By Jeremy Veillard and Daniela Romero
Mental health represents a significant public health challenge and a critical economic and social issue for countries in Latin America and the Caribbean (LAC), particularly following the COVID-19 pandemic.
Mental health and substance use disorders, along with suicide, have become leading causes of mortality, morbidity, and disability in the region. This burden disproportionately affects young people, with more than 10 adolescents losing their lives to suicide every day.
The social consequences are profound, but so are the economic ones: the costs associated with mental disorders among young people alone exceed USD 30 billion annually in productivity losses and healthcare expenses in Latin America and the Caribbean. The World Health Organization’s World Mental Health Report: Transforming Mental Health for All (2022) highlights that depression and anxiety alone cost the global economy approximately USD 1 trillion annually in lost productivity, mainly due to absenteeism, presenteeism (working while unwell), and reduced work capacity.
Despite these alarming figures, public spending on mental health remains surprisingly low, with only 2 percent of total health budgets allocated to this purpose. Addressing these enormous gaps requires strategic and informed investment decisions, along with innovative approaches to prevention and service delivery.
Promising practices in the region offer valuable lessons and data-driven models for achieving effective interventions:
In Colombia, the DIADA project (Detection and Integrated Care of Depression and Alcohol Consumption in Primary Health Care) employs digital screening tools that efficiently identify individuals at risk of depression and alcohol use disorders. General practitioners receive training to diagnose and treat these conditions, dramatically increasing detection rates from less than 0.1 percent to over 10 percent of patients with positive screening tests. The cost-effectiveness of the intervention is impressive, generating substantial improvements in mental health outcomes at an approximate cost of USD 2 per treated person. This integrated and technology-supported approach demonstrates the potential for substantial impact through affordable and targeted investments.
The proactive integration of mental health into primary health care in Chile represents another benchmark model. Under the Universal Access with Explicit Guarantees (AUGE) reform, Chile has firmly integrated mental health services into the primary health care model. This system promotes early identification and intervention of mental health conditions, reducing stigma and improving continuity of care. Chile’s specific approach, supported by the government’s goal to allocate 6 percent of its health budget to mental health—triple the regional median—highlights the country’s commitment to reducing the mental health burden.
Paraguay has taken significant steps in this direction by establishing a new regulatory framework that moves away from a hospital-centred model and focuses on primary care for mental health service delivery. As part of this reform, the country is advancing the training of primary care teams to expand access to quality mental health services.
Uruguay, facing one of the highest suicide rates in Latin America and the Caribbean, has launched a comprehensive mental health strategy. A central element of this effort has been the use of digital tools to monitor suicide attempts by recording these events in emergency rooms in real-time, enabling effective follow-up care and strengthening epidemiological surveillance. Access to mental health services has significantly improved by reducing financial barriers to psychotherapeutic treatments and common antidepressants. The results are promising, with a 7.3 percent reduction in suicide rates between 2022 and 2023.
In Sint Maarten, the government is investing to improve the national mental health system, focusing on governance, financing, and service delivery across the continuum of care. This project has the potential to transform the lives of Sint Maarten’s residents and serve as an example for other countries in the early stages of developing their national mental health systems.
Based on these examples, countries in Latin America and the Caribbean could consider prioritizing the following four strategic areas:
- Reorient investment from outdated psychiatric hospitals to community-based primary health care services.
- Make targeted investments to address the burden of mental disorders.
- Improve multisectoral governance. Effective mental health strategies require coordinated action across all sectors.
- Invest in strengthening data and research capabilities to provide reliable and timely information for evidence-based decision-making.
Prioritizing mental health in national and regional agendas is not only an ethical imperative but also an economic necessity.
The World Bank Group is committed to working with countries and partners through knowledge and access to financing to ensure healthier, resilient, and economically productive communities throughout Latin America and the Caribbean.
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