HOW TO IMPROVE THE QUALITY OF MENTAL HEALTH INTERVENTION WITH IMMIGRANTS
This text outlines a model of mental health care for immigrants based on differentiate the four types of problems that occur most frequently and are most relevant in healthcare practice. I believe that this approach would make it possible to optimize the intervention, avoiding, among other aspects, the medicalization of care
Before proposing this model, I consider it important to highlight that in order to achieve quality care for the immigrant population, it is very important to structure a specific intervention plan that takes into account
–the social and psychosocial perspective, the social determinants of mental health that affect immigrants, many of them living in extreme circumstances. It is important to take into account the stressors, the obstacles that the immigrant encounters in the host society
-the psychological perspective in relation to stress and migratory mourning. Thus, it is important to take into account the multiplicity of migration mourning (the seven migration mourning), the specific characteristics of migratory mourning, vulnerability (the limitations linked to the personal history of the immigrant that make it difficult for him to elaborate the migratory duels)
-in addition the transcultural perspective, respecting and valuing the cultural characteristics of immigrants, being critical of the neocolonialist and Eurocentric approaches with which work is frequently carried out from the West and keeping intersectionality well in mind
After these previous approaches, I consider it very useful to subdivide the immigrant population into 4 large groups based on their vulnerability, the intensity of the stressors they suffer, as well as in relation to their symptomatology. I have already developed these approaches in programs at the University of Berkeley and Sacramento-Davis, as well as have been addressed in the Mental Health Commission of the Colombian government.
DIFFERENTIATION IN FOUR GROUPS OF IMMIGRANTS FROM THE PERSPECTIVE OF MENTAL HEALTH CARE
Group A.
– immigrants with vulnerability a have a mental disorder
-no existence of extreme stressors
-symptoms compatible with having a mental disorder (Generalized anxiety, schizophrenia, obsessive disorder…)
-INTERVENTION: Treatment of mental disorder with psychoeducational and psychosocial intervention
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GROUP B.
–vulnerability to have a mental disorder
– existence of extreme stressors
– symptoms compatible with having a mental disorder
INTERVENTION. Treatment of mental disorder with psychoeducational intervention and with reinforced psychosocial intervention given extreme stressors
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GROUP C
-no vulnerability
– existence of extreme stressors
–reactive stress symptoms like the Ulysses Syndrome
INTERVENTION: In this group we would consider that a psychiatric intervention should not be carried out, but a psychoeducational intervention and a reinforced psychosocial intervention to increase resilience in the face of extreme stressors.
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GROUP D
-hay vulnerability
–extreme stressors
–reactive stress symptoms like the Ulysses Syndrome
INTERVENTION: a psychiatric intervention should not be carried out in this group either, but given the vulnerability of the immigrant, preventive strategies must be implemented, associated with a psychoeducational intervention and a reinforced psychosocial intervention to increase resilience in the face of extreme stressors.
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| Vulnerability | Extreme Stressors | symptomatology | intervention | |
| A | + | – | Mental disorder | p treatmentpsychiatric with psychoeducational and psychosocial intervention |
| B | + | + | Disorder. Mental | Psychiatric treatment with psychoeducational intervention and intervention reinforced psychosocial |
| C | – | + | Reactive stress charts. Ulysses syndrome | Psychoeducational intervention programs and reinforced psychosocial intervention |
| D | + | + | Reactive stress charts. Ulysses syndrome | Prevention programs associated with psychoeducational intervention and reinforced psychosocial intervention |
Developing programs of this type in the area of mental health for immigrants would allow:
-Avoid the medicalization of the mental health issue of immigrants, which largely belongs to the area of stress and grief, which means not only offering better care but also achieving significant economic savings, since it has been These programs have been shown to significantly reduce unnecessary spending on medication and psychiatric care. With the savings, psychological and psychosocial intervention could be improved and spaces would be freed up to better care for immigrants who really suffer from a mental disorder.
-in addition, these programs would help a better intercultural integration of these populations, with all the benefits that this entails for the whole of society
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