Reduces loneliness, helplessness and boredom, improves physical and mental health (e.g. reduces depression and behavioral problems); reduces unanticipated weight loss, reduces mortality, etc.
Additional Benefits
Significantly improves employee, resident and family satisfaction; increases involvement with the outside community including children, students, clubs, and religious organizations.
Effective January 1, 2015 NMBHI became a tobacco-free campus. After October 1, 2014, everyone moving into the Meadows and Ponderosa neighborhoods will not use tobacco.
Learn More
Please contact our admissions coordinator Sam Garcia at 505-454-2388 for more information.
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Directions
You will find customized driving directions to New Mexico Behavioral Health Institute from many of the most common locations below. Please call us with any questions you may have!
Traveling from the Albuquerque International Airport
Exit the airport area turn Left onto Yale Avenue. Travel on Yale Avenue for approximately 1 mile to Interstate-25. Take Interstate-25 North to Las Vegas (Approximately 125 miles). For continued directions, see driving directions North from Santa Fe.
Traveling North from Santa Fe
Travel North on Interstate-25, approximately 65 miles, to the first Las Vegas Exit #343. Turn Left from the off-ramp onto Grand Ave. Follow Grand Avenue for approximately 0.25 miles. You will see a red caboose on the left-hand side of the road, which serves as the Las Vegas Welcome Center. Turn Left at the caboose onto New Mexico Avenue. Stay on New Mexico Avenue for approximately 2 miles. At the first traffic light, turn Left onto Hot Springs Blvd. Follow Hot Springs Blvd for approximately 1.5 miles to the New Mexico Behavioral Health Institute.
Traveling South from Springer
Travel South on Interstate-25, approximately 70 miles, to the first Las Vegas Exit #347. Merge onto Grand Avenue. Travel on Grand Avenue for approximately 1.5 miles to the first traffic light. Turn Right at the light onto Mills Ave. Travel on Mills Avenue for approximately 3 miles through two traffic lights. At the third traffic light, turn right onto Hot Springs Blvd. Follow Hot Springs Blvd for approximately 1.5 miles to the New Mexico Behavioral Health Institute.
The New Mexico Behavioral Health Institute Campus
The Sandia Building is located on the left-hand side of the road, near the campus flagpole and Historical Marker. Many of the Administrative Offices are located within this building, where you may also get directions to other areas of the campus. Parking is available on the right-hand side of the road, across from the Sandia Building.
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Visitor Information
For detailed information, take a look at the Visiting Regulations for New Mexico Behavioral Health Institute publication. It provides specific visiting policies for all divisions of NMBHI.
The facility map on the right provides an overhead diagram of the entire facility grounds and a legend of locations to help you find where you need to during your visit.
Please contact the facility directly at the 505-454-2100 main number, or toll-free at 800-446-5970 if you need further information or have any questions at all.
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