Bridging from research evidence to health policy and from health policy to clinical practice: the case of the Spanish strategy for mental health

INTRODUCTION: In the last 30 years the Spanish NHS has evolved from a tightly centralized structure to seventeen autonomous regional health systems. As a result a number of benefits have been obtained but also important side-effects such as unjustified variation in clinical practice and a substantial loss of equity. DESCRIPTION: To deal with these unwanted developments the Spanish Inter-territorial Board of the NHS has recently approved and launched several health strategies on priority areas: diabetes, coronary ischemia, palliative care, cancer and mental health. The strategies are based on scientific evidence or consensus and they have been agreed on by all the regions. However, the degree of implementation is not as good as expected. CONCLUSION: The gaps from research to policy and from policy to practice in the strategy for mental health are identified and potential solutions are discussed.