Implementing the Community Mental Health Care Model in a Large Latin-American Urban Area The Experience from Santiago, Chile

This article outlines the development of the Barros Luco General Hospital's Psychiatry Service since its creation in 1968. Initially, some historical and political background is provided followed by a description of how our service has endeavored, over the last 10 years, to put the community mental health care model into practice. Subsequently, we describe the growth of a network of locally based mental health services. Another process running in parallel has been the acquisition, by the local primary care teams, of skills that have enabled them to manage, on an ambulatory basis, patients with severe and enduring mental illness. In this regard, some data are provided in order to illustrate the effect of the changes that are taking place, including a reduction in the proportion of emergency psychiatry consultations at the casualty department. Finally, current and future challenges are discussed, including the need for a mental health law, clinical governance issues, and the provision for people with developmental disorders and those with highly complex mental health needs.