Cristian Montenegro

[“No mental health without social justice”: Inequalities, social determinants, and mental health in Chile.]

(2021)

Jiménez-Molina, Á., Abarca-Brown, G., & Montenegro, C. (2021). Revista de Psiquiatría Clínica, 57

Abstract:

Inequalities in living conditions negatively impact the mental health of individuals and communities. This article aims to describe some of the main lines of research and reflection on the relationship between inequality and mental health. More than a systematic review, it contributes to the public debate about the material, symbolic and subjective dimensions of inequality, emphasising some mechanisms that allow for understanding its relationship with mental health. Among these dimensions we address income and gender inequalities in addition to others that have received less attention in national and international studies: inequalities in participation, in daily interaction, and socio-territorial and time-use inequalities. Finally, we mention some theoretical limitations of traditional research on health inequality and suggest potential lines of research that can guide studies on inequalities and mental health. Read more …

(April 2021)

Abimbola, S., Asthana, S., Montenegro, C. R., Guinto, R. R., Jumbam, D. T., Louskieter, L., Kabubei, K. M., Munshi, S., Muraya, K., Okumu, F., Saha, S., Saluja, D., & Pai, M. (2021). PLOS Medicine, 18(4), e1003604. https://doi.org/10.1371/journal.pmed.1003604

Abstract:

The Coronavirus Disease 2019 (COVID-19) pandemic, the Black Lives Matter movement, and the growing calls to decolonise and address reports of structural racism within humanitarian, development, international aid, and global health agencies are opening doors for uncomfortable but important conversations. They are revealing serious asymmetries of power and privilege that permeate all aspects of global health. Read more ….

(December 2020)

Montenegro, C. R., & Ortega, F. (2020)., 5(12), e004539. doi.org/10.1136/bmjgh-2020-004539

Abstract:

Global mental health is a field of research and intervention that aims to improve access to mental health on a global scale. A basic tenet in the field is the existence of a large ‘treatment gap’ for most mental disorders, especially in low-income and middle-income countries, and the need to ‘scale up’ interventions through, among other things, ‘task shifting/sharing’ to/with community health workers, traditional healers and peers. The rise of global mental health has unearthed old controversies in psychiatry such as the universality vs cultural specificity of mental disorders, their expressions and their relationship with forces beyond the individual. Read more ….

(November 2017)

Montenegro, C. R., & Cornish, F. (2019). Critical Public Health, 29(1), 61–73 doi.org/10.1080/09581596.2017.1400659

Abstract:

In western mental health systems, the involvement of user organisations has become an important dimension of contemporary policy development. But the processes constituting users as a relevant/irrelevant group have received little investigation, especially outside the English-speaking world. Drawing on Luhmann’s theory of society, this article presents a reconstruction of involvement initiatives in mental health policy in Chile between 1990 and 2005. It is based on 17 oral history interviews with policy-makers, high-level professionals, involved users, ex-users, and family activists, drawing also on relevant policy documents. Five processes are identified. In the early 1990s, the relevance of family groups as care providers in the context of deinstitutionalisation shaped the first encounters between psychiatry and community. Later, user groups became relevant as political supporters of the Mental Health Department’s funding requests, and in their capacity to legitimise decisions on involuntary treatment. The first National User Organisation resulted, in 2001. Its relevance was quickly undermined, however, by the AUGE health reform which restricted the definition of diseases and treatments with reference to evidence and costs. The legitimation of users was no longer needed and efforts to involve them subsided. Thus, we argue that the way in which the mental health system observes the voices of users is less a result of the actual status of users’ organisations than of the changing needs of mental health policy for ‘user representation’. By highlighting the contingency of policy shifts, we suggest that this historical and systemic perspective provides grounds for the strategic irritation and transformation of mental health systems through users’ activism. Read more ….

(November 2015)
Montenegro, C. R., Cornish, F. (2015). Global Mental Health, Vol. 2 (e22) 1-11 doi.org/10.1017/gmh.2015.20

Abstract:
The UN Convention on the Rights of Persons with Disabilities (CRPD) has been adopted by national governments to advance the interests and wellbeing of people with psychosocial disabilities (PPSD). It is often assumed that the adoption of a ‘rights’ framework will advance the dignity and autonomy of PPSD. However, little is known about how families and communities understand ‘rights’. The present paper, based on research conducted in Santiago, Chile, takes a contextual approach to rights, asking: How do family carers of PPSD understand and use the idea of ‘rights’? How does the context of caregiving shape families’ understanding of rights? Read more ….