A psychiatrist in Neuquén, Argentina, José Lumerman is developing and
implementing a new and much-needed approach to the treatment and
rehabilitation of people with serious mental disorders. In his approach,
general practitioners lead "practical teams" that provide the needed
services on a cost-effective, outpatient basis in the patients' home
communities. José's parents fled from Poland during the Nazi era and settled
in Buenos Aires, where José was born and raised. As a medical student during
an increasingly tempestuous and dangerous period, he was the leader of a
student association. In that role, he attracted the ire of a political group
that was not content with nonviolent tactics, and he was kidnapped in 1974,
some time before the overthrow of Argentina's elected government and the
imposition of military rule. He escaped and fled to Europe that year. He
returned to Argentina some months before the coup in 1976 completing his
medical studies in Buenos Aires University and served for a period as the
chief of residents in the Italian Hospital of Buenos Aires. With the
restoration of democracy in Argentina in 1983, however, the atmosphere
changed, and he began to develop and refine his ideas for a radically
altered approach to the treatment and rehabilitation of the chronically
mentally ill, and to share them with others engaged in the provision of
health services. During the first years of his residency in psychiatry, Dr.
Lumerman had observed that the methods that he was using were producing
unusually positive results, even among the most gravely ill patients. That
experience fortified his resolve to work for the development and
introduction of a much-needed alternative to the prevailing approach. He
migrated with his wife and children to Neuquén in 1987 in Patagonia, where
he worked as a psychiatrist for a period in the Neuquen province central
hospital and then opened his own clinic in 1994, which serves as the base
for his current initiative, and where almost 4000 people and their families
have been treated.
The Instituto Austral de Salud Mental model was selected by the mental
health department of the WHO in a book published in 2009 as one of the 12
best practices in mental health recommended for primary health teams.