Background: Nicaragua is a low and middle income country (LMIC) with a long history of socio-political, economic and environmental challenges that have profoundly affected the local population. Mental disorders and addictions are highly prevalent and suicide rates are the highest in the region. Mental health infrastructure and funding are sparse and care differs significantly from standards in Western countries. A final year medical student completed a seven-week psychiatry global mental health elective in Leon, Nicaragua. Her reflections on the current state of mental health care in Leon are presented. Methods: During the elective, the medical student participated in patient care in both inpatient and outpatient settings and documented her experiences through a reflective blog. Educator-practitioners, such as M.A. Jasper, have argued that reflective writing itself is a valid data source, promoting creativity and the formation of connections. We use the blog alongside published data as a source of information about mental health provision in Leon.