Relatives of Enforced Disappeared Persons in Mexico: Identifying Mental Health and Psychosocial Support Needs and Exploring Barriers to Care

摘要

In the current study, we explored the needs for psychosocial support as well as barriers to care among relatives of enforced disappeared persons in Mexico. Interviews were conducted with 29 relatives of disappeared persons as well as with representatives from seven organisations working with relatives. Needs and barriers to care mentioned by the interviewees were categorised and rated according to the frequency of mentioning. The interviewers, a psychiatrist and a medical doctor, assessed emotional distress. All interviewed relatives reported and showed signs of severe emotional distress. Frequently reported mental health symptoms included suicidal thinking, sleeplessness, anxiety, changes in appetite, intrusive memories, irritability and major role impairments. The most frequently expressed needs for psychosocial support included peer support, support when in contact with law enforcement officers, treatment of mental health conditions, religious support and family support. The most frequently encountered barriers included having a negative opinion about the quality of available services, feelings of judgement from other people (e.g., due to incrimination), lack of available services and not knowing where to get help. These findings emphasise the need to provide practical and informational support to relatives of disappeared persons as well as to provide emotional support during the entire search process for their missing relative, and beyond. Key implications for practice There is an urgent need to provide practical and informational support to relatives of disappeared persons as well as to provide emotional and family support during the entire process of searching for the missing relative, including during contact with the law, searching, reconnection, and/or before, during and after exhumations and handing over of the remains. Psychosocial support providers should focus on living with uncertainty and refrain from pressure for closure as well as from imposing hope as a moral imperative. Mental health care professionals need to provide adequate treatment for common mental health conditions, including depression and posttraumatic stress disorder, within a supportive context.