introduction: mental health and mental illness are phenomena of great complexity in which ecological and biopsychosocial aspects intervene. the natural history of mental health and mental illness could be modified by carrying out programs of general and public health. method: first, the reality of mental health in colombia is assessed by depicting epidemiological and social aspects and analyzing the circumstances related with mental illness such as poverty, violence, drug dependence and natural disasters. second, the needs of psychiatry and mental health are assessed with the purpose of confronting them with the first point. third, by means of different strategies the state of the specialty and the possibilities of care are examined. results: training of the psychiatrist in colombia does not include concepts of community psychiatry and community mental health, as its main emphasis is on medical training and assistance. colombian literature in the national and international context does not include topics related with experiences in community mental health. conclusion: great incongruity is observed between reality in mental health and training in psychiatry that could have grave repercussions when the time comes to outline intervention policies regarding mental health for communities.