For over 30 years, Latin American countries have been working together to reform their mental health services. This process has been led by the Pan American Health Organization, the WHO Regional Office for the Americas. The aim has been to make these services follow the principles of the 1990 Caracas Declaration. The Declaration made a clear call for the replacement of traditional psychiatric care based on psychiatric hospitals by integrated services including general hospitals, primary care and community-based services. These services must offer accessible, comprehensive, participatory and continuous care, as well as prevention and promotion activities. They must also ensure the protection of the human rights of people with mental disorders. The roots, conceptual foundations and innovative recommendations of the Caracas Declaration, as well as the main strategic lines developed within the initiative that have contributed most to the reform of mental health services in Latin American countries were analysed. An analysis was also made of the impacts of this process on the reforms implemented in Latin American countries, and how it has influenced the global mental health movement. The results of this analysis are clear: the reforms carried out in Latin America over the past 30 years have resulted in significant progress in the reforms already under way and increasing technical sophistication in the most recent ones. Furthermore, the positive contributions of this experience have extended far beyond the region. The process developed in Latin America since the Caracas Declaration is now an essential reference in the discussion of fundamental issues related to deinstitutionalisation, the development of truly community-based services, the organisation of human rights-based mental health services and the future of global mental health.