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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.
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.
Objetivo: Analizar las transformaciones producidas en las actitudes de la comunidad de vecinos al tener entre sus miembros a pacientes psiquiátricos. Metodología: estudio observacional analítico en el que se compararon zonas de vecinos de casas de convivencia en las que habitan pacientes psiquiátricos atendidos ambulatoriamente y zonas equivalentes pero sin casas de convivencia. Se elaboró y aplicó un cuestionario a 236 personas (grupo de estudio n = 117; grupo control n = 119), que indagaba por características del barrio, actitudes frente a poblaciones específicas e ideas frente a la enfermedad mental y su tratamiento. También se analizó una sub-muestra de vecinos (n = 9) con otro cuestionario que exploraba por la convivencia barrial con los pacientes psiquiátricos y sus efectos. El análisis de los datos fue cuantitativo (SPSS 18.0) y cualitativo. Resultados: se destaca la asociación estadísticamente significativa entre ser vecino y el grado de aceptación hacia personas con “enfermedad mental”, y entre el grado de cohesión social y la aceptación de la “enfermedad mental”. Conclusiones: la convivencia barrial con pacientes psiquiátricos tendría efectos en las actitudes de los vecinos, las cuales podrían ser vistas como una dimensión de su salud mental, entendida ésta en términos psicosociales.
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