Inequities in mental health and mental healthcare between international immigrants and locals in Chile: a narrative review

Abstract

Mental health in a context of international migration is a particularly pressing issue, as migration is recognised as a social determinant of physical and mental health. As Chile is increasingly becoming a receiving country of South-South migration, immigrants face mental health inequities, with regards to outcomes and access to care. In order to identify and synthetize mental healthcare inequities faced by international migrants with regards to locals in Chile, a narrative review of the literature on national mental healthcare policies in Chile and a narrative review of the literature on migrants’ mental healthcare in Chile were conducted, with a focus on describing mental health outcomes, policy environment and persisting gaps and barriers for both topics. The existing literature on mental healthcare in Chile, both for the general population and for international migrants, following the social determinant of health framework and categorised in terms of i) Inequities in mental health outcomes; ii) Description of the mental health policy environment and iii) Identification of the main barriers to access mental healthcare. Despite incremental policy efforts to improve the reach of mental healthcare in Chile, persisting inequities are identified for both locals and international migrants: lack of funding and low prioritisation, exacerbation of social vulnerability in the context of a mixed health insurance system, and inadequacy of mental healthcare services. International migrants may experience specific layers of vulnerability linked to migration as a social determinant of health, nested in a system that exacerbates social vulnerability. Based on the findings, the article discusses how mental health is a privilege for migrant populations as well as locals experiencing layers of social vulnerability in the Chilean context. International migrants’ access to comprehensive and culturally relevant mental healthcare in Chile and other countries is an urgent need in order to contribute to reducing social vulnerability and fostering mechanisms of social inclusion. International migration, social determinants of mental health, mental health inequities, social vulnerability, review.

Inmigración en La Araucanía, ¿cómo viven este proceso haitianos, colombianos y venezolanos?

“…Los desplazamientos poblacionales entre países han ocurrido a lo largo de toda la historia de la humanidad, sin embargo, en los últimos años estos se han vuelto más frecuentes (Blukacz, Cabieses, & Markkula, 2020;Cabieses, Chepo, Obach, & Espinoza, 2019;Mármora, 1989;Zlobina, Basabe, Paez, & Furnham, 2006). Chile, durante el siglo XX, se caracterizó por una llegada de inmigrantes latinos, principalmente peruanos y bolivianos (Aninat & Vergara, 2019).…”

Determinants of mental disorders of Afghan migrants during the COVID-19 pandemic

“…They might also suffer from mental disorders such as anxiety, post-traumatic stress and depression (Tinghög et al , 2017; Awuah et al , 2020) and experience acculturation problems in the host countries (Connor, 2010). Compared with first-rate citizens, migrants are generally more likely to deal with mental health issues (Blukacz et al , 2020). The degree and the starting point of migrants’ declining health or mental health status seem to be affected by a variety of factors such as the length of residence in the country of destination, their age, gender, place of birth, language proficiency, as well as marital status (Mangrio et al , 2021; Fuller-Thomson et al , 2011).…”

Overuse of Health Care in the Emergency Services in Chile

“…Despite the efforts made by the Department of Studies, Planning and Control of Human Resources Management of the MinSal, the problem has not yet been solved [ 9 ]. Several reasons have been reported by the Undersecretary of Assistance Networks of the Ministry of Health, and the following stand out: immigration has increased in the last decade [ 10 , 11 ], the changes and improvements that have been generated in the epidemiological standards, and the shortage of professionals in the area of mental health, emergency, intensive care in adults and children, family and anesthesiology [ 12 ]. One of the measures that have been implemented is the hiring of foreign doctors but this has not been effective due to the high failure rate that exists when they take the Single National Knowledge Exam [ 13 ].…”