World Mental Health Day 2026: what you live through also counts in the consultation

When someone tells me how they sleep, what they no longer enjoy, what effect a medication had on them or what worries them about starting a treatment, they are not giving me background information. They are giving me clinical information that no test can replace. This happens with anxiety, depression, ADHD, OCD, bipolar disorder and many other conditions.

October 10 is World Mental Health Day. For 2026, the World Federation for Mental Health chose the theme “Lived Experiences Heard: Real Voices, Real Change”. In this article I explain why what you live through matters in the consultation, what is known about deciding on treatment together and what rights Peruvian law recognizes for you.

Why is what you live through clinical information?

In psychiatry, much of what I need to know does not show up in a blood test or in an imaging scan. It is in what the person tells me and in how they tell it. The regulations of Peru’s Mental Health Law define diagnosis as a “process of listening, observation, understanding and analysis”. And they state that it takes into account and includes the point of view of the person, of their family and of their peers, that is, of other people who have lived through something similar.

An international report on depression goes along the same lines. It is the Commission convened by the journal The Lancet and the World Psychiatric Association, published in 2022: a broad review written by a group of experts. For depression, it recommends that the diagnosis be accompanied by a formulation for each person, that is, an understanding of their case that takes into account their values, their preferences, their life history and their circumstances. And it proposes that this formulation be built together with the person and, where appropriate, with those who care for them.

That report also includes a finding that I find revealing. According to a study it cites, mental pain and functioning in daily life are aspects that people with depression, those who care for them and professionals consider very important. However, most of the depression scales used in clinical trials do not measure them. Part of what matters most to you can be left out of a questionnaire, so it is worth saying it out loud.

What is shared decision-making?

It means deciding on treatment together. The Cochrane review on the subject in mental health describes it as a form of communication in which both parties, the person (sometimes with their family) and the professional, contribute their experience and their knowledge, and work together to reach a decision. Sometimes it is supported by leaflets, videos or online tools that present the options with their benefits and their risks.

In practice, I put on the table what the evidence says and my clinical experience, and you bring what you live through, what matters to you and what you are willing to do. Deciding together does not mean that I won’t give you a recommendation: I will tell you clearly what I recommend and why, and together we look at how it fits with your life.

For depression, the Lancet Commission puts it this way: since there are still no individual characteristics that reliably indicate which treatment will work best for each person, the aspiration is to offer a choice among the main scientifically supported treatments, in order to respect each person’s preferences. That choice has limits: depending on the type of condition and its severity, as in severe depression, bipolar disorder or psychosis, some options are not interchangeable, and part of my job is to explain to you why.

Does deciding together improve symptoms?

Here it is worth being honest, because it is easy to exaggerate. A Cochrane review is an analysis that gathers and evaluates the published trials on a question. The 2022 review on shared decision-making brought together 15 trials, published up to January 2020, with 3141 adults. The trials included people with schizophrenia, depression, bipolar disorder, post-traumatic stress disorder, dementia, substance use disorders and other conditions; most had severe mental disorders and lived in high-income countries. None of the trials included children or adolescents. This is what it found:

• People who received these interventions could feel more involved in decisions right after the consultation (3 studies, 534 people, all in people with depression or bipolar disorder). The evidence is of low certainty: it is possible that new studies will change the result. There was not enough evidence that this involvement was maintained over time.
• It was not possible to know whether they improve symptoms or whether they reduce hospital readmissions, because the evidence is of very low certainty.
• They probably do not make the consultation longer (2 studies, 282 people with depression or bipolar disorder, moderate certainty).
• No adverse effects were reported in the studies.

In other words, it has not been shown that deciding together improves health on its own. What the evidence suggests is that it probably does not make the consultation longer and that people could feel more involved. For me, that is reason enough: the treatment is yours.

What rights do you have in Peru?

Law 30947, Peru’s Mental Health Law (2019), and its regulations (2020) recognize specific rights for anyone who uses mental health services. These are some that have a direct bearing on your voice in the consultation:

• Receive complete and understandable information about your mental health, including the diagnosis, the prognosis and the treatment alternatives, as well as the risks and precautions of the treatments and medications prescribed to you.
• Give your informed consent, that is, accept freely and without being unduly persuaded, after receiving accurate, sufficient and understandable information about the diagnosis, the treatment, the alternatives, the side effects and the risks.
• Be informed that you can refuse to receive or to continue a treatment, and have the consequences of that decision explained to you.
• If you are offered psychiatric medications, have the doctor inform you of their possible short-, medium- and long-term risks and adverse effects, and of your right to start a discontinuation process, that is, to stop taking them (I explain further down why it is worth planning this).
• Have one or more support persons, at any time, to help you assess and weigh the treatment alternatives.
• Decide whether to authorize the presence at your assessment of people who are not directly involved in your care.
• Not face discrimination or stigma for having a mental health problem, whether permanently or temporarily.
• File a complaint if you are not satisfied with the care you received, and be listened to and receive a response. Health services must have a clear mechanism for this.

In addition, the law establishes as a principle that the information obtained in the consultation is confidential and that your medical records are not disclosed without your express consent. The Ley General de Salud (Peru’s General Health Law) provides for some exceptions, for example when a judge requests it.

If the person seeking care is a minor, consent is given by their mother, father or legal representative. Even so, the adolescent’s opinion is taken into account, and how we handle the part of the conversation held one-on-one is something we agree on with the family from the first consultation.

About medication, an important clarification: the fact that the law recognizes your right to stop a treatment does not mean it is advisable to do so on your own. Some medications, if they are stopped or reduced without a plan, can cause discontinuation symptoms or a relapse. Do not stop or adjust your medication without consulting your doctor. If you want to stop it, we plan it together in a consultation.

This summary is not a substitute for reading the legal text or for legal advice.

How can you bring your voice to the consultation?

Some things that, in my experience, help:

• Write down beforehand what you most want to resolve. It is not always the most visible symptom: sometimes it is sleeping, going back to work or no longer arguing at home.
• Tell me what has changed since last time, including what has improved.
• If a medication caused an effect you didn’t like, say so, even if it seems minor or embarrassing to you, and before stopping it on your own. Many effects can be managed, but I can’t do that if I don’t know about them.
• Ask what alternatives there are, what can be expected from each one and what happens if you decide to wait. Sometimes waiting is reasonable and sometimes it is not; if that is your case, I will tell you clearly.
• If you disagree with something, say so in the consultation. We talk it over, I explain my reasoning and, if needed, we adjust the plan. I would rather know then than find out later that you stopped the treatment.
• If it helps, come with someone you trust. And if you prefer part of the conversation to be one-on-one, that is possible too.

Why do so many people not receive care?

Listening to those who live with a condition also matters outside the consultation. According to the WHO, in 2023 nearly 1 in 7 people in the world were living with a mental disorder, about 1.2 billion people, and the most common were anxiety disorders and depression. Effective prevention and treatment options exist, but most people with a mental disorder do not have access to effective care. The WHO points out that the gap between the need for treatment and what is provided is wide all over the world, and that care, when it arrives, is often of poor quality. According to data it cites, only 40% of people with psychosis and one third of people with depression receive formal mental health care. Many also experience stigma, discrimination and violations of their human rights.

These are global figures, not figures for Peru. Depression makes it possible to see how much is lost along the way, because it has more detailed data. The Lancet Commission cites the World Mental Health Survey in 15 countries, which it does not break down, according to which only about 1 in 10 adults with depression received effective care, that is, a treatment that met a minimum standard: an antidepressant taken as prescribed and with monitoring, or psychotherapy with a minimum number of sessions.

According to the WHO, health systems still do not respond adequately to the needs of people with mental disorders and have very few resources. In depression, the Lancet Commission considers the active role of those who have lived through it essential, for example when they share their experience to reduce stigma, and it states that the voices of those who have recovered are crucial to drive changes in policy. Listening to those voices is exactly the theme of World Mental Health Day 2026.

When should you seek help?

It is worth seeking help if what you feel lasts for weeks, if you find it hard to function at work, in your studies or at home, or if the people close to you notice a change in you. And if you are already in treatment and feel that the plan doesn’t fit your life, the first step is to tell your doctor.

There are situations in which it is not advisable to wait for an appointment. If you or someone close to you has gone several days with almost no sleep and a lot of agitation, sees or hears things that others do not perceive, cannot take care of themselves or is in danger, you need to go to an emergency department or call 106 (SAMU, the free emergency ambulance line). If you need advice, guidance or help, you can also call 113, option 5, free of charge. The practice’s WhatsApp is for booking appointments, not for emergencies.

Frequently asked questions

What is the theme of World Mental Health Day 2026?
The World Federation for Mental Health chose “Lived Experiences Heard: Real Voices, Real Change”. World Mental Health Day is on October 10.

What is shared decision-making in mental health?
It is a way of making decisions about treatment in which the person and the professional each contribute their experience and their knowledge, and decide together. Sometimes it is supported by materials that present the options with their benefits and risks.

Does deciding on treatment together improve symptoms?
With the studies available, this could not be established. According to a 2022 Cochrane review, with studies up to 2020, the effect on symptoms is unclear because the evidence is of very low certainty. In studies with people with depression or bipolar disorder, those who decided this way could feel more involved right after the consultation, and the consultation probably does not get longer.

What rights do I have as a mental health patient in Peru?
Peru's Mental Health Law recognizes, among others, your right to receive complete and understandable information about your diagnosis and your treatment alternatives, to give your informed consent, to be informed that you can refuse to receive or to continue a treatment and to not face discrimination or stigma. Its regulations add the right to have support persons to help you make decisions.

Can I refuse psychiatric treatment in Peru?
Yes, as a general rule. According to Peru's General Health Law, in the wording given to it by the Mental Health Law, treatment and hospitalization are carried out with your informed, free and voluntary consent, except in emergency situations. In addition, you have the right to be informed that you can refuse to receive or to continue a treatment, and to have the consequences explained to you. Once the emergency is resolved, any treatment again requires your consent. If you take medication, do not stop or adjust it without consulting your doctor.

Can I bring someone I trust to the consultation?
Yes. The regulations of the Mental Health Law recognize your right to have support persons to help you make decisions about your treatment, and the law allows you to decide whether people who are not directly involved in your care can be present at your assessment.

This article is for information only and does not replace an individual medical evaluation or create a doctor-patient relationship. I recommend not starting, changing or stopping a treatment without first discussing it with your doctor.

References

1. World Federation for Mental Health. World Mental Health Day 2026: Announcing This Year's Theme. 11 Aug 2026.
2. World Health Organization. World Mental Health Day.
3. World Health Organization. Mental disorders. Fact sheet. 11 Sep 2026.
4. Herrman H, Patel V, Kieling C, et al. Time for united action on depression: a Lancet-World Psychiatric Association Commission. The Lancet. 2022;399(10328):957-1022. doi:10.1016/S0140-6736(21)02141-3
5. Aoki Y, Yaju Y, Utsumi T, et al. Shared decision-making interventions for people with mental health conditions. Cochrane Database of Systematic Reviews. 2022;11(11):CD007297. doi:10.1002/14651858.CD007297.pub3
6. Ley N.° 30947, Ley de Salud Mental. Diario Oficial El Peruano, 23-may-2019.
7. Decreto Supremo N.° 007-2020-SA, Reglamento de la Ley N.° 30947, Ley de Salud Mental. Diario Oficial El Peruano, 5-mar-2020.
8. Ley N.° 26842, Ley General de Salud. Diario Oficial El Peruano, 20-jul-1997.
9. Ley N.° 31627, que modifica la Ley 30947, Ley de Salud Mental. Diario Oficial El Peruano, 18-nov-2022.