RESUMO

Background: The number of migrants at the Mexico-US border has increased to historic levels, and frequently changing immigration policy impacts this population as they await entry into the US. This study evaluated the usability and health effects of the Customs and Border Protection (CBP) One™ mobile application among asylum seekers near the US port of entry in Reynosa, Mexico. Methods: We conducted semi-structured qualitative interviews with 20 asylum seekers in Reynosa, Mexico, in February 2023. Our objective was to explore the subjective experiences of migrants, usability of CBP One™, and presence of perceived health effects from using the application. Interviews were conducted until saturation occurred, transcribed verbatim into Word, coded in NVivo using a validated, team-based coding methodology, and analyzed according to internal domains, external domains, and health effects regarding CBP One™. Results: Twenty participants originated from eight countries throughout Latin America and the Caribbean. In total, 18 subthemes were identified among internal, external, and effects domains. Internal themes included a confusing application interface (80%), technical malfunction (60%), and perceived racial bias from the photo-capture features (15%). External themes challenging CBP One™ use included unavailable appointment slots (80%), inequity and inaccessibility (35%), and inadequate internet (25%). Most perceived effects were negative (85%), including worsening mental health effects (40%), exacerbation of pre-existing physical conditions (35%), and forgoing health expenditures to pay for internet (25%). Conclusions: Our findings suggest that asylum seekers at the Reynosa port of entry perceive CBP One™ negatively, with detrimental effects towards their mental and physical health. This study highlights how immigration policy can influence health and suggests that more creative and humane approaches are needed for people seeking asylum at the Mexico-US border.

RESUMO

In this Viewpoint, we provide an overview of the worsening trend of traumatic injuries across the United States-Mexico border after its recent fortification and height extension to 30-feet. We further characterize the international factors driving migration and the current U.S. policies and political climate that will allow this public health crisis to progress. Finally, we provide recommendations involving prevention efforts, effective resource allocation, and advocacy that will start addressing the humanitarian and economic consequences of current U.S. border policies and infrastructure.

RESUMO

BACKGROUND: The number of migrants and asylum seekers at the Mexico-US border has increased to historic levels. Our objective was to determine the medical diagnoses and treatments of migrating people seeking care in humanitarian clinics in Matamoros, Mexico. METHODS: We conducted a cross-sectional study of patient encounters by migrating people through a humanitarian clinic in Matamoros, Mexico, from November 22, 2019, to March 18, 2021. The clinics were operated by Global Response Medicine in concert with local non-governmental organizations. Clinical encounters were each coded to the appropriate ICD-10/CPT code and categorized according to organ system. We categorized medications using the WHO List of Essential Medicines and used multivariable logistic regression to determine associations between demographic variables and condition frequency. RESULTS: We found a total of 8,156 clinical encounters, which included 9,744 diagnoses encompassing 132 conditions (median age 26.8 years, female sex 58.2%). People originated from 24 countries, with the majority from Central America (n = 5598, 68.6%). The most common conditions were respiratory (n = 1466, 15.0%), musculoskeletal (n = 1081, 11.1%), and skin diseases (n = 473, 4.8%). Children were at higher risk for respiratory disease (aOR = 1.84, 95% CI: 1.61-2.10), while older adults had greater risk for joint disorders (aOR = 3.35, 95% CI: 1.73-6.02). Women had decreased risk for injury (aOR = 0.50, 95% CI: 0.40-0.63) and higher risk for genitourinary diseases (aOR = 4.99, 95% CI: 3.72-6.85) compared with men. Among 10,405 medications administered, analgesics were the most common (n = 3190, 30.7%) followed by anti-infectives (n = 2175, 21.1%). CONCLUSIONS: In this large study of a migrating population at the Mexico-US border, we found a variety of clinical conditions, with respiratory, musculoskeletal, and skin illnesses the most common in this study period which encompassed a period of restrictive immigration policy and the first year of the COVID-19 pandemic.

Assuntos

RESUMO

Resumo: Neste artigo, partimos de uma preocupação com a Contrarreforma Psiquiátrica em curso no Brasil para tratar das relações entre a morte e o Hospício. Operando com a abordagem teórico-metodológica da cartografia, tomamos como principais referências textos elaborados por pessoas que estiveram internadas em Hospitais Psiquiátricos entre os séculos XX e XXI, abordando questões de gênero, raça e classe de maneira encarnada. As articulações entre a morte e a cultura manicomial se apresentam, desde os escritos da experiência, na desvalorização da vida, no suicídio, no assassinato, no abuso do eletrochoque e dos medicamentos, no abandono, na cronificação e no silenciamento dos corpos hospiciados. O Hospício se mostra aqui como mais uma peça da necropolítica brasileira, fazendo com que o retorno do seu fortalecimento nos convoque a agir, como ensina o Movimento Antimanicomial, novamente em direção a uma sociedade sem manicômios.

Resumen: En este artículo, partimos de una preocupación por la Contrarreforma Psiquiátrica en curso en Brasil para abordar las relaciones entre muerte y Manicomio. Operando con el enfoque teórico-metodológico de la cartografía, tomamos como referencias principales textos escritos por personas que estuvieron internadas en Hospitales Psiquiátricos entre los siglos XX y XXI, abordando cuestiones de género, raza y clase de manera corporeizada. Las articulaciones entre muerte y cultura del manicomio se presentan, a partir de los escritos de la experiencia, en la desvalorización de la vida, el suicidio, el asesinato, el abuso de electroshocks y medicamentos, el abandono, la cronificación y el silenciamiento de los cuerpos hospitalizados. El Manicomio se muestra aquí como una pieza más de la necropolítica brasileña, haciendo que el retorno de su fortalecimiento nos llame a actuar, como enseña el Movimiento Antimanicomial, una vez más hacia una sociedad sin manicomios.

Abstract: In this article, we start from a concern with the Psychiatric Counter-Reform underway in Brazil to address the relationship between death and the Asylum. Operating with the theoretical-methodological approach of cartography, we take as main references texts written by people who were hospitalized in Psychiatric Hospitals between the 20th and 21st centuries, addressing issues of gender, race and class in an embodied way. The articulations between death and asylum culture are presented, from the writings of experience, in the devaluation of life, suicide, murder, abuse of electroshock and medication, abandonment, chronification and silencing of hospitalized bodies. The Asylum is shown here as another piece of Brazilian necropolitics, making the return of its strengthening call us to act, as the Anti-Asylum Movement teaches, once again towards a society without asylums.

RESUMO

BACKGROUND: Recent U.S. immigration policy has increasingly focused on asylum deterrence and has been used extensively to rapidly deport and deter asylum-seekers, leaving thousands of would-be asylum-seekers waiting indefinitely in Mexican border cities, a large and growing proportion of whom are pregnant and parenting women. In the border city of Tijuana, Mexico, these women are spending unprecedented durations waiting under unsafe humanitarian conditions to seek safety in the U.S, with rising concerns regarding increases in gender-based violence (GBV) among this population during the COVID-19 pandemic. Given existing gaps in evidence, we aimed to describe the lived experiences of GBV in the context of asylum deterrence policies among pregnant and parenting asylum-seeking women at the Mexico-U.S. border. METHODS: Within the community-based Maternal and Infant Health for Refugee & Asylum-Seeking Women (MIHRA) study, we conducted semi-structured qualitative interviews with 30 asylum-seeking women in Tijuana, Mexico between June and December 2022. Eligible women had been pregnant or postpartum since March 2020, were 18-49 years old, and migrated for the purposes of seeking asylum in the U.S. Drawing on conceptualizations of structural and legal violence, we conducted a thematic analysis of participants' experiences of GBV in the context of asylum deterrence policies and COVID-19. RESULTS: Pregnant and parenting asylum-seeking women routinely faced multiple forms of GBV perpetuated by asylum deterrence policies at all stages of migration (pre-migration, in transit, and in Tijuana). Indefinite wait times to cross the border and inadequate/unsafe shelter exacerbated further vulnerability to GBV. Repeated exposure to GBV contributed to poor mental health among women who reported feelings of fear, isolation, despair, shame, and anxiety. The lack of supports and legal recourse related to GBV in Tijuana highlighted the impact of asylum deterrence policies on this ongoing humanitarian crisis. CONCLUSION: Asylum deterrence policies undermine the health and safety of pregnant and parenting asylum-seeking women at the Mexico-U.S. border. There is an urgent need to end U.S. asylum deterrence policies and to provide respectful, appropriate, and adequately resourced humanitarian supports to pregnant and parenting asylum-seeking women in border cities, to reduce women's risk of GBV and trauma.

Assuntos

RESUMO

BACKGROUND: Over the past decade, the United States (US) has seen a spike in migration across the US-Mexico border with an increase in hospital admissions of migrants and asylum-seekers under the custody of immigration law enforcement (ILE). This study aimed to determine how the presence of ILE officials affects patient care and provider experience in a teaching hospital setting. METHODS: This cross-sectional online survey solicited quantitative and qualitative feedback from medical students, residents, and attending physicians (n = 1364) at a teaching hospital system with two campuses in Arizona. The survey included participant demographics and addressed participants' experience caring for patients in ILE custody, including the perception of respect, violations of patients' privacy and autonomy, and the comfort level with understanding hospital policies and patient rights. Thematic analyses were also performed based on respondent comments. RESULTS: 332 individuals (24%) responded to the survey. Quantitative analyses revealed that 14% of participants described disrespectful behaviors of ILE officials, mainly toward detained patients. Qualitative thematic analyses of respondent comments revealed details on such disrespectful encounters including ILE officers violating the Health Insurance Portability and Accountability Act (HIPAA) and using intimidation tactics with patients. Nearly half of the respondents did not have knowledge of policies about ILE detainees' medical care, detainees' privacy rights, or ILE's authority in patient care. CONCLUSIONS: This study points out the complexities, challenges, and ethical considerations of caring for patients in ILE custody in the hospital setting and the need to educate healthcare professionals on both patient and provider rights. It describes the lived experiences and difficulties that providers on the border face in trying to achieve equity in the care they provide to detained migrant patients.

Assuntos

RESUMO

Inspired by political philosophy, critical studies of border regimes often reduce human rights and relief work to some accomplice role in migratory control and surveillance. Drawing on ethnographic research on pro-migrant activism in Tijuana, a large city on Mexico's northern border, I contrast such critical literature on border policies with an anthropological approach to the study of organizations and bureaucracies. In particular, drawing attention to activists as providers of goods and services enables us to deal with activism as an ensemble of concrete actors, institutions, and practices. The contradictory directives to which providers are subject, faced with inevitable conflicts, shifting alliances, and overlapping structures, are apparent in cases of co-production of services through complex forms of coordination between local authorities, civil associations, and international organizations. Revealing the political dimensions of service delivery-not reducible to domination-these assemblages of modes of governance are frequently oriented to cope with migrants' immobility in cities like Tijuana, turned into places of indefinite delay by policies that extend the spaces of interception and expulsion to neighboring "transfer" countries.

RESUMO

BACKGROUND AND OBJECTIVE: In this article we sought to characterize the Long Stay Establishments for the Elderly in Chile, besides presenting the services offered in the public and private. MATERIAL AND METHODS: It is a quantitative, cross-sectional descriptive study, with secondary information source. We analyze all establishments in the country registered with the National Service of the Elderly. As of November 2015, a total of 724 establishments were registered and distributed in 169 neighborhoods throughout the country in which 16,985 adults aged 60 and over were institutionalized. RESULTS: Most of the establishments (65.9% [n=246/724]) are private, 47.5% of them (n=344/724) are located in the metropolitan region of Santiago. Of the residents' health, only 26.5% are considered functional brave, 28.3% are physically handicapped and 8.8% are mentally handicapped. Most establishments offer manual activities, physical exercises, memory classes, cultural classes and recreational or touristic tours. Proportionally of the activities offered were mostly private ones. CONCLUSIONS: In Chile, most of the establishments are private, located in the metropolitan region where there is the largest supply deficit of this type of service, with an occupancy rate of 90.7%, with 72.4% women and almost half 47.7% with some physical or psychic dependence.

Assuntos

RESUMO

Although the United States has been a nation of immigrants since its founding, the massive number of asylum seekers arriving at the US-Mexico Border is a relatively new phenomenon that requires attention and study. This paper describes the lived experience of three asylum seekers, demonstrating how physical and mental health are structured by US policies and politics. The in-depth accounts are informed by participant observation and policy analysis of humanitarian, non-governmental organizations advocating for asylum seekers. We focus on health and geographical trajectories using the triple trauma paradigm that includes trauma in the country of origin, trauma incurred during transit/flight, and the trauma of arrival and relocation/resettlement in the host country. We suggest that a form of necropower, understood as processes exacerbating the potentiality for death, is embedded in the structure of the US asylum apparatus.

Assuntos

RESUMO

BACKGROUND: Whilst increased numbers of people worldwide exercise their human right to seek asylum, the US has greatly reduced the number of asylum seekers able to enter its southern border, resulting in informal encampments. Women and children are uniquely vulnerable to violence and other health risks. AIM: To describe the health and safety concerns of female asylum seekers living in an informal migrant camp, with a particular focus on the risks of violence against women and children. METHODS: For this qualitative descriptive study, female asylum seekers were purposively recruited in an informal tent encampment in Matamoros, Mexico (n = 43). Semi-structured interviews were conducted in January and February 2020. Qualitative data were analysed using thematic analysis. RESULTS: The themes identified were constant vigilance, the effects of constant vigilance, lack of resources, and uncertainty. Women's unrelenting fears about their own safety and that of their children impacted their ability to access the camp's meagre resources and exacerbated negative effects on women and children. CONCLUSION: Applying established guidelines and best practices for health and safety in humanitarian settings could mitigate threats to women and children. Additionally, camp conditions represent human rights violations. Nurses have an ethical duty to advocate for an end to the US policies creating and maintaining this humanitarian crisis. IMPACT: As a result of changes to the United States immigration policy, individuals seeking asylum at the Southern border of the US have been largely prevented from entering the US since early 2018. Asylum seekers living in an informal encampment on the border awaiting entry describe a public health, humanitarian and human rights crisis. Women in this already vulnerable group lacked necessities, such as housing, food security, potable water, protection against gender violence and other forms of physical threats to themselves and their children. This created a heightened sense of vigilance and fear, with implications for their mental health and well-being and that of their children. These findings highlight the need for governmental and international organizations to implement the best health and safety practices for humanitarian settings to ensure equity in relation to the social determinants of health. Nurses have an ethical obligation to be strong human rights advocates. PATIENT OR PUBLIC CONTRIBUTIONS: One member of the research team has extensive experience as an advocate for recently immigrated women experiencing intimate partner violence. The study procedures were reviewed with advocates providing direct services to migrant women and children.

Assuntos

RESUMO

Resumo Estima-se que no mundo, atualmente, haja 89,3 milhões de pessoas em deslocamentos forçados, incluindo 27,1 milhões de refugiados. Entre as razões para essas migrações forçadas estão a tortura e outras formas de violência, embora a prevalência de violências antes e durante a migração ainda seja pouco conhecida. O objetivo deste estudo é analisar a prevalência e alguns fatores associados às violências relatadas por solicitantes de refúgio no Rio de Janeiro. Foram coletados dados preenchidos nos formulários de solicitação de refúgio do Comitê Nacional para Refugiados de 2010 a 2017 e em entrevistas adicionais conduzidas na Cáritas Arquiocesana-RJ. Foram incluídos 1.546 solicitantes de refúgio com idade mediana de 30 anos (faixa 15-72 anos), dos quais 65% eram homens. Um terço informou ter sofrido violência antes de chegar ao Brasil, com chances de violência relatada entre 20 e 40 vezes maiores entre migrantes oriundos de Paquistão, Congo, Colômbia, República Democrática do Congo e Guiné. Violência física/tortura, ameaça e violência psicológica foram as mais frequentes (relatadas por 10%, 7% e 6% da população estudada, respectivamente). Entre as mulheres, a violência sexual foi a modalidade mais frequente (9%). Conclui-se que a história de violência entre os solicitantes de refúgio no Brasil é frequente, em particular para alguns grupos nacionais, aspecto a ser considerado no acolhimento e na prestação de serviços a essa população em situação de extrema vulnerabilidade.

Abstract Currently, the world has 89.3 million forcibly displaced people, including 27.1 million refugees. Among the reasons for displacement are torture and other forms of violence, but the real prevalence of violence before and during migration is poorly reported. The aim of this study is to analyze the prevalence of reported violence among asylum seekers in Rio de Janeiro and its associated factors. We collected secondary data from individuals who filled out the National Committee for Refugees' asylum application forms from 2010 to 2017 and responded to the social interview at Cáritas-RJ. We included 1,546 asylum seekers with a mean age of 30 (range 15-72), 65% of whom were men. One third reported experiencing violence before arriving in Brazil. Chances of experiencing violence were 20 to 40 times higher among refugees arriving from Pakistan, Congo, Colombia, the Democratic Republic of Congo and Guinea. Physical violence/torture and psychological threats were the most frequent forms (10%, 7% and 6% of the population, respectively). Among women, sexual violence was the most frequent form of violence (9% of women). We conclude that asylum seekers in Brazil frequently suffered violence before their arrival, particularly some groups. This needs to be addressed when providing services to this extremely vulnerable population.

Resumen Actualmente, hay en el mundo 89,3 millones de personas desplazadas por la fuerza, incluidos 27,1 millones de refugiados. Entre las razones de desplazamiento forzado están la tortura y otras formas de violencia, pero la prevalencia real de la violencia antes y durante la migración ha sido poco estudiada. El objetivo de este estudio es analizar la prevalencia de violencia reportada entre los solicitantes de asilo en Río de Janeiro y los factores asociados a esta. Recolectamos datos secundarios de personas que completaron los formularios de solicitud de asilo del Comité Nacional para Refugiados desde 2010 hasta 2017 y de entrevistas adicionales en Cáritas RJ. Incluimos a 1546 solicitantes de asilo con una edad media de 30 (15-72) años, de los cuales 65 % eran hombres. Un tercio informó haber experimentado violencia antes de llegar a Brasil, con posibilidades de violencia de entre 20 a 40 veces mayores para entre migrantes oriundos de Pakistán, Congo, Colombia, República Democrática del Congo y Guinea. Violencia/tortura física, amenazas y violencia psicológica son las formas más frecuentes (10 %, 7 % y 6 % respectivamente) relatadas. Entre las mujeres, la más frecuente fue la violencia sexual (9 % de los relatos). Concluimos que la historia de violencia entre los solicitantes de asilo en Brasil es frecuente, sobre todo en algunos grupos nacionales en particular, aspecto que se debe considerar al prestarle servicios a esta población extremadamente vulnerada.

Assuntos

RESUMO

Economic, political, humanitarian and health crises in Venezuela have resulted in mass out migration -thousands of Venezuelans emigrated to Trinidad and Tobago. However, little is known about their food security status in the host country. This study assessed the food security status among Venezuelan migrants and asylum seekers in Trinidad and Tobago and tested the validity of the online application of the food insecurity experience scale (FIES), a tool to measure food insecurity, in a small group. This convenience, cross-sectional study applied an online questionnaire to 433 Venezuelan migrants in Trinidad and Tobago in 2020. Snowball sampling was used to connect to migrants based on their access to locally-based NGO service providers, and organizations directly connected to the Venezuelan migrant community. Researchers applied the 12-month reference period to the FIES to measure food insecurity at the individual level. Descriptive analyses, Rasch modeling and binary logistic regression were conducted. Overall, 61.9% of respondents displayed behaviors characterized as severely food insecure. Significant differences in food security status were observed when categories of employment status (p = 0.032) and paying rent (p = 0.005) were considered. There were greater proportions of unemployed individuals who were severely food insecure (67.6%) compared to those who were employed (56.7%). There were greater proportions of individuals paying rent who were severely food insecure (62.6%) compared to those who were not paying rent (50.0%). Logistic regression with adjusted odds ratios and 95% confidence intervals revealed that food insecurity was less likely among migrants who were employed (OR 0.112, 95% CI 0.016-0.763) relative to those who were not employed, while food insecurity was more likely among migrants who were paying rent (OR 7.325, 95% CI 1.965-27.312) relative to those not paying rent. The FIES was consistent in assessing food security status. These findings provide a rapid assessment that can be used to galvanize international, national and community-level stakeholders to devise and target responses to assist migrants experiencing food insecurity.

Assuntos

RESUMO

Families and youth from the Northern Triangle of Central America seeking asylum in the U.S. report substantial trauma exposure and post-traumatic stress symptoms. Sexual and gender minorities of this population especially present unique circumstances and thus challenges and needs. However, with immigration along the southern U.S. border at a 21-year high, health and social resources for refugees and asylum seekers are being strained. Accordingly, the primary aim of this review is to raise awareness about migration-related trauma and the mental health needs among Central American and LGBTQ + refugees and asylum seekers in the U.S.-Mexico border. The authors also discuss practical, clinical, and advocacy implications to improve the mental health of refugees and asylum seekers entering the United States.

Assuntos

RESUMO

The COVID-19 pandemic illuminates possibilities for creating states of exception while simultaneously destabilizing the Mexico-U.S. border through the politics of fear. Specifically, the Migrant Protection Protocols (MPP), Zero Tolerance Policy (ZTP), COVID-19 CAPIO, Asylum Cooperative Agreements (ACA), and Title 42-using the pandemic under an arcane section of U.S. law to immediately expel asylum seekers and refugees, in particular-highlight the formation of a state of exception consistent with the work of Agamben. They also document how the politics of fear is used to reinforce hegemonic narratives targeting asylum seekers while attempting to reinforce political agendas that lean toward a specific brand of nationalism using the lens of public health as a context. The U.S. government under the Trump administration, and the Biden administration to a lesser extent, constructed these policies aimed primarily at refugees and asylum seekers from El Salvador, Guatemala, Honduras, and Mexico, thereby violating laws and international treaty obligations. Related Articles: Correa-Cabrera, Guadalupe. 2013. "Security, Migration, and the Economy in the Texas-Tamaulipas Border Region: The 'Real' Effects of Mexico's Drug War." Politics & Policy 41(1): 65-82. https://doi.org/10.1111/polp.12005.Duman, Yoav H. 2014. "Reducing the Fog? Immigrant Regularization and the State." Politics & Policy 42(2): 187-220. https://doi.org/10.1111/polp.12065.Garrett, Terence M. 2020. "The Security Apparatus, Federal Magistrate Courts, and Detention Centers as Simulacra: The Effects of Trump's Zero Tolerance Policy on Migrants and Refugees in the Rio Grande Valley." Politics & Policy 48(2): 372-35. https://doi.org/10.1111/polp.12348.

La pandemia de COVID­19 ilumina las posibilidades de crear estados de excepción y, al mismo tiempo, desestabilizar la relación México­Estados Unidos. frontera a través de la política del miedo. Específicamente, los Protocolos de Protección de Migrantes (MPP), la Política de Tolerancia Cero (ZTP), Covid­19 CAPIO, los Acuerdos Cooperativos de Asilo (ACA) y el Título 42: usar la pandemia bajo una sección arcana de la ley de EE. UU. para expulsar de inmediato a los solicitantes de asilo y refugiados, en particular, destaca la formación de un estado de excepción consistente con el trabajo de Agamben mientras documenta cómo la política del miedo se usa para reforzar las narrativas hegemónicas dirigidas a los solicitantes de asilo mientras intenta reforzar las agendas políticas que se inclinan hacia una marca específica de nacionalismo usando la lente de la salud pública como contexto. El gobierno de los EE. UU. bajo la administración de Trump, y la administración de Biden en menor medida, construyeron estas políticas dirigidas principalmente a refugiados y solicitantes de asilo de El Salvador, Guatemala, Honduras y México, violando así las leyes y las obligaciones de los tratados internacionales.

RESUMO

Involuntary sterilization is a violation of human rights and grounds for asylum in the United States. Forensic medical evaluations can be useful in documenting this form of persecution and supporting asylees' claims for immigration relief. We conducted a retrospective case analysis of the personal and medical affidavits of 14 asylum-seeking women from four Latin America countries who all reported they had been involuntarily sterilized. Sixty-four percent said that "consent" was coerced; the remainder were unaware of having been sterilized at the time of the procedure. In all cases, findings on hysterosalpingogram were consistent with sterilization, revealing that all 14 had undergone a tubal ligation. Eighty-six percent of the women had been sterilized at the time of childbirth. The healthcare providers involved in the 14 cases failed to obtain informed consent, misled patients about sterilization, engaged in discriminatory behavior, and/or breached patient confidentiality regarding their HIV-status. All 14 asylum cases were defensive; of the 7 cases (50%) that have been decided to date, 100% have been granted asylum.

Assuntos

RESUMO

Immigration typically occurs from low- to high-income countries and regions. Unfortunately, these wealthier areas also have higher rates of cannabis use (e.g. European Union and the US). This systematic review aimed to summarize available studies on cannabis use among immigrants, refugees, and asylum seekers. In addition, evidence on the association between immigration and cannabis use was reviewed. The rates of cannabis use were lower among immigrants than natives. The risk and protective factors to cannabis use were quite similar to those of the native populations. The population at greatest risk for cannabis use were refugees, males, singles, non-religious, those with lower educational level, living in urban areas, with friends that use cannabis and/or other drugs. Cannabis use tend to increase over generations, and acculturation seems to play a pivotal role. First generation migrants report equal or lower consumption of cannabis when compared with the majority population with a subsequent increase in following generations, with a clear association with acculturation factors. A higher cannabis use was found among migrants with lower cultural congruity as well as a higher level of culture assimilation. This use seems to be unrelated to alcohol or illicit drugs consumption, but possibly associated with tobacco smoking.

Assuntos

RESUMO

Asylum and refuge in Chile h¬ave received limited attention in policymaking and academia, and there is scarce evidence on their mental health needs and outcomes. Studies on mental healthcare access for international migrants suggest systemic barriers linked to costs and coverage, administrative issues, and adequacy of services. Today, we see that asylum and refuge is an emerging topic in Chile, which opens up the challenges around the mental health of refugees and asylum seekers. This topic is gaining visibility due to increased asylum claims over the past ten years, making it an urgent topic at a policy level. An exploratory qualitative study was conducted in 2018 on the health and social needs of asylum seekers and refugees from Latin America in Chile. This study indicated a general lack of knowledge on the mental health needs of refugees and asylum seekers and Chile and a lack of training in mental health professionals to address specific needs. Consequently, the health needs of these people remain largely unaddressed in terms of the number of available services and the relevance and pertinence of the services delivered. As Chile is positioning itself as a receiving country of refugees and asylum seekers in Latin America and the Caribbean, there is an opportunity to "do better" and adequately address the mental health of these marginalized populations.

Las temáticas de asilo y refugio han recibido escasa atención por parte de los decidores públicos y de la academia, existiendo poca evidencia respecto a las necesidades de salud mental, índices y acceso a atención de salud de refugiados y solicitantes de asilo. La literatura en temas de acceso a salud mental de migrantes internacionales en general sugiere la existencia de múltiples barreras vinculadas a costos y cobertura, temas administrativos y de adecuación de servicios. Los desafíos en términos de salud mental de estas poblaciones aumentan en la medida en que es un problema emergente en el país, que ha ganado visibilidad debido al importante incremento de las solicitudes de refugio en los últimos diez años. Un estudio cualitativo exploratorio fue conducido durante el año 2018 sobre las necesidades sociales y de salud de refugiados y solicitantes de refugio de origen latinoamericano presentes en Chile. Los resultados indican que existe falta de disponibilidad y de competencias por parte de los profesionales de salud mental para abordar las necesidades de esta población. En consecuencia, la salud mental de esta población está quedando desatendida tanto en términos cuantitativos debido a la falta de disponibilidad de servicios, cuanto en términos cualitativos por falta de adecuación y aceptabilidad de los servicios ofrecidos. Debido a que Chile se está posicionando como país de acogida de migrantes en la región Latinoamérica y Caribe, incluyendo a refugiados, es necesario acoger la oportunidad de hacer “mejor las cosas” respecto a la salud mental de poblaciones particularmente emarginadas, como son solicitantes de asilo y refugiados.

Assuntos

RESUMO

Today, growing numbers of mothers and children are fleeing Mexico and Central America. Most scholars attribute this displacement to organized crime, and a few note the importance of gender violence in driving women's migration. Yet, less has been said about how violence affects motherhood or how motherhood shapes women's decisions to leave. Drawing on 44 in-depth interviews with Mexican and Central American women seeking U.S. asylum, we show how multifaceted violence intensifies the burdens on mothers. At the same time, we argue, motherhood can offer a source of agency in contexts of normalized violence, inspiring women to flee.

Assuntos

RESUMO

Trata-se de uma estratégia de ensino construída e utilizada como disparador para a temática sobre Instituições Totais e o hospital psiquiátrico como dispositivo de segregação e degradação da identidade dos internos. Por meio do registro etnográfico e das transformações políticas e paradigmáticas de cuidado em Saúde Mental, foi conformada uma crônica que destaca os principais conceitos do Interacionismo Simbólico de Erving Goffman. O texto convida os leitores a percorrer as várias camadas que acionam as engrenagens da instituição e produzem a carreira moral do doente mental e dos trabalhadores que ali atuam. Processos em que a mortificação e a profanação do Eu são recobertos por um saber oficial que controla, pune e reage diante de qualquer ameaça de desestabilização do aparato manicomial. (AU)

This article discusses a teaching strategy developed as a trigger for the theme of total institutions and psychiatric hospitals as devices for segregating and degrading the identity of inpatients. Based on an ethnographic record and political and paradigmatic shifts in mental health care, we created a chronicle highlighting the main concepts of Erving Goffman's symbolic interactionism. This text invites readers to traverse the various layers that drive the institution's cogs and wheels and produce the moral career of the mentally ill and staff who work there. Processes in which the mortification and profanation of the Self are shrouded by an official knowledge that controls, punishes and reacts to anything that threatens the asylum apparatus with destabilization. (AU)

Se trata de una estrategia de enseñanza construida y utilizada como gatillo para la temática sobre Instituciones Totales y el hospital psiquiátrico como dispositivo de segregación y degradación de la identidad de los internos. A partir del registro etnográfico y de las transformaciones políticas y paradigmáticas de cuidado en salud mental, se formó una crónica que destaca los principales conceptos del Interaccionismo Simbólico de Erving Goffman. El texto invita a los lectores a recorrer las diversas capas que ponen en acción los engranajes de la institución y producen la carrera moral del enfermo mental y de los trabajadores que allí actúan. Procesos en que la mortificación y profanación del Yo están recubiertos por un saber oficial que controla, castiga y reacciona ante cualquier amenaza de desestabilización del aparato de manicomios. (AU)

Assuntos

RESUMO

Visitando textos de Antonin Artaud, Lima Barreto, Maura Lopes Cançado e Rodrigo de Souza Leão acerca da internação psiquiátrica, este artigo aborda as relações entre corpo, escrita e política em torno da lógica manicomial e suas dissidências. Com o objetivo de propor, com os loucos, possíveis táticas de resistência ao julgamento psiquiátrico, a metodologia de pesquisa utilizada é a cartografia psicossocial, acoplada a uma análise das relações de poder. Começamos investigando as transformações históricas na separação discursiva entre razão e loucura, e de que modo elas incidiram no campo literário. Passamos, em seguida, por como o hospício cria, com a disciplina e sua prática de escrita, relações hierarquizantes e homogeneizantes que têm como efeito a individualização do corpo. Ao final, elaboramos como a linguagem poética e a criação ficcional podem funcionar, aliadas ao papel coletivo e revolucionário da literatura, como potentes estratégias antimanicomiais de resistência num convite para repensarmos nossas produções escritas. (AU)

Visiting texts by Antonin Artaud, Lima Barreto, Maura Lopes Cançado and Rodrigo de Souza Leão about the psychiatric hospitalization, this article addresses the relationship between body, writing and politics around the logic of the asylum and its dissidences. In order to propose, with the mad, possible resistance tactics to psychiatric judgment, the research methodology used is psychosocial cartography, coupled with an analysis of power relations. We begin by investigating the historical transformation in the discursive separation between reason and madness, and how it affected the literary field. We then go through how the asylum creates, with discipline and its writing practice, hierarchical and homogenizing relations that have the effect of individualizing the body. At the end, we elaborate how poetic language and fictional creation can work, combined with the collective and revolutionary role of literature, as powerful anti-asylum resistance strategies in an invitation to rethink our written productions. (AU)

Visitando textos de Antonin Artaud, Lima Barreto, Maura Lopes Cançado y Rodrigo de Souza Leão sobre la hospitalización psiquiátrica, este artículo aborda las relaciones entre cuerpo, escritura y política en torno a la lógica del asilo y sus disidencias. Para proponer, junto a los locos, posibles tácticas de resistencia al juicio psiquiátrico, la metodología de investigación utilizada es la cartografía psicosocial, junto con un análisis de las relaciones de poder. Comenzamos investigando las transformaciones históricas en la separación discursiva entre razón y locura, y cómo afectaron al campo literario. A continuación, repasamos cómo el hospicio crea, con la disciplina y su práctica de escritura, relaciones jerárquicas y homogeneizadoras que tienen el efecto de individualizar el cuerpo. Al final, elaboramos cómo el lenguaje poético y la creación de ficción pueden funcionar, combinados con el papel colectivo y revolucionario de la literatura, como potentes estrategias antimanicomiais de resistencia en una invitación a repensar nuestras producciones escritas. (AU)

Assuntos