Chile Takes Bold Step for Mental Wellbeing: Depression Treatment Now Available for Children Under 15

SANTIAGO, CHILE – In a landmark decision poised to reshape mental healthcare access across the nation, Chile has announced the expansion of its Universal Access Plan for Explicit Guarantees (AGE) to include depression treatment for children under the age of 15, effective December of this year. This builds upon existing coverage for those 15 and older, which has been in place for two decades, and represents a significant investment in the mental health of future generations. This is a developing story, and Archyde is committed to bringing you the latest updates as they unfold. This expansion is a major win for advocates pushing for increased mental health resources, and signals a growing global recognition of the importance of early intervention.

What Does the GES Cover for Depression?

The Explicit Health Guarantees (GES) program provides a structured pathway to care for 87 pathologies, and depression is a key component. For individuals with a confirmed diagnosis of mild, moderate, or severe depression, the GES offers a comprehensive treatment plan. Accessing these benefits is straightforward: simply present a medical certificate to your Isapre or Fonasa provider and complete the necessary paperwork. The process differs slightly depending on your healthcare system.

Accessing Treatment: Fonasa vs. Isapre

• Fonasa: Diagnosis is conducted at CESFAM/CECOSF/Consultorio, Cosam, Cesam, therapeutic diagnostic centers (CDT)/Health Reference Centers (CRS), or Hospitals.
• Isapre: Diagnosis is available at private medical centers or clinics.

Once activated, the GES provides access to a tiered system of care, tailored to the severity of the condition. This includes consultations with doctors and psychologists, necessary examinations, and prescription medications. In the most acute cases, hospitalization is also covered.

Treatment Baskets: Tailored Care for Every Need

The GES recognizes that depression manifests differently in each individual. Therefore, five distinct treatment “baskets” are available:

• Mild Depression Treatment
• Moderate Depression Treatment
• Severe Depression Treatment
• Depression Treatment with Psychosis, High Suicidal Risk or Refractory (Acute Phase)
• Depression Treatment with Psychosis, High Suicidal Risk or Refractory (Maintenance Phase)

Treatment begins promptly upon diagnosis, with specialist consultations scheduled within 30 days of referral. Importantly, the treatment basket can be adjusted as the patient progresses and their needs evolve, as determined by their doctor.

Understanding Copays: Fonasa and Isapre Differences

The financial burden of treatment varies depending on your healthcare affiliation. Here’s a breakdown:

• Fonasa A, B, C and D: 0% copayment – treatment is fully covered.
• Isapre: 20% copayment. For example, a benefit with a $13,200 tariff would require a $2,640 copayment.

(See the MINSAL GES Copay Table for Depression for a complete overview.)

Navigating the System: Closed Networks and Complementary Plans

It’s crucial to understand that activating the GES typically means accessing care within your Isapre or Fonasa’s network of providers. If you prefer to see a provider outside of this network, you can utilize your complementary health plan (if you have one) for coverage. This provides flexibility and ensures access to the care that best suits your individual needs.

This expansion of mental health coverage in Chile isn’t just a policy change; it’s a powerful statement about prioritizing the wellbeing of its citizens, especially its youngest and most vulnerable. By removing financial barriers and streamlining access to care, Chile is taking a proactive step towards building a healthier, more resilient future. As mental health awareness continues to grow globally, Chile’s initiative serves as a potential model for other nations seeking to improve access to vital mental healthcare services. Stay tuned to Archyde for further developments on this important story and other breaking news from around the world.