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Presidente Gustavo Petro sanciona Ley de Salud Mental: ¿cuáles son los artículos nuevos y los cambios más relevantes?
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En un acto solemne realizado en la histórica Quinta de Bolívar en Bogotá, el presidente Gustavo Petro sancionó la Ley de Salud Mental, marcando un antes y un después en el abordaje institucional del bienestar psicosocial en Colombia. Esta norma, ampliamente respaldada por el Congreso de la República y producto de la acumulación de seis proyectos legislativos (PL 029/24S, 014/23C, 080/23C, 151/23C, 261/23C y 268/23C), representa una reforma estructural a la Ley 1616 de 2013.
La nueva ley representa un avance normativo de alto impacto al reformular el objeto, principios y mecanismos de articulación institucional en salud mental, e incorpora, por primera vez, herramientas como el Sistema Nacional de Salud Mental, los Consejos Territoriales de Salud Mental, y un enfoque diferencial y poblacional transversal.
“Colombia se fortalece cuando su gente se escucha y no juzga, cuando nos ponemos en los zapatos del otro y cuando tendemos la mano a quien lo necesita y hoy muchas personas están pidiendo a gritos ser escuchados. Por eso, Presidente, le doy las gracias por poner a la salud mental en este primer orden”: Olga Lucía Velásquez, autora de la Ley de Salud Mental.
Reconocimiento integral de la salud mental y sus determinantes – Ley de salud mental
Uno de los primeros cambios sustanciales se observa en el artículo 1, que redefine el objeto de la Ley 1616 de 2013. La nueva redacción enfatiza que la salud mental es parte constitutiva del derecho fundamental a la salud, y su garantía debe hacerse bajo los principios de equidad, integralidad, interculturalidad y participación. La norma reconoce de forma explícita los determinantes sociales, ambientales y culturales que influyen en la salud mental, lo cual obliga a las instituciones públicas a abordar esta dimensión desde una perspectiva más amplia que la clínica tradicional.
Se incorporan enfoques diferenciales obligatorios para la atención a personas y comunidades históricamente excluidas, incluyendo pueblos étnicos, víctimas del conflicto armado, personas LGBTIQ+, habitantes de calle, privados de la libertad, y personas con consumo problemático de sustancias.
Corresponsabilidad intersectorial como principio rector
Con la adición del artículo 4A, se establece el principio de corresponsabilidad como eje transversal de las políticas públicas de salud mental. En adelante, la formulación e implementación de estas políticas no será competencia exclusiva del sector salud, sino que deberán participar activamente los sectores de educación, trabajo, cultura, deporte, justicia, protección social, vivienda y desarrollo económico.
Este enfoque permite que la promoción de la salud mental y la prevención de trastornos mentales se conviertan en compromisos colectivos, articulando acciones comunitarias, institucionales y gubernamentales en todos los niveles territoriales.
Sistema Nacional de Salud Mental: una nueva arquitectura de coordinación
Uno de los avances más significativos introducidos por esta ley de salud mental es la creación del Sistema Nacional de Salud Mental, mediante el nuevo artículo 6A. Este sistema estará liderado por el Ministerio de Salud y Protección Social, y su objetivo es estructurar una red interinstitucional permanente para coordinar, formular, ejecutar y evaluar las políticas de salud mental en el país.
Entre sus funciones se destacan:
- Formular lineamientos técnicos y operativos.
- Definir indicadores de seguimiento y evaluación.
- Promover estándares de calidad para servicios y programas.
- Facilitar la participación ciudadana y comunitaria en la toma de decisiones.
La operatividad del sistema se apoyará en el trabajo conjunto con organizaciones de la sociedad civil, academia, usuarios del sistema de salud y cuidadores.
Nuevas responsabilidades para entidades territoriales
La ley de salud mental a su vez modifica el artículo 9 de la norma original, exigiendo a los departamentos, distritos y municipios que formulen e implementen Planes Territoriales de Salud Mental basados en evidencia y alineados con las necesidades locales. Estos planes deben contemplar acciones de promoción, prevención, atención, rehabilitación y mitigación de factores de riesgo psicosocial, además de estrategias de lucha contra el estigma y la discriminación.
Se enfatiza que las entidades territoriales deberán habilitar redes comunitarias de apoyo psicosocial, establecer protocolos frente a conductas suicidas y asegurar que las rutas de atención respondan a los determinantes del contexto local.
Atención prioritaria y sin barreras a poblaciones vulnerables
El artículo 11, reformulado, establece que la atención en salud mental a poblaciones vulnerables debe ser preferente y sin barreras administrativas. Esto aplica especialmente a personas con consumo problemático de sustancias psicoactivas, personas privadas de la libertad, víctimas de violencia de género, niños, niñas y adolescentes en situación de riesgo, y personas en situación de calle.
La norma prohíbe expresamente la exigencia de autorizaciones innecesarias o trámites administrativos que dificulten el acceso efectivo a los servicios de salud mental en estos grupos.
Uno de los ejes más técnicos de la reforma es el reforzamiento de las responsabilidades de entidades promotoras (EPS) y prestadoras (IPS). Estas organizaciones deberán garantizar no solo la disponibilidad de servicios de salud mental en sus redes, sino también la continuidad y calidad de la atención. Se exige la oferta de:
- Servicios ambulatorios y hospitalarios especializados.
- Intervenciones comunitarias y redes de atención primaria.
- Capacitación permanente al talento humano en salud mental.
- Inclusión de usuarios y cuidadores en comités de calidad.
Además, las EPS e IPS estarán obligadas a reportar de manera periódica el cumplimiento de estos estándares ante los organismos de inspección, vigilancia y control.
Educación y promoción de salud mental desde las aulas
Con la reforma del artículo 14, las instituciones educativas deben integrar estrategias de promoción de salud mental en sus proyectos pedagógicos. Se incluyen acciones como:
- Formación docente en salud mental y emocional.
- Detección temprana de señales de riesgo.
- Fortalecimiento de vínculos familiares y redes de cuidado.
- Implementación de protocolos de atención psicosocial.
La norma vincula directamente a las secretarías de salud y educación para que estas acciones se desarrollen en el entorno escolar desde la primera infancia.
Participación ciudadana y veeduría social
La ley de salud mental crea los Consejos Territoriales de Salud Mental, como espacios de participación consultiva y control social. Estos consejos estarán conformados por representantes de organizaciones sociales, usuarios, cuidadores, veedurías ciudadanas y actores comunitarios. Sus funciones incluyen:
- Emitir conceptos sobre los planes territoriales de salud mental.
- Proponer ajustes en las estrategias locales.
- Realizar seguimiento al cumplimiento de metas e indicadores.
Producción de evidencia y sistemas de información
La nueva norma refuerza el deber del Estado de generar información confiable para la toma de decisiones. El Ministerio de Salud deberá implementar estudios periódicos, actualizar los sistemas de información (como el SISPRO), y garantizar la disponibilidad de datos desagregados por territorio, grupo poblacional, sexo y edad. Asimismo, se establece el deber de reportar anualmente los avances en cobertura, oportunidad, calidad y equidad de los servicios de salud mental.
Finalmente, la ley amplía las facultades de la Superintendencia Nacional de Salud para vigilar el cumplimiento de estas disposiciones. Las EPS e IPS que incumplan sus obligaciones podrán ser sancionadas con base en el régimen vigente, con énfasis en aquellas acciones que impidan el acceso efectivo o generen barreras para la atención integral en salud mental.
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