Comparative study of mental health services availability and use in Chile and Spain

Introduction: There is an enormous interest about improving international comparisons to provide relevant information for policy and planning in mental health. Most of the available information is provided at the macro-level (countries or regions). However, information gathered at the meso-level may diverge from data aggregated at higher territorial levels. Objectives: This study describes the comparison on availability and use of mental health services between Chile and Spain. Methods: Availability and utilization of services for the adult population were assessed in two urban areas in Chile and in three (two urban and one rural) areas in the South of Spain by using the European Service Mapping Schedule (meso-level data). Results: For the two countries, local data on availability differed from data provided at the national level. There were differences in use of residential and day care between the benchmark area in Spain and the areas explored in Chile. In Chile’s catchment areas there was no availability of non-acute hospital services, any work-related services for persons with mental disorders, or 24-h mobile or non-mobile emergency psychiatric care. The meso-level data indicated that delivery and use of care in Chile was more similar to the pattern found in the poorer area in Southern Spain than macro-level data would indicate. Conclusions: The European Service Mapping Schedule was useful for describing mental health care outside of Europe and allowed for an international comparison between Chile and Spain. The meso-level description gathered in this study adds to the macro-level information on the mental health care system that has been provided in other reports.