[Mental health in Argentina and Brazil: advances and challenges based on subnational experiences in Río Negro and Ceará].

Mental health policies in Latin America are diverse, with different strategies, processes, and outcomes in their psychiatric reforms. This article aimed to analyze the progress and challenges of mental health policies in Argentina and Brazil, considering subnational reform experiences. A qualitative research design was used, including a descriptive, critical, and comparative approach. In addition to documental analysis, 35 interviews were conducted with national policymakers and members of the mental health network in Río Negro Province (Argentina) and Ceará State (Brazil). The results pointed out that legal frameworks, political contexts, and structural characteristics shape the studied cases. Local leadership is evident in the formulation and implementation of community-oriented mental health care services. City size is a relevant factor in policy implementation. Both experiences face challenges related to professional training, working conditions, policy funding, as well as the coordination and integration of health care network services. The studied policies endure resistance and, at times, setbacks that may impact the progress achieved in recent decades. The study concludes that there are similarities between the cases analyzed, influenced by specific contextual and structural factors.