Mental health systems in El Salvador, Guatemala, and Nicaragua: results of a WHO-AIMS evaluation

The authors evaluated the mental health systems of El Salvador, Guatemala, and Nicaragua, using a group of select indicators. The World Health Organization Assessment Instrument for Mental Health Systems (WHO-AIMS) was used to collect data from the nations. The national mental systems of Nicaragua, Guatemala, and El Salvador have serious limitations, especially in primary care, and a marked lack of qualified human resources. Budget allocations for mental health care are barely 1% of the total health care budgets; and the psychiatric hospitals located in the national capitals consume at least 90% of those funds. The limited human and material resources available are concentrated in the respective country capital cities. National mental health policies and legislation have not been adopted; however, all three countries do have national plans in progress. Furthermore, all three have designed and implemented programs for mental health care in case of disaster. Agreements must be reached with offices for the defense of human rights to raise awareness and protection of rights for the mentally ill. In recent years, new experiences have been gained and these should be distributed more widely. The Pan American Health Organization (PAHO/WHO) and the WHO-AIMS project have contributed toward developing community models for mental health services. Lastly, priorities have been identified and action items recommended.