Plan Plurinacional de Salud Mental 2026–2030

Objectives

The Plurinational Mental Health Plan 2026–2030 seeks to improve integral wellbeing and quality of life through mental health promotion, prevention of mental disorders, timely care and rehabilitation. Its general objective is to strengthen mental health through promotion, prevention, diagnosis, treatment and rehabilitation using an integral, community-based approach centred on individuals and families and articulated across all levels of Bolivia’s National Health System.[1]The plan is aligned with the Family, Community and Intercultural Health Policy, known as SAFCI, the World Health Organization Comprehensive Mental Health Action Plan 2013–2030 and the Andean Mental Health Plan 2022–2026.[1]

• Strengthen leadership and governance, including a proposed Community Mental Health Law, national and departmental mental health structures, normative instruments, epidemiological surveillance and social participation.[2][3]
• Promote wellbeing and prevent mental health problems and disorders throughout the life course, addressing social determinants, human rights, gender, interculturality and territorial and cultural diversity.[4][5]
• Develop the community mental health workforce through undergraduate, postgraduate, residency and continuing education, particularly for first- and second-level personnel.[2][6][7]
• Improve integrated mental health care through Integrated Health Service Networks, spanning promotion, prevention, treatment, rehabilitation and recovery from primary to specialised care.[1][2]
• Strengthen national information and research through records covering promotion, prevention, care, rehabilitation and recovery, generating reliable evidence for decision-making.[2][8]

The plan aims to shift from hospital-centred psychiatric provision towards decentralised, participatory, rights-respecting and community-based care, while reducing the treatment and access gap.[9][10]It gives particular attention to children and adolescents, women, Indigenous Native Peasant Peoples, older people, people with disabilities, people deprived of liberty, people experiencing homelessness, LGBTIQ+ communities and migrants.[2]This focus responds to substantial unmet need, including the reported finding that nine in ten people with mental disorders had not been diagnosed in the 2024 assessment.[11]

Implementation

Implementation is based on a community mental health model integrated into SAFCI and the Unified Health System, combining person-, family- and community-centred care with intercultural, gender-responsive, inclusive, human-rights and multisectoral perspectives.[9][12][13][14]Services are intended to be free for eligible users through the Unified Health System and delivered across care levels through Integrated Health Service Networks.[15][16][17]

• Strengthen the Ministry of Health and Sports’ Mental Health Unit and specialised areas, and establish or reinforce mental health teams and Departmental Mental Health Committees in all nine Departmental Health Services.[2][3]
• Coordinate national, departmental, municipal and Indigenous autonomous governments, alongside other ministries, scientific societies, professional bodies, civil society, associations, communities and social organisations.[3][4][18]
• Prepare a Community Mental Health Implementation Manual, technical and normative instruments, communication strategies and guidance on child and adolescent mental health, suicide prevention, substance-use prevention, emergencies and disasters, and support for vulnerable groups.[3][4][5]
• Integrate community mental health into academic curricula, postgraduate programmes and medical residencies, and provide continuing training for health workers, Telehealth personnel, penitentiary health teams and criminal justice staff.[6][7]
• Expand care by enabling early detection, treatment, referral and follow-up at first level; developing second-level services; reinforcing multidisciplinary third-level units; updating service portfolios and clinical protocols; and progressively extending psychiatric and psychological telehealth.[19][20][21]
• Build community support networks, promote deinstitutionalisation and social inclusion, and incorporate rehabilitation for people with mental, psychosocial or intellectual disabilities into primary-care guidance.[21][8]

The plan assigns specific clinical functions by level of care: first-level services promote health, identify risks, detect and diagnose disorders, refer when needed and follow up; second-level services provide differential diagnosis, inpatient care where required, psychotherapy and social interventions; and third-level and specialist services provide complex diagnosis, psychotropic treatment and specialised interventions.[19]Community teams are expected to coordinate multidisciplinary care and work, where appropriate, with traditional practitioners through the intercultural SAFCI framework.[22][23]

Monitoring is intended to use strategic-line indicators, baselines, targets and responsible institutions, with periodic review to identify achievements, gaps and adjustments.[3][8]Follow-up is to include technical reports and inter-institutional coordination spaces, while intermediate and final evaluation should assess objectives, results, indicators and effects on service access, quality and comprehensiveness.[18]The information agenda includes strengthening the Unified Health Information System, developing justification for mental-health indicators in the General Guide to Health Management Indicators, and creating a tool for mental-health reports.[24][8]

Selected capacity targets include increasing national Mental Health Unit personnel from three to 15, departmental personnel from nine to 18, Departmental Mental Health Committees from three to nine, trained network coordination teams from 0% to 70%, and trained health facilities from 0% to 30%.[3]Financing is to be shared among the Ministry of Health and Sports, other ministries and territorial autonomous governments, incorporated into territorial annual operating plans, and allocated equitably across promotion, prevention, primary care and specialised services.[18]Although the plan contains a budget chapter and extracted tables show some Boliviano amounts, the available material does not provide a reliable consolidated budget, action-level allocation, funding gap or cost assumptions.[25][26]

Monitoring & Evaluation

The plan establishes a monitoring, follow-up and evaluation approach based on strategic-line indicators, periodic progress review, technical reporting and coordination between institutions. It also recognises that national mental health information requires strengthening to support reliable decision-making and address incomplete administrative reporting.[8][18][27][2]

• Monitor implementation periodically against indicators for each strategic line to identify achievements, gaps and required adjustments.[8][18]
• Conduct follow-up through technical reports and inter-institutional coordination spaces, intended to assess implementation, promote management transparency and inform evidence-based decisions.[8][18]
• Undertake intermediate and final evaluations of objectives, results and indicators, including the plan’s effect on access, quality and comprehensiveness of mental health services.[18]
• Use action-specific indicators with baselines, targets and named responsible institutions for governance, workforce development, promotion, prevention, service delivery, telehealth, rehabilitation and information-system outputs.[3][4][5][6][7][20][21][8]
• Track institutional capacity through indicators including national Mental Health Unit personnel, departmental mental health personnel, Departmental Mental Health Committees, completion of an implementation manual, and proportions of coordination teams and facilities trained in community mental health.[3]
• Record baseline-to-target progress from 3 to 15 personnel in the national Mental Health Unit, 9 to 18 departmental personnel, 3 to 9 departmental committees, 0 to 1 implementation manual, 0% to 70% of trained network coordination teams and 0% to 30% of trained health facilities.[3]
• Measure selected workforce and service actions through targets including 25% of first- and second-level establishments having at least two staff trained in community mental health, 100% for training Telehealth operational staff, three training actions for penitentiary health teams, three awareness-raising actions for criminal justice staff, and one technical regulatory document on clinical mental health care.[7][20]
• Strengthen data capture through the Unified Health Information System, including Form 302 B and its 12 mental-health variables, and through proposed indicators in the General Guide to Health Management Indicators and a tool for generating mental health reports.[24][8]
• Use epidemiological data, administrative records, departmental health-service information and national institutional data to update the national situational diagnosis and identify service gaps, concentration patterns and potential territorial inequalities.[14][28]
• Apply the International Classification of Diseases, 10th Revision, to diagnoses reported by health establishments.[16]
• Strengthen social oversight through associations of users and families, while improving the consolidation of information on services, human resources and research publication channels.[27][29]

Costing & Financing

Financing is intended to support equitable implementation of community mental health across promotion, prevention, first-level care and specialised services, with shared responsibility among national ministries and territorial autonomous governments. The extract identifies some budget-table amounts but does not provide a reliable consolidated budget, complete activity-level allocation, funding gap or economic assumptions.[18][26][30][31]

• Coordinate financing among the Ministry of Health and Sports, other ministries, Autonomous Departmental Governments, Autonomous Municipal Governments and Autonomous Indigenous Original Peasant Governments to support the model’s sustainability.[18]
• Incorporate funding into the health Annual Operating Plans of Territorial Autonomous Entities and distribute resources from the governing entity to local health services.[18]
• Allocate resources equitably across promotion, prevention, primary care and specialised mental health services.[18]
• Recognise additional workforce needs in the national Mental Health Unit and departmental mental health areas, although no monetary valuation is provided.[3]
• Address affordability barriers, as private outpatient and inpatient mental health services are reported to have high costs and restricted accessibility.[29]
• Note that the document’s preparation received financial support from the Pan American Health Organization, without a quantified value in the available extract.[32]
• Record budget-table figures of 1,000, 2,000, 4,000, 10,000 and 20,000 Bolivianos, associated with the General Treasury of the Nation and the Ministry of Health and Sports, but without a reliable allocation to individual actions, years or entities.[26]
• Record further unlabelled tabular figures associated with the General Treasury of the Nation or the Ministry of Health and Sports, for which the extract does not provide table headings, currency, dates or a dependable activity-level mapping.[30][31]