Scaling mental health where life happens: Helping Santiago thrive across the lifespan

On a weekday morning in Renca, a working-class municipality in northern Santiago, Chile, high school students arrive at school carrying more than a backpack. They carry anxiety. Sleepless nights. The quiet weight of a pandemic that reshaped adolescence across the globe.

These mental health challenges do not discriminate by age. Across Santiago, people are struggling. In the neighboring municipality of Providencia, older adults are carrying something just as heavy: loneliness, depression, and the lasting effects of prolonged isolation.

In both municipalities, mental health needs have been rising. Until recently, there were few places for people to turn for timely mental health support. Long waiting lists and limited specialist capacity has meant help often comes too late—if it comes at all.

Healthy Santiago, a city-level mental health initiative that brings together cross-sector leaders, is changing that, beginning with a focus on two particularly vulnerable populations: youth and older adults. The governments of Renca and Providencia, private sector leader ACHS (a Chilean workplace insurance and health provider), CETA Global (an implementor of evidence-based mental health interventions), and the McKinsey Health Institute (MHI) are working together to advance mental health through a sustainably financed model.

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“I’ve seen how prevalent mental health issues are in Santiago and in Chile overall,” says Javier Valenzuela, a McKinsey partner and McKinsey Health Institute leader in Latin America. “For me, realizing that we were still addressing mental health with the same tools we used 30 years ago was a personal wake-up call.”

The goal of Healthy Santiago is to expand access to evidence-based mental healthcare through task sharing: training trusted clinical and nonspecialist providers (people already embedded in daily community life) to deliver structured, clinically proven interventions such as cognitive behavioral therapy and problem-solving therapy under specialist supervision. The model is designed to scale, supported by a sustainable financing approach.

“We have interventions that we know work, but they aren’t at scale today,” says Erica Coe, a McKinsey partner and global executive director of MHI. “We saw an opportunity to build out a business model for task sharing to show that there is an investment angle for a wide range of cross-sector stakeholders.”

In Renca, a lower-income community with a relatively young population, the focus has been on adolescents and scaling the Renca Contigo program. Municipal counselors, midwives, and other professionals have been trained in the Common Elements Treatment Approach (CETA)—an evidence-based system that treats a wide range of mental health needs—and now deliver structured sessions within schools, tracking progress and adjusting care in real time under clinical supervision. For students, that might mean learning practical coping strategies, setting achievable goals, and building confidence to re-engage in school and daily life.

A trained task-sharing provider working in Renca schools noted that the shift has been immediate and tangible. “What changed was having a concrete methodology that works and seeing young people apply those tools in their daily lives, week by week,” she said.

More than 80 percent of young people who have received care from trained task-sharing providers have completed the program. Schools have reported improved engagement in class, while families say students are more confident and better able to participate in daily life. As one program participant shared, “It cleared a lot of my worries—and if they reappear, I know how to handle them.” Another youth shared, “I used to feel alone, like I didn’t belong. But Renca Contigo helped me find my voice. My friends and I learned that we were not alone—we were waiting for someone to teach us how to ask for help.”

Parents also shared gratitude for the positive impact of this program: “Sometimes we notice our kids are not well and we don’t know what to do, what to say, how to help. This program gave my child a safe space to open up. Thanks to the program, we now have a way to communicate. A lot of families don’t know how to confront the difficulties our children face. This program not only helps our children but also helps parents and families.”

For Renca Mayor Claudio Castro, the impact has gone beyond individual outcomes. “For us, strengthening mental health is part of building a stronger community,” he says. “With Renca Contigo, our implementation of task sharing in schools, we have combined a clear diagnosis, evidence-based programs, strong partnerships, and financial sustainability from the beginning. This has given us better results that we can sustain and scale over time.”

In Providencia, the program applies the task-sharing approach to primary care centers serving seniors—as well as through home visits—for the many older adults experiencing anxiety, depression, or isolation. Task-sharing-trained social workers and nurse technicians now support seniors during their weekly check-ins, helping them manage stress and providing the mental health care they need before issues escalate into crises.

“We have a very large older community. We knew we needed to create prevention mechanisms to help them lead fuller, healthier lives and to help reduce the burden on families caring for their elderly relatives,” says Providencia Mayor Jaime Bellolio. “We are able to meet our older adults where they are already showing up.”

Older adults have reported feeling less isolated and more supported, while professionals have gained practical tools to address mental health needs as part of everyday care rather than as a separate service, which, while important, can create stigma. “The sessions helped me realize that what I am experiencing is not something trivial—and that I have support and help,” one participant said. “This provider was my angel. She’s given me tips to manage my anger and anxiety. I’m grateful for the work she’s done,” shared another participant. “If I didn’t have this program, I would have struggled to keep going.”

CETA-trained providers working with older Providencia residents see the transformation this initiative is bringing. “We’ve overlooked the mental health of older adults for too long. This program is changing that by offering early support, practical tools, and a space where people feel heard, not just treated with medication,” shared one provider.

Across the municipalities, the delivery model for care has been the same: Rather than building parallel systems, Healthy Santiago strengthens the ones that already exist—in schools, nursing homes, community centers, and primary care settings—by equipping staff with the tools to respond earlier and more effectively. The premise is straightforward: When care is delivered in familiar settings by trusted providers, access expands and stigma declines.

As Laura Murray, founder of CETA Global, says: “Task sharing naturally builds trust and connection within communities. It also eases the burden on providers, helping retain and expand the workforce while increasing access to mental healthcare.”

Cross-sector collaboration is central to the initiative’s success. That alignment has not only delivered measurable results but also created a model built to last.

Many initiatives fall short because they rely on short-term grant funding and lack the systems in place to support local communities’ self-sustainability. Healthy Santiago is different: It was designed from the start with a cross-sector financing model, with the ability to train local supervisors, and with a system that maintains fidelity and tracking.

Because of the strong business case for task sharing, aligned with commitment from the top—from mayors to ACHS’s leadership—each local stakeholder has been able to dedicate resources to launch and scale the training. Municipalities have funded providers on staff to become task-sharing trained and dedicate time to providing mental health services, because they see real healthcare cost savings and broader societal benefits. ACHS has funded training and certification of local providers in part because of alignment with its own business model, and is further integrating the training into its offerings for employers more broadly.

Kana Enomoto, director of Brain Health for MHI, comments, “It’s exciting that we’re talking about how a private sector company can help support a mental health innovation that has incredible implications for public sector entities, for community schools, for health centers, for senior centers. It shows that we can benefit both the public sector and the private sector at the same time by investing in mental health.”

“When it comes to solving health challenges, the private sector has much to contribute in terms of capabilities, knowledge, and management skills,” says Juan Luis Moreno, CEO of ACHS and key partner of the initiative. “Public–private partnerships and academic involvement will undoubtedly be fundamental to establishing and scaling up sustainable solutions over time.”

As of early 2026, 24 task-sharing providers have been trained across the two municipalities, supporting more than 2,700 individuals and family members and closing up to 45 percent of the mental health access gap for the target populations. Furthermore, a clear business case has been established—an MHI analysis estimates that task sharing could potentially generate societal and economic value with an Social Return on Investment of up to seven to 17 times (depending on population) by lowering healthcare costs, helping people to continue working, and improving school and career outcomes.

Santiago is fast becoming a reference case for other cities seeking to address rising mental health needs. To support similar efforts elsewhere, MHI and partners have developed a playbook outlining practical financing approaches. Drawing on examples from diverse contexts, including Santiago’s experience, it explores funding models and the system-level conditions required to embed and sustain task sharing, so it can evolve from isolated initiatives into a routine part of mental health service delivery.

Additionally, in collaboration with Grand Challenges Canada and Google, MHI has developed a field guide for how AI can support mental health skill-building programs. It offers foundational knowledge, actionable strategies, and real-world examples that task-sharing programs can use to responsibly and effectively expand their work with the help of AI.

The Healthy Santiago effort is grounded in a simple but powerful belief: Cities are where health happens, and investing in health at the city level is one of the highest-return investments leaders can make.