Mental health disorders, particularly depression, anxiety, and stress-related disorders, are common in Guatemala. Following Guatemala’s nationally mandated shift from institutional to community-based mental health care, driven by Inter-American Human Rights System findings, the role of general practitioners in providing mental health services has heightened. However, these doctors have reported a lack of confidence and training in prescribing effective treatments for patients. In this project, Dr. Daryn Reicherter, MD, Stanford Clinical Professor of Psychiatry, Dr. Gabriela Asturias, MD, Stanford Chief Resident in Psychiatry, and their team are bridging this gap by offering a culturally adapted digital curriculum tailored to the local context.

Through a structural digital training and mentorship program, primary care physicians in Guatemala will receive four months of mentorship from experienced Guatemalan psychiatrists, as well as ongoing support, to ultimately improve patient outcomes. The initiative will integrate implementation science, health systems, and clinical research methodology, as well as in-kind support from Stanford’s coalition partners, including Johns Hopkins, Glasswing International, and the local non-profits Fundación Astra and FUNDEGUA.

Through their intervention, the research team hopes to boost prescribers’ confidence, improve patient access to antidepressants through prescribing and referrals, and identify barriers, facilitators, and adaptation requirements to inform a scale-up blueprint.

“What is most compelling is that this work sits at the rare intersection of human rights enforcement and practical health systems change,” said Asturias. “Guatemala’s transition away from institutional psychiatric care is not an aspirational reform but a binding mandate arising from the Inter-American Human Rights System’s findings on the Hospital Federico Mora. That mandate creates a genuine opening to build community-based care—but it can only succeed if frontline general practitioners feel equipped to treat mental illness.”

Asturias added, “We hope to demonstrate that a low-cost, culturally adapted digital curriculum paired with structured peer mentorship can meaningfully strengthen primary care physicians’ capacity to deliver evidence-based mental health care, and that this model is feasible to scale across diverse regions using existing government systems.”

Principal Investigators:

Daryn Reicherter, MD, Clinical Professor of Psychiatry, Stanford University (Principal Investigator)

Dr. Gabriela Asturias, MD, Stanford Chief Resident in Psychiatry (Co-Investigator)

Franco Mascayano, MPH, Johns Hopkins University (Co-Investigator, Implementation Science)

Rebecca Walker, MD, MPH, Emergency Medicine (Co-Investigator, Health Systems)

Lisa Brown, PhD, ABPP, Psychiatry (Co-Investigator, Clinical Research Methodology)

Joaquin Barnoya, MD, Ministry of Health of Guatemala (Co-Investigator, In-Country Lead)

Funders:

Stanford Center for Innovation in Global Health

Stanford Department of Emergency Medicine

Stanford Department of Psychiatry & Behavioral Sciences