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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.

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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.

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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.

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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.

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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.

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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.

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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.

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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.

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BACKGROUND: Asylum evaluations are highly specialized medico-legal encounters to collect physical or mental health evidence for use in immigration proceedings. Although the field of asylum medicine is growing, access to these evaluations is still inadequate, particularly for those in United States immigration detention or other forms of custody, such as under the U.S. Migrant Protection Protocols or "Remain in Mexico" policy. Given advances in telehealth in recent years and growing evidence of similar outcomes with in-person management, it seems prudent to examine whether remote modalities may also be effective for conducting mental health asylum evaluations in hard-to-reach populations. METHODS: We analyzed the responses of 12 U.S. clinicians who conducted 25 cross-border remote mental health evaluations with clients in Mexico prior to the COVID-19 pandemic, and completed a post-evaluation survey regarding their impressions and experiences of the remote encounter. Data were coded through a process of thematic analysis. RESULTS: The average evaluation time was 2.3 h, slightly shorter than might be expected from an in-person encounter. Five themes emerged from the coding process: rapport building, achieving overall goal, comparison of in-person vs. remote, technical issues, and coordination. Clinicians encountered a number of challenges including technical difficulties and a decreased ability to establish rapport. Nearly uniformly, however, clinicians noted that despite difficulties, they were able achieve the goals of the evaluation, including rapport building and diagnosis. CONCLUSION: Remote evaluations appear to achieve their intended goal and may be useful in expanding legal options for hard-to-reach asylum seekers.

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BACKGROUND: Since 2015, more than four million Venezuelans have fled their once prosperous nation, prompting an ever-intensifying refugee crisis. Recent research with Venezuelan parents suggests that many are exposed to elevated migration-related stress, experience behavioral health problems, and express profound concern for their children's post-migration wellbeing. We examine the relationships between stress, family functioning, and substance use risk with a cultural stress theoretical lens. Methods: Survey data were collected between November 2018 and June 2019 from 402 recently-arrived Venezuelan immigrant youth ages 10-17. Outcomes include perceived discrimination, negative context of reception, family support/communication, and substance use intentions and normative beliefs. Structural equation modeling was used to examine the relationships between variables. Results: Structural equation modeling results indicated that negative context of reception was associated with permissive substance use norms (via family communication; B = 0.070, p < .01) and intentions to use (via family support; B = 0.051, p < .01). Discrimination was not mediated by family functioning, rather it exerted a direct effect on substance use norms (ß = 0.20, p < .01) and intentions (ß = 0.33, p < .001). Discussion: We see clear evidence that negative context of reception and discrimination are related to substance use risk, both directly (in the case of discrimination) and indirectly (in the case of negative context of reception). Given the manifold stressors faced by Venezuelan immigrants both prior to migration and in the process of resettling in the US, it is critical that practitioners and policymakers support this rapidly-growing population.

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BACKGROUND: It is estimated that more than 4 million Venezuelans have left their country as a direct result of their nation's widespread social and economic challenges. Although recent research identifies Venezuela as one of the nations with the highest rates of harmful alcohol consumption in the Americas, no research has been conducted on alcohol use among Venezuelan youth in diaspora. METHODS: Data was collected between November 2018 and June 2019 from 373 Venezuelan immigrant youth ages 12-17 in the United States. The prevalence of past-month and lifetime alcohol use among Venezuelan youth is compared to that of other Hispanic and immigrant youth from the National Survey on Drug Use and Health (NSDUH), and the Construyendo Oportunidades Para Adolecentes Latinos (COPAL) study using independent sample t tests. RESULTS: The prevalence of past-month and lifetime alcohol use was significantly higher among Venezuelan immigrant youth (15% and 52%, respectively) compared to other Hispanic (9% and 28%) and immigrant (4.5% and 28%) youth in the NSDUH, and youth ages 14-17 in the COPAL study (4.0% and 22%). Among Venezuelan youth reporting alcohol use initiation, 1.5% of youth ages 12-14 and 19% ages 15-17 report lifetime alcohol intoxication. DISCUSSION: Although preliminary, results indicate that a disconcerting proportion of Venezuelan crisis migrant youth in the US report lifetime alcohol initiation and past-month use. These findings suggest the importance of future research to examine the prevalence and correlates of alcohol use in this population using recruitment and sampling methods that will allow for population-level estimates.

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Resumo O trabalho buscou verificar se o princípio de non-refoulement seria aplicável aos indivíduos não reconhecidos formalmente como refugiados e se o impedimento de acesso ao território do Estado de destino violaria tal princípio, além de analisar o exercício soberano de controle migratório diante da ameaça ao non-refoulement e aos direitos humanos por ele protegidos. Para tanto, realizou-se pesquisa teórica, bibliográfica e documental, com análise crítico-dogmática dos instrumentos normativos imperativos de direito internacional de proteção aos refugiados, das diretrizes de organizações internacionais e dos precedentes judicias sobre o tema. Em seguida, elaborou-se estudo contextualizado com breve análise de alguns casos recentes de emprego de barreiras fronteiriças como mecanismos de controle migratório. Como norma jus cogens e consuetudinária do direito internacional, o princípio demonstra-se aplicável independentemente de reconhecimento formal do status de refugiado, relativizando a soberania nacional. Apesar da divergência na aplicação do princípio, a imposição de barreiras fronteiriças viola tal princípio, uma vez ser necessário o acesso ao território do Estado de destino para que o processo de determinação da condição de refugiado seja justo e eficaz.(AU)

Abstract Keywords: Principle of non-refoulement. Asylum-seekers. Border barriers. Migration control. Human rights.

Resumen Este estudio trata de determinar si el principio de no devolución se aplicaría a los individuos no reconocidos oficialmente como refugiados y si la denegación de acceso al territorio del Estado de destino violaría este principio, además de analizar el ejercicio soberano de control migratorio ante la amenaza de no devolución y los derechos humanos protegidos por ella. Para eso se desarrolló una investigación teórica, bibliográfica y documental, con un análisis crítico-dogmático de los instrumentos normativos imperativos del derecho internacional para la protección de los refugiados, de las directrices de las organizaciones internacionales y de los antecedentes judiciales sobre el tema. Posteriormente, se elaboró un estudio contextualizado con un breve análisis de los casos recientes en los que se hayan empleado las barreras fronterizas como mecanismos de control de la migración. Como norma jus cogens y consuetudinaria del derecho internacional, el principio se demuestra aplicable independientemente del reconocimiento formal de la condición de refugiado, relativizando la soberanía nacional. A pesar de la divergencia en la aplicación del principio, la imposición de barreras fronterizas viola el principio de no devolución ya que el acceso al territorio del Estado de destino es necesario para que el proceso de determinación de la condición de refugiado sea justo y eficaz.

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Neste artigo, buscaremos evidenciar a especificidade e os limites de uma consulta transcultural no Serviço de Psiquiatria do Hospital Avicenne (França) com sujeitos requerentes de refúgio, originários principalmente da África e Ásia do Sul, atendidos por distúrbios psicotraumáticos. Tratar-se-á de tentar mostrar que uma abordagem clínica, que leve em conta o contexto sociopolítico e a situação jurídica desses pacientes "migrantes", irá possibilitar a emergência da palavra do sujeito. A partir da construção de dois fragmentos de caso, mostraremos como as representações político-sociais acerca do "migrante", "refugiado", "vítima", "suspeito", deixam suas marcas concretas e simbólicas nos sujeitos bem como influenciam os modos de condução do trabalho clínico. Isso nos permitirá, em um segundo momento, questionar a noção de alienação. Por fim, iremos lançar uma proposição clínica que tem a finalidade de esvaziar o espaço da consulta em psicoterapia das amarras impostas pelas representações sociais que calam o sujeito...

In this article, we will aim to highlight the specificity and limits of a transcultural consultation in the Psychiatry Service of the Avicenne Hospital (France) with asylum seekers from Africa and South Asia affected by traumatic experiences that resulted in psychological disturbances. We will try to show that a clinical approach that takes into account the social and political context and the legal status of these "migrant" patients will allow the emergence of the word of the subject. Based on the construction of two case fragments, we will demonstrate how the political and social representations concerning the "migrant", "refugee", "victim", "suspect" leave their concrete and symbolic marks in the subject as well as influence the way the therapy is carried out. This will allow us, in a second step, to question the notion of alienation. Lastly, we will make a clinical proposition that aims to empty the clinical space from the constraints imposed by social representations that silence the subject...

Cet article interroge les spécificités et les limites de la consultation de psycho-traumatologie du service de psychiatrie de l'hôpital Avicenne avec des demandeurs d'asile originaires principalement d'Asie du Sud et d'Afrique. Seul un abordage clinique qui prend en compte la particularité du contexte socio-politique et de la situation juridique des patients peut permettre au sujet de faire entendre sa parole. A partir de deux cas cliniques, nous montrerons comment les représentations qui entourent le sujet, successivement catégorisé comme migrant, réfugiés, victime ou suspect, ont un impact concret et symbolique sur le patient et sur la dynamique clinique. A partir de ce constat, nous interrogerons la notion d'aliénation. Dans un troisième temps, nous ferons des propositions cliniques afin de dégager l'espace clinique des impositions aliénantes qui imposent le silence au sujet...

En este artículo, se destaca la especificidad y los límites de un servicio de consulta de psiquiatría transcultural en el Servicio de Psiquiatría del Hospital Avicena (Francia) con los solicitantes de refugio, originarios principalmente de África y Asia del Sur, y que buscan atención psicológica por presentaren trastornos psicotraumáticos. Se trata de demostrar que un enfoque clínico que tiene en cuenta el contexto socio-político y la situación jurídica de los pacientes 'migrantes' permitirá la reaparición de la palabra al sujeto. Desde la construcción de dos fragmentos clínicos, tratamos de mostrar cómo las representaciones políticas y sociales del "migrante", "refugiado", "víctima", "sospechoso" dejan sus marcas concretas y simbólicas en los sujetos así como influyen en nuestra forma de conducir el trabajo clínico. Esto nos permitirá, en un segundo momento, cuestionar la noción de alienación. Por último, vamos a lanzar una proposición clínica que tiene como objetivo eliminar de la consulta en psicoterapia las limitaciones impuestas por las representaciones sociales que callan a los hombres...

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Neste artigo, buscaremos evidenciar a especificidade e os limites de uma consulta transcultural no Serviço de Psiquiatria do Hospital Avicenne (França) com sujeitos requerentes de refúgio, originários principalmente da África e Ásia do Sul, atendidos por distúrbios psicotraumáticos. Tratar-se-á de tentar mostrar que uma abordagem clínica, que leve em conta o contexto sociopolítico e a situação jurídica desses pacientes "migrantes", irá possibilitar a emergência da palavra do sujeito. A partir da construção de dois fragmentos de caso, mostraremos como as representações político-sociais acerca do "migrante", "refugiado", "vítima", "suspeito", deixam suas marcas concretas e simbólicas nos sujeitos bem como influenciam os modos de condução do trabalho clínico. Isso nos permitirá, em um segundo momento, questionar a noção de alienação. Por fim, iremos lançar uma proposição clínica que tem a finalidade de esvaziar o espaço da consulta em psicoterapia das amarras impostas pelas representações sociais que calam o sujeito.(AU)

In this article, we will aim to highlight the specificity and limits of a transcultural consultation in the Psychiatry Service of the Avicenne Hospital (France) with asylum seekers from Africa and South Asia affected by traumatic experiences that resulted in psychological disturbances. We will try to show that a clinical approach that takes into account the social and political context and the legal status of these "migrant" patients will allow the emergence of the word of the subject. Based on the construction of two case fragments, we will demonstrate how the political and social representations concerning the "migrant", "refugee", "victim", "suspect" leave their concrete and symbolic marks in the subject as well as influence the way the therapy is carried out. This will allow us, in a second step, to question the notion of alienation. Lastly, we will make a clinical proposition that aims to empty the clinical space from the constraints imposed by social representations that silence the subject.(AU)

Cet article interroge les spécificités et les limites de la consultation de psycho-traumatologie du service de psychiatrie de l'hôpital Avicenne avec des demandeurs d'asile originaires principalement d'Asie du Sud et d'Afrique. Seul un abordage clinique qui prend en compte la particularité du contexte socio-politique et de la situation juridique des patients peut permettre au sujet de faire entendre sa parole. A partir de deux cas cliniques, nous montrerons comment les représentations qui entourent le sujet, successivement catégorisé comme migrant, réfugiés, victime ou suspect, ont un impact concret et symbolique sur le patient et sur la dynamique clinique. A partir de ce constat, nous interrogerons la notion d'aliénation. Dans un troisième temps, nous ferons des propositions cliniques afin de dégager l'espace clinique des impositions aliénantes qui imposent le silence au sujet.(AU)

En este artículo, se destaca la especificidad y los límites de un servicio de consulta de psiquiatría transcultural en el Servicio de Psiquiatría del Hospital Avicena (Francia) con los solicitantes de refugio, originarios principalmente de África y Asia del Sur, y que buscan atención psicológica por presentaren trastornos psicotraumáticos. Se trata de demostrar que un enfoque clínico que tiene en cuenta el contexto socio-político y la situación jurídica de los pacientes 'migrantes' permitirá la reaparición de la palabra al sujeto. Desde la construcción de dos fragmentos clínicos, tratamos de mostrar cómo las representaciones políticas y sociales del "migrante", "refugiado", "víctima", "sospechoso" dejan sus marcas concretas y simbólicas en los sujetos así como influyen en nuestra forma de conducir el trabajo clínico. Esto nos permitirá, en un segundo momento, cuestionar la noción de alienación. Por último, vamos a lanzar una proposición clínica que tiene como objetivo eliminar de la consulta en psicoterapia las limitaciones impuestas por las representaciones sociales que callan a los hombres.(AU)

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