Mental Health Reform in Peru: Innovations, Challenges, and Sustainability

In recent years, South American countries have implemented models to better care for people with mental illness emphasizing the role of the community. Starting in 2004, the Peruvian government along with increasing support from civil society has taken a series of steps that have allowed to initiate the Peruvian mental health reform. Legal, policy, and fiscal changes have been proposed with the ultimate goal to implement a community mental health model (CMHM). Increasing expenditure in mental health, legislation changes to improve access to mental health care, and the development of CMHM guidelines are crucial aspects of mental health reform (Int J Health Policy Manag. 6, 501–508, 2017). The Peruvian Ministry of Health (MoH) partnered with academic institutions and non-governmental organizations (NGOs) to obtain expertise in different aspects of implementation strategies. The Community Mental Health Center (CMHC) has been proposed to be a cornerstone to articulate and integrate the Peruvian mental health network across the country and to offer outpatient mental health services in the community (Lancet Psychiatry. 4, 90–92, 2017). Expansion of inpatient and outpatient mental health services in general hospitals and strengthening of mental health care in primary care clinics (PCCs), along with the implementation of protected homes and residencies and rehabilitation centers, also complement the mental health network proposed in the Peruvian CMHM (Salud Mental Comunitaria: Nuevo Modelo de Atencion, 2016b). This chapter aims to review key aspects of the Peruvian mental health reform, challenges to implementation, and strategies that would contribute to ensure sustainability as well as country characteristics, burden of mental health, and health-care services before and during the ongoing mental health reform in Peru.