Contemporary mental health practices
As mentioned above, mental health currently works from a community approach.This approach focuses on people who have a severe and persistent mental disorder, and the impact on their entire family and social environment. What is sought is the recovery of the person, favoring their social inclusion and the recovery of the full exercise of their rights (Ministerio de Salud 2017).
This approach is integrated and complemented with the Model of Comprehensive Family and Community Health Care, a central axis in mental health since 2005. Both approaches, which coexist, have three axes in current policies. First, the promotion of community mental health is emphasized; This promotion consists in deploying actions that allow the creation of environments that protect the integral and healthy development of the communities. These actions revolve around education, work, justice, transport, the environment, housing, municipalities, NGOs, among others. This model seeks to work with all these actors in order to deliver the minimum conditions so that the population can maintain their mental health (Ministerio de Salud 2017).
The second axis of work consists in prevention. Prevention from a community approach consists in knowing, promoting and supporting self-management capacities of individuals, families and communities in the face of risk conditions, such as economic vulnerability, marginalization and social exclusion. With prevention, it is sought, on the one hand, to strengthen the protective conditions of mental health that work on axis number one and, on the other, to counteract the effects of unfavorable social determinants such as, social inequality and lack of opportunities. In addition, preventive strategies seek that those who are involved maintain or recover their ability to interact with others and to participate in community, so that the family and the environment become fundamental. These strategies go beyond the symptomatology and are oriented in a change in the relations of the subject with their social conditions (Ministerio de Salud 2017).
The third axis of work issued by the Ministry of Health (Ministerio de Salud 2017) consists in direct treatment and care in mental health. This focus is on the person and aims to recover the ability to interact with others and participate in community life; Again, the family becomes a fundamental aspect. This axis also goes beyond the symptoms and is oriented towards the articulation of networks that provide basic conditions for the well-being of the users, focusing on work, housing, education, emotional ties, social relationships, among other things.
These three axes are the basis of all mental health practices in the public service in Chile. However, in the private service there are numerous guidelines and models that are not possible to describe each and every one of them in this chapter. However, it should be mentioned that in the private system there are clinics that work under these same guidelines and also others that have orientations towards particular psychological schools such as psychoanalysis, cognitive behavioral therapies, among others; There are also institutions that work from anthroposophy or with the use of complementary therapies and homeopathy. The current mental health field is extensive and offers multiple options.
Future directions
In recent years, there have been various social phenomena that have transformed ways of thinking about mental health and illness. Higher education students in our country have initiated various protests about the integration of quality of life and mental health into the education system. Our Psychology Unit of the Directorate of Student Affairs of the School of Medicine of the University of Chile has contributed from the investigation of the prevalence of mental disorders in university students, studies on profiles, crossings of sociodemographic variables, quality of the teaching-learning process, and evaluation systems.
In 2011, numerous universities, colleges and educational institutions formed a popular movement that covered most of that year and that ended in important modifications in education in Chile. In 2018, again students from higher education institutions led a new mobilization in which this time was focused on womens rights. Also, in 2018 the abortion law was approved in three cases and in 2019 the laws on gender and homoparental adoption are beginning to change towards a more inclusive and tolerant Chile. Not to mention the increase in immigration from various Latin American countries that should also be considered.
These political changes are generating cultural transformations that we still cannot analyze. The question that concerns us in the midst of all of this is how these changes will affect the mental health field of the country, how the community approach will address these sociocultural changes and how universities will modify their programs or not towards training that benefits or slows these transformations.
Chile, as mentioned at the beginning of this work, is a country with a chronic lack of attention in mental health matters. Statistics do not suggest a good future. Therefore, it is necessary to study in depth the aforementioned transformations in order to generate mental health models according to the needs of the nation and sensitive models to the continual changes of the contingency. Mental health professionals should be at the forefront of research and not be afraid when creating new avenues for the study and practice that contribute to the improvement of the mental health of all and all those who make up this State called Chile.
