Progress of Panama 30 years after the Declaration of Caracas

Since 1970, Panama has incorporated into Primary Health Care professionals in psychiatry, psychology, nursing and social work by the Ministry of Health, the Social Security Fund and the private sector.  However, the hegemonic and centralizing role was played by Psychiatric Hospitals, even integrating a large percentage of the Training of Human Resources in Mental Health.

Since the 90s, the transformation from asylum to a Psychiatric Hospital was carried out, and from this to the National Institute of Mental Health (INSAM). The chapter on the Mentally Ill under  closed doors was finished  and the Outpatient Consultation is eliminated within the INSAM Service Portfolio, referring users to Primary Care throughout the country, strengthening the capacity of Mental Health teams and including the prescription of psychotropics medication.  At the same time, progress was made in training within Clinical Masters and Doctorates.

With the Brasilia Principles in 2005, the existence of successful experiences is recognized, among others those of Panama, with the development of a decentralized Mental Health system. The inclusion of users and family members is promoted to empower themselves in the defense of the Rights of the Mentally Ill and to oversight entities on  the quality of care.

In the 2010 with the  Panama consensus, neighboring governments are urged to implement Strategies and Action Plans on Mental Health; the slogan of the conclave was: “The decade of the leap towards the community; for a continent without madhouses in 2020 ”. In this framework, the use of the mhGAP tool (Global Action Plan to overcome the gaps in Mental Health) is encouraged.

At the legal level, the Republic Law 174 “Establishing the legal framework for the comprehensive approach to suicidal behaviors” has recently been enacted, published in official gazette # 29147 on November 2, 2020.

Additionally, Law 314 of 2020 is under review, "Establishing public policies on Mental Health" for its expansion and strengthening, in addition to innumerable efforts to guarantee Prevention, Promotion and Qualified Attention around Mental Health and making visible the rehabilitative treatment of substance abuse.

Panama continues to advance as a model of changes in favor of the Rights of people with Mental Illness and towards a sensitized population, erasing stigmas and improving access to Mental Health Services.