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Objectives: There is a demand for international comparisons of mental health care in Latin America. The purpose of this study was to describe mental health care in catchment health areas in Chile and Spain in order to complement information reported at the macro-level (countries or regions). Methods: Availability and utilization of services for the adult population were assessed in two urban areas in Chile and in three urban areas in Spain by using the European Service Mapping Schedule (meso-level data). Indicators from a previous data envelopment analysis (DEA) model of basic community care were applied to this analysis. Results: For the two countries, local data on beds and staff differed from data provided at the national level. In Chile meso-level data indicated more available beds and more psychologists per capita than did macro-level data. Quantitative indicators of community care were described, and the main gaps in Chile's urban areas were identified, particularly in day care and non- hospital residential care. There was nearly a tenfold difference in use of residential and day care between the benchmark area in Spain and the areas explored in Chile. In Chile's catchment areas there was no availability of nonacute hospital services, any work-related services for per- sons with mental disorders, or 24-hour mobile or nonmobile emergency psychiatric care. The meso-level data indicated that delivety and use of care in Chile was more similar to the pattern found in the poorer area in southern Spain than macro-level data would indicate. Conclusions: The European Service Mapping Schedule was useful for describing mental health care outside of Europe and allowed for an international comparison between Chile and Spain. The meso-level description gathered in this study adds to the macro-level information on the mental health care system that has been provided in other reports. The gap between mental health treatment needed and mental health treatment received in Chile may be lower than expected. (Psychiatric Services 59:421-428, 2008) [ABSTRACT FROM AUTHOR]

Introduction: Research on psychiatric deinstitutionalization has neglected that reforms in this field are nested in a health system that has undergone financial reforms. This subordination could introduce incentives that are misaligned with new mental health policies. According to Chile's National Mental Health Plan, this would be the case in the Community Mental Health Centers (CMHC). The goal is to understand how the CMHCpayment mechanism is a potential incentive for community mental health., Methods: A mixed quantitative-qualitative convergent study using grounded theory. We collected administrative production data between 2010 and 2020. Following the payment mechanism theory, we interviewed 25 payers, providers, and user experts. We integrated the results through selective coding. This article presents the relevant results of mixed selective integration., Results: Seven payment mechanisms implemented heterogeneously in the country's CMHC are recognized. They respond to three schemes subject to rate limits and prospective public budget. They differ in the payment unit. They are associated with implementing the community mental health model negatively affecting users, the services provided, the human resources available, and the governance adopted. Governance, management, and payment unit conditions favoring the community mental health model are identified., Conclusions: A disjointed set of heterogeneously implemented payment schemes negatively affects the community mental health model. Formulating an explicit financing policy for mental health that is complementary to existing policies is necessary and possible., Competing Interests: There is no conflict of interest for any of the authors., (This work is licensed under a Creative Commons Attribution 4.0 International License.)