2024 Theses Doctoral

Mental Health & Psychosocial Support Opportunities for People on the Move in Mexico: A Mixed Methods Exploratory Study

Costigan, Elen

We are in a new global era, framed and shaped by migration and record movements across borders. The intersection of migration, mental health, and psychosocial wellbeing represents an increasingly important matter in the humanitarian space. Global rates of migration are at an all-time high, with internal and cross-border migration hitting record figures (United Nations Department of Economic and Social Affairs, Population Division, 2020). Mexico is a country that has been particularly affected by migration, as a top country of transit, as well as destination for migrants and asylum-seekers from the Americas and across the globe. The rise of displaced people traveling to Mexico and the United States, in combination with limited protection and legal support for migrants, has resulted in an unprecedented situation requiring attention. Population displacement results from an array of push factors, including political instability, climate degradation, natural disasters, and economic/physical insecurity. As growing numbers of people migrate to and through Mexico in search of protection and improvements in livelihoods, it is crucial to consider gaps in access to support services for migrants and asylum-seekers.

Access to health care has long been a challenge for migrant populations in Mexico (Infante, 2022), and in particular, barriers have been reported in relation to Mental Health and Psychosocial Support (MHPSS) for people migrating while seeking asylum further North (Allande, 2022). Thus, there exists a need for the provision of improved and adapted MHPSS programs for migrants in Mexico, with particular attention to those from outside of Mexico seeking asylum in the United States.

Working in collaboration with local partners, this Integrated Learning Experience (ILE) summarizes findings from a multi-stage exploratory assessment. The overarching goal of this ILE was to identify opportunities for improving the design and implementation of MHPSS for migrant populations in Mexico. To do so, this research focused on addressing three specific aims: identify major gaps and challenges in delivering MHPSS services from the perspectives of practitioners and scholars (Aim 1); assess perceptions of existing MHPSS services from the perspective of intended users through in-depth inquiry with migrant communities (Aim 2); and, map barriers and facilitators to accessing MHPSS services as well as co-creating implementation strategies, tools and key recommendations through participatory workshops with key actors (Aim 3).

The specific research methods utilized in this assessment included: A) synthesis of 3 years of survey data gathered from service providers, along with key informant interviews (KIIs) with service providers to identify existing programs, gaps, and challenges; B) focus group discussions with migrant populations combined with ethnographic observations to assess support and how they are perceived, and C) participatory workshops with key actors to co-create implementation strategies to improve supports from a systems perspective. By mapping existing MHPSS supports in key locations and engaging with different stakeholders through participatory methods, this ILE presents a systematic, conceptual approach to identify leverage points for improvements in programs that fit the unique situation and lived experiences of people on the move.

The final recommendations outline practical steps to promote more coherent and comprehensive approaches to MHPSS programming while recognizing and responding to overlapping risks of violence, discrimination, and other challenges this population may face. Key takeaways reveal overall shortages in availability of services, and gaps in information-sharing and coordination. Most importantly, findings show a cultural disconnect with many MHPSS programs, calling for a rethink of how to design and implement services in a manner that better fit the realities and preferences of migrant communities. Ways forward include promoting cultural humility, community engagement, listening, and promoting agency in order to strengthen MHPSS practices that are grounded in and sensitive to the views of those migrating.