Mental Health in Vulnerable Areas and the Role of Non-State Programs
Mental health care often takes a back seat, especially in areas where other emergencies dominate. Yet responses are urgently needed. An overview of the fieldwork being done.
Outside major cities and in isolated rural areas, where poverty, violence, and inequality are part of daily reality, mental health is a silent emergency—frequently unseen and undervalued.
People living in these regions face a heavy emotional burden, for which adequate care is rarely available through public systems. This is where non-state programs, led by social organizations, foundations, NGOs, and religious communities, have become an essential pillar in meeting mental health needs.
Mental Health in Vulnerable Communities
Mental health problems in vulnerable communities are often tied to environments marked by food insecurity, unemployment, overcrowding, domestic violence, substance abuse, discrimination, and social exclusion. Generally, this branch of healthcare is not implemented in these territories.
Historically, public policies have prioritized the treatment of physical illnesses, relegating mental health to a second—or even third or fourth—tier. According to the Pan American Health Organization (PAHO), in Latin America and the Caribbean, less than 2% of health budgets are allocated to mental health, and much of this funding goes to psychiatric hospitals, with little investment in community services.
The COVID-19 pandemic further worsened this scenario. Isolation, job losses, and collective mourning heightened emotional distress, particularly in precarious neighborhoods.
This global crisis exposed the lack of institutional infrastructure to respond to such emergencies, underscoring the need for more comprehensive and decentralized approaches.
With limited state response, numerous civil society organizations stepped in to provide solutions. Some emerged from community activism, while others operate within professional models funded by international donors, universities, or technical cooperation.
What unites them all is their commitment to providing care that is close, culturally appropriate, and accessible—even for those who distrust traditional health systems.
In Buenos Aires, for example, the organization Andamio works in urban slums, offering emotional expression workshops for young people and women who are victims of violence. In Bolivia, a program coordinated by the Acción Solidaria Foundation implements community mental health spaces in Quechua and Aymara, recognizing the value of indigenous community involvement in therapeutic processes.
One of the most valuable contributions of these programs is their ability to rethink care models beyond traditional clinical frameworks that privilege individual consultations and diagnoses. Many non-state initiatives favor group dynamics, spaces for collective listening, circles of care, and peer support networks.
The community therapeutic support model trains local leaders to provide basic emotional care, identify warning signs, and refer to professionals when necessary. These approaches not only improve access but also strengthen social ties in the area.
Challenges and Opportunities
Financial sustainability is one of the main limitations of these programs. Many initiatives operate with unstable budgets or rely on temporary donations. Additionally, the lack of coordination with public systems can lead to overlapping efforts or discontinuity in care, a problem that must be addressed.
Nonetheless, the experience gained from these non-state programs offers valuable lessons for governments, showing that public policies should integrate them into a plural, decentralized, and community-based mental health system.
The WHO advocates for a “community mental health” approach as an alternative to closed hospital systems, and many countries are moving toward reforms in this direction. However, without sufficient funding and political will, these changes are unlikely to reach the most vulnerable areas.
Reaffirming that mental health is a human right, not a privilege, is a message that must be repeated worldwide—especially in regions where material needs are many, since emotional suffering is also an emergency.
Non-state programs have shown that it is possible to reach places where the state does not, with creativity, commitment, and proximity. But sustaining and expanding these experiences is crucial, by linking them to public policies that recognize the diversity of ways to heal.
Caring for the mental health of the most vulnerable communities is not only a healthcare task but also an ethical commitment to building a fairer, more empathetic, and more supportive society.