The majority of the European Countries are facing the challenge to address the very high prevalence of mental disorders with limited mental health resources. Some of them drafted mental health strategies with community based models of care with the aim to give the best care as possible. Mutualista Association is the largest Portuguese mutual association, one of the largest mutual associations in Europe. Is also a reference as an institution in the social economy sector and financial activity in Portugal. The commitment with all the mutual association members brings to the institution importante and unique solidarity values.

The authors reflect about the psychiatric response of the Mutualidade Terras de Santa Maria to the psychiatric community patients attending the Clinic. The project gives “voice” to a vulnerable communitie perceived as a “receptive social environment” and emphasise the need for greater attention to the impacts of context, culture and local resources on people's responses to adversity and illness. They present a social-demographic characterization of the population attended as well as local strategies put in action to the various clinical situations.

The authors highlight the role of potential partnerships such as National Health System and Community Groups that are able to recognize better their communities's needs and assist them in working for improved well-being. Respectful local-global alliances have a key role to play in this process.