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The situation of Mental Health in Latin America is analyzed. Urgently creating a system able at handling the psychiatric disease increase in the years to come is a conclusion this paper strongly aims at. The beginning of Psychiatry is reviewed, and the importance of Psychiatry at the General Hospital is outlined as well as its rapprochement toward the community, which led to a better control and prevention in the field of Mental Health. A definition of Psychiatry is proposed, as a branch of Medicine which stands in between mental hospitals and communities. Active teamwork, coupled with the physician's work and the tasks other members of the health personnel are engaged in, has led to a more integrated approach onto the ill thus benefiting not only patients but also the whole community.

The paper attempts at a general assessment of mental health conditions in Latin America. Starting from methodological considerations the author points out at the difficulties for obtaining reliable data, gathered with compatible basis and the basical hindrances for building the concepts of health and illness, and for finding indicators reflecting the real health and welfare levels. The available data are discussed, together with their significance and scope. Stress is laid upon the meaning of prevalence and assistance data, which reflect only the problems of one sector of the population. The meaning of suicide and homicide is also discussed, and their use as indicators, together with data on occident rate, is suggested. The prevalence of alcoholism, psychosis and neuroses is examined, together with their role in the procedures for assessing mental health levels. Mental retardation and epilepsy are also considered. The author examines also human, technical and physical resources and facilities devoted to mental health, as well as training of personnel in the field. On the basis of statistical figures, it is showed a general deficit in all areas. As a conclusion, the author stresses the need to pay more attention to mental health problems and proposes a series of criteria in that sense.

This paper suggests that research on human behavior conducted in Latin America must be particularly careful in avoiding the false assumption that methods and constructs developed in one culture are equally valid in another. Three areas are proposed in which researchers must be particularly careful: Proper understanding of the emic/etic difference, that is properly differentiating between what is universal and applicable across cultures (etic) and what reflects the peculiarities of one cultural group. Establishment of appropriate equivalences: Conceptual (where constructs have the same meanings across cultures); linguistic (whereby words share the same connotative and denotative meanings); and, metric. Control of variables related to an individual's subjective culture that may influence response patterns and accuracy (e.g., social desirability, self-presentation needs, etc.).

This paper is based on a presentation delivered at a PAHO Regional Meeting on Mental Health. It focuses mainly on research issues and is to be considered as a preliminary prospective exercise. From a biomedical perspective, research in Latin America appears to be limited, but it is not clear to what extent. Costly technology, and scarce funding, together with the assumption that this type of research is a privilege of rich countries, are serious disadvantages, and yet, it need to be further promoted. Methodology of clinical and social research has grown in complexity. That is likely to be one of the reasons why local efforts are rarely internationally competitive. But there are groups in the Region that have shown that this can be achieved. Training of competent investigators and innovative means to shorten the scientific and technologic gap that separate us from developed countries are urgent, as Latin America has the potential to do better in research.