There are very limited mental health resources in developing countries. There is a major imbalance in the amount of available mental health resources in proportion to the ever-increasing number of clients requiring treatment. A key reason for this underestimation, according to WHO, is the rising gap in health service capacity in different countries. WHO estimates that more than three-quarters of people with severe mental disorders in low- and middle-income countries never receive any treatment for their illness. (World Bank Group, 2018).
These conditions are reflected in the mental health care situation in Bolivia. The International Journal of Mental Health Systems published an overview of psychiatric care in Bolivia, its history, demographics, and background. Unlike other countries in the region, Bolivia only recently adopted a universal healthcare system, one reason why it has lagged so much in providing mental health care (Jaen-Varas, 2014).
Alcohol abuse and mental health account for a large majority of hospitalizations in the country, according to Jaen-Varas, and the country has very few licensed mental healthcare professionals. Jaen-Varas reports that before adopting universal healthcare, Bolivia had a dire lack of “well-structured mental health networks” for care (Jaen-Varas, 2014, 2). In 2008, Jaen-Varas reported, Bolivia documented 39 outpatient facilities, seven of which were for children; nine psychiatric hospitals; and no mental health services at all for the incarcerated (Jaen-Varas, 2014).
In 2008, the most frequently reported cause of admission to psychiatric hospitals in Bolivia was substance abuse, with “alcohol consumption… responsible for 90% of these admissions, in addition to being a major cause of deaths in traffic” (Jaen-Varas, 2014, p. 3). Jaen-Varas also reports suicide as “disproportionately high in Bolivia” (Jaen-Varas, 2014, p. 3). Suicide was the cause of 40% of youth mortality in one Bolivian city, Alto.
Jaen-Varas, D., Ribeiro, W. S., Whitfield, J., & de Jesus Mari, J. (2014). Mental health and psychiatric care in Bolivia: What do we know? International Journal of Mental Health Systems, 8. https://doi.org/10.1186/1752-4458-8-18
Kohrt, B. A., Mutamba, B. B., Luitel, N. P., Gwaikolo, W., Onyango Mangen, P., Nakku, J., Rose, K., Cooper, J., Jordans, M. J. D., & Baingana, F. (2018). How competent are non-specialists trained to integrate mental health services in primary care? Global health perspectives from Uganda, Liberia, and Nepal. International Review of Psychiatry, 30(6), 182–198.
Pan American Health Organization. (2018). The Burden of Mental Disorders in the Americas: Country Profile [Plurinational State of] Bolivia. PAHO.org. https://www.paho.org/sites/default/files/2020-09/MentalHealth-profile-2020%20Bolivia_Country_Report_Final.pdf.
World Bank Group. Moving the needle : mental health stories from around the world – summary report of symposium (English). (2018) WBG Global Mental Health Initiative Washington, D.C. : World Bank Group. http://documents.worldbank.org/curated/en/617351529998944991/Moving-the-needle-mental-health-stories-from-around-the-world-summary-report-of-symposium