Mental health services in 42 low- and middle-income countries: a WHO-AIMS cross-national analysis.

Objective: The authors describe characteristics and capacities of mental health systems in low- and middle-income countries.

Methods: The World Health Organization Assessment Instrument for Mental Health Systems was used to assess services in 42 countries (13 low-, 24 lower-middle, and five upper-middle income).

Results: Of 36 countries with a mental health plan, 90% include the goal of developing community services. However, inpatient facilities are the main service providers, with less than one community contact (.70) for each inpatient day. Mental hospitals consume 80% of mental health budgets, and outpatient care is limited.

Conclusions: Mental health services in participating countries are limited and often hospital based.