This lecture will address the three types of pathways that have to be explored in efforts to improve mental health care. The first are the pathways that people who have a mental disorder (or fear that they might have one) will take to get help. Information about these pathways can be of immense value to public health decision-making and obtaining it is relatively simple but rarely done in a systematic way.

The second type of pathways are those that lead to an integration or at least a coordination of care provided by the various types of institutions and social sectors, that provide care in the community. Parallel to this effort is also the effort to integrate or coordinate the action by health professionals, psychologists, social workers and the many other professionals who are dealing with people with mental health problems. The integration of care provided by families and non-professional carers with that of the professional care system is a neglected area leading to a wasteful and sometimes harmful use of resources that are often very scarce.

The third type of pathways that need exploration (and creation) are pathways that lead from research and educational efforts to those directed to the improvement of care. The gaps that exist between these endeavours grow in parallel with the advances of science and with the separation between academic and clinical (particularly private) psychiatry that can be observed in many countries.