Abstract：
For the past years, Ecuador has been transitioning away from a hospital-based model of mental healthcare to one that is community-centred. However, challenges associated with hospital-based models endure, notably financial burden faced by those with severe mental health problems (SMHPs) due to labour market discrimination. Employment access for this group is often disregarded in policy planning, despite evidence of its benefits on mental health. Huertomanías, an urban garden initiative in Ecuador founded in 2015, works with individuals with SMHPs, providing work, income, and social inclusion. A case study using a participatory approach was carried out to explore factors that impact the recovery of people with SMHPs. Twelve participants engaged in diverse stages of the research, where several participatory activities were conducted including cognitive mapping, a photovoice project, and interviews. The analysis employed a thematic approach leading to four categories of impact within the urban garden: autonomy (financial and personal), interpersonal relations and relation with the environment, mental health, and family dynamics. A final category of impact was established encompassing external factors (family support and public policy and healthcare services) that influence recovery. Findings suggest that the urban garden promotes autonomy and active participation within society, improves mental health, and transforms family dynamics. Further, this study highlights the importance of community-based mental healthcare (CBMHC), emphasising the need of public policies and healthcare in promoting autonomy through employment and community-centred services. Lastly, the study contributes insights into recovery experiences and CBMHC benefits, informing programme development and similar initiatives in Latin America.
摘要：
在过去的几年里,厄瓜多尔已经从以医院为基础的精神保健模式过渡到以社区为中心的模式。然而,与基于医院的模式相关的挑战持续存在，特别是由于劳动力市场歧视而导致严重心理健康问题（SMHP）的人面临的经济负担。在政策规划中，这一群体的就业机会往往被忽视，尽管有证据表明它对心理健康有好处。Huertomanías,厄瓜多尔的城市花园倡议成立于2015年，与SMHP的个人合作，提供工作,收入,和社会包容。使用参与式方法进行了案例研究，以探索影响SMHP患者康复的因素。12名参与者参与了不同阶段的研究，在那里进行了一些参与性活动，包括认知制图，一个photovoice项目，和采访。分析采用了主题方法，导致城市花园内的四类影响：自治（财务和个人），人际关系和与环境的关系，心理健康,和家庭动态。建立了最后一类影响，包括影响复苏的外部因素（家庭支持，公共政策和医疗保健服务）。研究结果表明，城市花园促进了社会的自治和积极参与，改善心理健康，并改变家庭动态。Further,这项研究强调了社区精神保健(CBMHC)的重要性，强调公共政策和医疗保健在通过就业和以社区为中心的服务促进自治方面的必要性。最后,这项研究有助于深入了解恢复经验和CBMHC的好处，为拉丁美洲的方案制定和类似举措提供信息。
