Pilot Implementation of a Remote Primary Care and Psychiatry Model (MAP-PSI) for Youth Depression in Rural and Indigenous Mexican Communities
L. Díaz-Castro, G. B. Ramírez-RodríguezIntroduction
Youth depression represents a growing burden in rural and Indigenous communities, where access to mental health services is scarce. There is an urgent need for scalable, culturally adapted, and community-based models to improve detection and care.
Objectives
To evaluate the feasibility and effectiveness of the MAP-PSI (Primary Care and Psychiatry Model), a telemedicine-based intervention designed to reduce depressive symptoms among youth aged 15–25 in marginalized settings.
Methods
A quasi-experimental pre-post study was conducted (March 2023 – March 2025) in Ciudad Fernández, San Luis Potosí, Mexico. The intervention combined: (1) bilingual psychoeducation, (2) brief cognitive-behavioral therapy (CBT), and (3) psychiatric care via telemedicine. Screening instruments included the PHQ-9 and KAP questionnaires. A total of 1,057 youth were screened, and 400 received stepped-care based on symptom severity. Data were analyzed using non-parametric tests (Wilcoxon, Mann-Whitney U).
Results
Analysis of the results showed a 60% average reduction in depressive symptoms across modalities (p < .001). Also, 25 cases of suicidal ideation were successfully treated, and 34,224 school absence days were prevented (84% reduction). Moreover, the intervention reached over 1,500 youth with >85% adherence and high community acceptability. The pilot implementation achieved a 98% reduction in out-of-pocket expenses. This pilot study involved 67 bilingual community health promoters who were trained and certified.
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