Analysis and Evolution of Mental Health Public Policies in Ecuador: A State of the Art

Abstract

The study aims to analyze public mental health policies in Ecuador from 1999 to 2023, focusing on their conceptual and regulatory structure, scope, and limitations. The study uses a review of the state of the art, a documentary research method, to recover and reflect on the accumulated knowledge on mental health policies in Ecuador. This approach involves systematically reviewing the existing literature to identify, describe, and interpret the dynamics and logic present in previous research. The aim is to establish current knowledge, uncovering gaps and unresolved issues in order to formulate new assumptions and proposals for action. The analysis of Ecuador's mental health policies reveals several key issues. First, while international regulatory standards are met, the omission of social determinants of health, as recommended by the WHO, limits the effectiveness of these policies in addressing the complexities of mental health holistically. Second, the inclusion of mental health in the public agenda is limited by electoral considerations and insufficient interaction between legislators and citizens, indicating the need for a deeper understanding of legislative processes in shaping mental health policies. Third, the lack of accurate and up-to-date information on the target population hinders effective policy-making and resource allocation, requiring a stronger commitment to the collection, analysis, and dissemination of reliable mental health data. Finally, the implementation of mental health plans is challenged by political decision-making, resource management, and sectoral negotiation. It is essential to increase the budget and hire professionals specialized in psychology and psychiatry. Recent law requires developing regulations to integrate the mental health system into the national health governance system, emphasizing the importance of human and financial resources for the success of mental health policies.