Page 167 - GHES-2-4

Global Health Economics and
Sustainability

ORIGINAL RESEARCH ARTICLE
Evaluation of mental health law 21,331 in Chile

Gonzalo Leyton *
1,2
1 School of Public Health, Faculty of Medicine, University of Chile, Santiago, Chile
2 Department of Studies, Superintendence of Health, Santiago, Chile

Abstract
This study evaluates whether the implementation of law 21,331 on mental health
(MH) affected financing in Chile’s private health-care system. The effects of effective
financial coverage and the acceptance rate of sick leaves are analyzed. The results
show increased coverage in plans without coverage constraints in MH concerning
those with restricted coverage; however, differences imply a lower effective coverage
in MH services concerning physical health services. Regarding sick leaves, the practice
of refusing and reducing sick leaves for mental disorders increased, further deepening
the gap concerning other diagnostic groups. Notably, medical consultations by
telemedicine have allowed significant increases in coverage, including for MH.
Analyzing the differences by gender shows that there is less financial coverage for
women than for men regarding MH services. Furthermore, women experience a
higher proportion of rejected and reduced sick leaves than men. Law 21,331 works
toward the World Health Organization recommendations in this area; however,
a significant gap remains between the effective financial coverage of MH services
Academic editor: compared to physical health services and the resolution of sick leaves for mental
Mihajlo Jakovljevic M.D. Ph.D. MAE
disorders versus other diagnostic groups.
*Corresponding author:
Gonzalo Leyton
(gleyton@uchile.cl) Keywords: Mental health; Mental health law; Financing; Evaluation; Financial coverage;
Citation: Leyton, G. (2024). Sick leaves; Law 21,331; Private health-care system
Evaluation of mental health law
21,331 in Chile. Global Health Econ
Sustain, 2(4):3408.
https://doi.org/10.36922/ghes.3408
1. Introduction
Received: April 11, 2024
A phrase widely used in mental health (MH) is that there is no health without MH. The
Accepted: July 17, 2024
World Health Organization (WHO) conceives MH as a “state of well-being in which the
Published Online: October 29, individual realizes his or her capabilities, overcomes the normal stresses of life, works
2024
productively and fruitfully, and contributes something to his or her community” (WHO,
Copyright: © 2024 Author(s). 1946, p.1).
This is an Open Access article
distributed under the terms of the Worldwide, mental disorders have had a high prevalence and incidence for some
Creative Commons Attribution time (The Lancet, 2022). The COVID-19 pandemic has highlighted the importance of
License, permitting distribution,
and reproduction in any medium, MH, which has become a significant public health issue. As a result of the pandemic,
provided the original work is the health needs associated with mental disorders have been identified as the fourth
properly cited. wave of effects, which, unlike other impacts (increased mortality, relocation of resources,
Publisher’s Note: AccScience and interruption of treatment of chronic diseases), is expected to have a stable behavior
Publishing remains neutral with over time (without reductions) after reaching its peak. This situation is linked to the
regard to jurisdictional claims in
published maps and institutional psychosocial burden, the emergence of new mental disorders, relapses in people with
affiliations. controlled mental disorders, and economic impacts (O’Connor et al., 2021).

Volume 2 Issue 4 (2024) 1 https://doi.org/10.36922/ghes.3408