Governing suicide prevention in Chile 2013-2021: Documentary analysis of the state response from the perspective of collaborative governance
DOI:
https://doi.org/10.29393/GP2-7GPJS10007Keywords:
governance, health policy, suicide prevention, collaborative governance, public health, Chile, mainstreamingAbstract
Suicide prevention is a complex problem of public health that defies the administrative capacity of most States. To help States address this problem, the World Health Organization has developed guidelines to orient governments in the collaborative construction of a national strategy of suicide prevention. The objective of the present article is to analyze the Chilean State’s response in suicide prevention between 2013 and 2021 using the collaborative governance approach. Working with the principal official documents, I use content analysis to trace the deliberative process on relevant information and the efforts to build a shared understanding of the problem (i.e., high suicide rate) and its causes.
In conclusion, for the period 2013-2021, the governance of suicide prevention in Chile is similar to a collaborative governance regime with a distant relation to stakeholders. It is based in the National Program of Suicide Prevention, designed by the Health Ministry at the national level. Even when it recognizes the importance of an intersectoral approach, the advances are limited although it has improved since 2019. Collaboration with non-governmental stakeholders is inexistent. Since 2017, the integration of the social determinants of health into the National Plan of Mental Health now favors actions to strengthen community and social protective factors, key for suicide prevention.
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References
Aguilar, L. (2007) “El aporte de la política pública y de la nueva gestión pública a la gobernanza”, Revista del CLAD Reforma y Democracia 39: 5-32.
Aguilar, L. (2010) El futuro de la gestión pública y la gobernanza después de la crisis. Frontera norte, 22(43): 187-213.
Andriessen, K. (2021) The role of volunteer organizations in suicide prevention. Wasserman, D (Ed.). Oxford Textbook of Suicidology and Suicide Prevention, (2nd), pp.797-801. Oxford: Oxford University Press.
Ansell, C.; Gash, G. (2008) Collaborative Governance in Theory and Practice, Journal of Public Administration Research and Theory 18(4): 543-571, https://doi.org/10.1093/jopart/mum032
Arellano, D.; Sanchéz J.; Retana, B. (2014). ¿Uno o varios tipos de gobernanza? Más allá de la gobernanza como moda: la prueba del tránsito organizacional. Cuadernos de Gobierno y Administración Pública 1(2), 119-137. https://doi.org/10.5209/rev_CGAP.2014.v1.n2.47538
Brugué, Q.; Canal, R.; Paya, P. (2015) ¿Inteligencia administrativa para abordar “problemas malditos”?. El caso de las comisiones interdepartamentales. Gestión y Política Pública, 24: 1, 85-130.
Cisternas, C.; Vásquez, J. (2018) Comisiones Asesoras Presidenciales en Chile: Entre la expertise y la pluralidad de actores sociales. European Review of Latin American and Caribbean Studies,(106): 1–24. http://doi.org/10.32992/erlacs.10349
Díaz-Castro, L.; Arredondo, A.; Pelcastre-Villafuerte, B. E.; Hufty, M. (2017) Governance and mental health: contributions for public policy approach. Revista de saude publica 51(4): 1-13. https://doi.org/10.1590/S1518-8787.2017051006991
Dirección de Presupuestos (2021). Evaluación Ex Ante - Proceso Formulación Presupuestaria 2021, Programa Nacional de Prevención del Suicidio. https://www.dipres.gob.cl/597/articles-212538_doc_pdf.pdf
Dudgeon, P.; Calma, T; Milroy, J; McPhee, R; Darwin, L; Von Helle, S; Holland, C. (2018) Indigenous governance for suicide prevention in Aboriginal and Torres Strait Islander communities: A guide for primary health networks, Report, https://www.nintione.com.au/?p=13921.
Emerson, K.; Nabatchi, T. (2015) Collaborative Governance Regimes. Washington, DC: Georgetown University Press.
García Solana, M. J. (2017). La Colaboración Público-Privada: capacidades públicas para la gestión del modelo desarrollado por el Servicio Público de Empleo Estatal y las Agencias Privadas de Colocación. Cuadernos de Gobierno y Administración Pública 4(2), 135-168. https://doi.org/10.5209/CGAP.57916
Guajardo, G., ed. (2017) Suicidios Contemporáneos: vínculos, desigualdades y transformaciones socioculturales. Santiago: FLACSO-Chile.
INJUV (2021) Documento Técnico: Ansiedad, Angustia, Depresión y Suicidio Hablemos de Todo 2020-2021, https://hablemosdetodo.injuv.gob.cl/wpcontent/uploads/2021/02/AADS.pdf.
Kooiman, J (2003) Governing as governance. Londres: SAGE.
Krug EG, Dahlberg LL, Mercy JA, Zwi AB, Lozano R, eds. (2002) World report on violence and health. Ginebra: World Health Organization.
McQueen, D., Wismar, M., Lin, V., Jones, C., Davies, M (2015) Gobernanza intersectorial para la salud en todas las políticas: Estructuras, acciones y experiencias.
Organización Mundial de Salud https://www.euro.who.int/__data/assets/pdf_file/0006/298464/Gobernanza-26-Intersectorial-para-la-Salud-en-Todas-las-Politicas.pdf
Ministerio de Salud (2010) Estrategia Nacional de Salud 2011-2020 https://www.minsal.cl/portal/url/item/c4034eddbc96ca6de0400101640159b8.pdf
Ministerio de Salud (2013) Programa Nacional de Prevención del Suicidio. https://www.minsal.cl/sites/default/files/Programa_Nacional_Prevencion.pdf
Ministerio de Salud, (2016) Orientaciones Técnicas para la Atención de Salud Mental Con Pueblos Indígenas: Hacia Un Enfoque Intercultural http://www.bibliotecaminsal.cl/wp/wp-content/uploads/2018/01/028.MINSAL-saludmental-indigena-2016.pdf
Ministerio de Salud (2017) Plan Nacional de Salud Mental, 2017-2025, https://www.minsal.cl/wp-content/uploads/2017/12/PDF-PLAN-NACIONAL-SALUDMENTAL-2017-A-2025.-7-dic-2017.pdf.
Ministerio de Salud (2018) Modelo de Gestión. Red Temática de Salud Mental en la Red General de Salud (MGRTSM) https://www.minsal.cl/wpcontent/uploads/2015/09/2018.05.02_Modelo-de-Gesti%C3%B3n-de-la-RedTem%C3%A1tica-de-Salud-Mental_digital.pdf
Ministerio de Salud (2019) Recomendaciones para la Prevención de la Conducta Suicida en Establecimientos Educacionales, https://saludresponde.minsal.cl/wpcontent/uploads/2019/09/GUIA-PREVENCION-SUICIDIO-ENESTABLECIMIENTOS-EDUCACIONALES-web.pdf.
Ocampo, J. ed. (2015) Gobernanza global y desarrollo Buenos Aires: Siglo XXI/ CEPAL (Naciones Unidas).
OMS (2000) Prevención del Suicidio. Un Instrumento Para Médicos Generalistas WHO/MNH/MBD/00.1, Ginebra. https://www.who.int/mental_health/media/general_physicians_spanish.pdf?ua=1
OMS (2012) Public Health Action for the Prevention of Suicide: A Framework https://apps.who.int/iris/bitstream/handle/10665/75166/9789241503570_eng.pdf?sequence=1&isAllowed=y
OMS (2013) Plan de Acción para Salud Mental, 2013–2020. Ginebra: OMS. https://apps.who.int/iris/bitstream/handle/10665/97488/9789243506029_spa.pdf?sequence=1&isAllowed=y
OMS/OPS (2014) Prevención del suicidio: un imperativo global. Washington, DC: OPS. https://iris.paho.org/bitstream/handle/10665.2/54141/9789275318508_spa.pdf?sequence=1&isAllowed=y
Ordóñez-Sedeño, J., & González, I. de P. (2017). Estado constitucional y gobernanza: bases para una apertura democrática de las políticas públicas en México. Vniversitas, 66(134), 169–208. https://doi.org/10.11144/Javeriana.vj134.ecgb
Ran, B., Qi, H., Oszlak, O. (2018) Gobernanza colaborativa. Estado Abierto 2(3): 47-90.
Rhodes, R. (1996) The New Governance: Governing without Government. Political Studies 44(4):652-667. doi:10.1111/j.1467-9248.1996.tb01747.x
Rojas Moreno, I. (2017) “Instalación del Programa Nacional de Prevención del Suicidio en Chile” en Prevención de la conducta suicida. Washington, DC: OPS. https://iris.paho.org/bitstream/handle/10665.2/31167/9789275319192-spa.pdf
Saraceno, B. (2009) The World Health Organization's role in suicide prevention. En Oxford Textbook of Suicidology and Suicide Prevention: A Global Perspective. DOI:10.1093/med/9780198570059.003.0096
SENAME (2019) Procedimiento Prevención del Suicidio en Centros y Programas de Justicia Juvenil, https://www.sename.cl/wsename/ot-justicia-juvenil/Prevencion-delSuicidio-para-Medidas-Sanciones.pdf.
SAMHSA (2017) National Strategy for Suicide Prevention Implementation Assessment Report. HHS Publication No. SMA175051. Rockville, MD: Center for Mental Health Services, Substance Abuse and Mental Health Services Administration. (https://store.samhsa.gov/product/National-Strategy-for-SuicidePrevention-Implementation-Assessment-Report/sma17-5051).
United Nations, Department of Policy Coordination and Sustainable Development (1996) Prevention of suicide: guidelines for the formulation and implementation of national strategies. New York, USA.
U.S. Department of Health and Human Services (HHS) (2012) National Strategy for Suicide Prevention: Goals and Objectives for Action. Washington, DC: HHS.
Zalsman, G et al. (2017). Evidence-based national suicide prevention taskforce in Europe: A consensus position paper. European neuropsychopharmacology 27(4), 418–421. https://doi.org/10.1016/j.euroneuro.2017.01.012
Zurbriggen, C., y González Lago, M. (2020). Innovación y Co-Creación: Nuevos Desafíos para las Políticas Públicas. Revista de Gestión Pública, 3(2), 329–361. https://doi.org/10.22370/rgp.2014.3.2.2245
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