In Renca, Chile, as in so many other places around the world, the COVID-19 pandemic had a psychological impact on young people. A 2018 survey revealed that 60% of residents aged 14 to 16 reported having good mental health. By 2022, that figure had dropped to 40%.

Local leaders in Renca responded with new support for teenagers, built using data on existing mental health programs in the city. Combined with input from young people themselves, the initiative, known as Renca Contigo (Renca With You), is making a real difference.

Renca is a municipality of approximately 160,000 inhabitants and one of the many districts that make up the Santiago Metropolitan Region. Even before the pandemic, Renca had already begun to address youth mental health by creating a community center called Rucalaf, where children can attend therapy sessions focused on play, art, cooking, and other activities. In 2021, Renca added the services of 10 psychologists to several community health centers in the area.

These initiatives helped. However, by 2023, data from Renca showed significant gaps in access. Approximately half of young people aged 15 to 19 who likely needed care were not receiving it. Among those with depression or anxiety, most who attended therapy did not continue treatment, dropping out after one or two visits.

Municipal leaders set out to find out why. In focus groups with teenagers, parents, and mental health professionals, several issues emerged; for example, that the therapists in the program were not trained to work with young people. The most frequent observation had to do with proximity. The therapy appointments offered at community health centers were difficult to access.

Renca responded by moving services to where most young people are: at school. A school-based mental health pilot program was implemented, utilizing brief, scientifically validated interventions (by institutions such as the Johns Hopkins Institute) that were culturally adapted. In 2024, 37 students from three high schools received in-person counseling. Services were provided not only by psychologists but also by social workers, nutritionists, and other staff trained to work with children. In the pilot program, the percentage of students who attended more than six sessions increased significantly to 62 percent, compared to 15 percent among students who traveled to external health centers for care. Overall, the pilot program achieved an 80 percent reduction in clinical mental health symptoms.

Based on these positive results, the municipal authorities decided to expand the model, investing more than $2 billion and ensuring its implementation in all 14 public and private schools in Renca by 2025, moving towards universal school-based mental health coverage with a preventive, community-based, and evidence-based approach.

From now on, program coordinators are monitoring data through numerous indicators. For example, they are tracking process-related measures (such as how quickly young people referred to the program are seen by a therapist), the quality of care (how many experience significant clinical improvements), and cost-effectiveness (average cost per patient). They hope to use this and other data to improve the efficiency and impact of their programs, so that young people in Renca continue to feel better about themselves.

“For us, it’s very important to be able to measure what we’re doing,” says Patricia Castillo, the municipal director of health. “This will always be a program that is being tested and refined based on our operational methods and the feedback we receive from users.”