[Marxism] The Cuban mental health system

Louis Proyect lnp3 at panix.com
Wed Oct 10 07:43:30 MDT 2012

Hispanic Journal of Behavioral Sciences December 1980 2: 337-354,

The Organization of Mental Health Services in Cuba
by Yohel Camayd-Freixas and Miren Uriarte

The Cuban mental health system is based on traditional public health 
theory.That is, it assumes that common illnesses cannot be controlled 
simply by treating affected individuals. Instead, it seeks to control 
illness through the identification of etiology and the implementation of 
primary prevention programs. Its objectives are to reduce incidence of 
mental illness and to promote early identification and intervention 
systems through an ecological approach (Barrientos Llano, 1977; Galan 
Rubi, 1975; Hernandez, 1975a; Le6n Alsina, 1975).

The concept of three levels of prevention described in this paper is not 
endemic to Cuba. It is used by the World Health Organization and was 
originally conceptualized by the English psychoanalyst, Caplan, of 
Harvard University (see Caplan, 1964). Similarly, "psychiatry in the 
community" reflects trends in deinstitutionalization and community-based 
care that can be identified in other countries. In fact, besides a few 
endemic techniques, the component elements of the Cuban system are 
common to a number of mental health systems in this hemisphere. What 
characterizes the Cuban system is the extent to which some of these 
elements are used and its systematic efforts to integrate mental health 
into public health and the sociopolitical structures.

The Cuban system is flexible, practical, and often ingenious. Services 
are generally accessible,free,and of good quality. Treatment does not 
differ as a function of social class or race (Camayd-Freixas &	Uriarte, 
Note 1). Services in the community are decentralized to increase their 
accessibility and effectiveness, while chronic care is centralized to 
increase efficiency and develop comprehensive rehabilitation programs. 
Prevention and mental health promotion are emphasized. The Cuban system 
is also characterized by the simultaneous existence of centralized 
planning, extensive community involvement, and the systematic 
adaptability of services that respond to the reality and needs of the 
communities where they are based. Perhaps the most robust demonstration 
of this system’s success is its own development from a nominal hospital 
to an effective network of services.


More information about the Marxism mailing list