Mental, neurological and substance use disorders among the Latino migrant population in the United States who visited the Health Windows and Mobile Health Units in 2021.

Background: Mental health is defined by the World Health Organization as a state of wellbeing in which people are aware of their own abilities to cope with the normal stresses of life, work productively and fruitfully, and contribute to their community. Among the minority groups that may be vulnerable to experiencing greater risks for their physical and mental health and full development is the migrant population. The mobile population's migration experience, from their place of origin to destination translates into psychosocial problems and clearly stressful conditions which could be resolved using certain coping strategies. Accordingly, numerous epidemiological studies have found differences in the prevalence of mental health problems between migrants and native-born residents of destination countries, as well as between migrants and their non-migrant co-nationals. Purpose: To describe sociodemographic characteristics of the Latino migrant population in the United States who visited the Health Windows (HW) and Mobile Health Units (MHU) in 2021, who may have been at risk for mental, neurological or substance use disorders and agreed to a screening for signs and symptoms of mental health conditions. Method: Users of the HW and MHU were offered preventive health services and completed a mental health screening. These variables were registered in SICRESAL. If their results showed signs and symptoms of mental health conditions, they were screened by credentialed professionals from the Psychology Faculty of the National Autonomous University of Mexico. Screened individuals received a diagnosis and specialized care remotely and/or online with the MHU and HW network partners. To analyze sociodemographic variables corresponding to neurological or substance induced mental illness among the Latino migrant population in the United States who visited the Ventanillas de Salud (VDS)/Health Windows (HW), and Unidades Móviles de Salud (UMS)/Mobile Health Units (MHU), during 2021; contingency tables were created showing percentages and chi square with a significant p < 0.05. Findings: During 2021 HW and MHU completed a total of 794 mental health screenings of which 84% were completed at HW. Further, 59% were women with an average age of 43, ranging from 7 to 86 years of age. Twenty percent 20% of the population who voluntarily agreed to screening yielded a positive result for some type of mental health symptom or problem. This percentage (37%) was greater among those who consulted MHU. With respect to age, results showed that youth were at greatest risk for mental health problems. Among the screened population, the independent variables, type of Health Window attended, gender, age group, and place of origin are related to the existence of some type of mental health symptom or problem yielding a significance level of <0.05 for depression and anxiety symptoms. Discussion and prospects: In this study, as in others, the migrant population that visited the HW and UMS in 2021 reported a greater risk of mental health problems, with symptoms related to depression and anxiety among the socio-demographic variables of gender, age group, and place of origin. Thus, these symptoms relate to being a female aged between 18 and 38 and originating from Mexico. Finally, the possibility of screening the migrant population for signs and symptoms of mental health conditions that attended the Health Windows or Mobile Health Units during 2021, made it possible to refer them to psychology or psychiatry services and improve the quality of life of those who accessed the services and, consequently, that of their families and communities. Limitations: The main limitation is associated with the information source since we worked with secondary data and relied on the information provided by those who attended both the HW and the MHU.

The epidemiological follow-up process for suspected and confirmed cases of COVID-19 in migrant shelters on the northern border of Mexico from July to December 2020: Between contagion underestimation and containment.

Background: Elements associated with an increased risk factor for the contagion of COVID-19 in shelters include the turnover and overcrowding of people, time spent in communal areas, daily supply needs, water availability, and sanitation levels. The "Report on the Effects of the COVID-19 Pandemic on Migrants and Refugees," shows that factors such as the shortage of food, supplies, water, sanitizing materials, spaces for healthy distancing, financial resources for rent and essential services, and the lack of medical or psychological care complicated providing care for migrants and applicants seeking international protection. Objective: We describe shelter operations regarding the detection and follow-up of suspected and confirmed COVID-19 cases showing mild symptoms among the migrant population housed in the border cities under study. Methods: We conducted semi-structured, in-depth interviews with study subjects (people in charge, managers, coordinators, shelter directors) from 22 migrant shelters, and 30 with key informants. We studied the cities of Tijuana (Baja California), Nogales (Sonora), Ciudad Juárez (Chihuahua), Piedras Negras (Coahuila), and Heroica Matamoros (Tamaulipas). The research was based on a qualitative methodological design with an ethnographic approach. The information collected was transcribed and systematized into two tables or analytical templates, one for interviews with study subjects, and another for interviews with key actors. Findings: Overall, seventy-eight registered shelters provided accommodation services for migrants in the five cities the study focused on: thirty-seven in Tijuana, five in Nogales, twenty-two in Ciudad Juárez, eight in Piedras Negras, and five plus a camp (six in total) in Matamoros. The major concentration of shelters was in Tijuana (47.4%) and Ciudad Juárez (28.2%). At the beginning of the pandemic, only a few shelter facilities met quarantine and isolation guidelines, such as having separate bathrooms and sufficient space to isolate the "asymptomatic" and "confirmed" from close "contacts". The lack of isolation space and the inability to support the monitoring of patients with COVID-19 posed a challenge for those housed in shelters, forcing many shelters to close or continue operating behind closed doors to avoid becoming a source of infection during the pandemic. Discussion and outlook: Contrary to speculation, during the onset of the pandemic northern border migrant shelters did not become sources of COVID-19 infection. According to the data analyzed from 78 shelters only seven had confirmed cases, and the classification of "outbreak" was applied only in two facilities. Contagion control or containment was successful as the result of following a preventive containment logic, including the isolation of all suspected but unconfirmed cases, without a clear understanding of the human and financial resources required to maintain isolation areas. However, shelters in the study implemented protocols for epidemiological surveillance, control, and prevention with elements that interfered with monitoring spaces, and processes that caused oversights that resulted in underestimating the number of cases. Limitations: Due to travel restrictions imposed to prevent and contain coronavirus infections it was impossible to stay on-site in the cities studied, except for Tijuana, or carry-out recordings of migrants' views in shelters.

Ventanillas de Salud (VDS) and Mobile Health Units (MHU): A binational collaborative models.

Over the years, the Mexican population in the United States has faced high prevalence of health-related inequalities and disadvantages and represents one of the most vulnerable migrant groups in the country. To help reduce the gaps in health care for the Mexican population, the Mexican government, in collaboration with strategic allies from various sectors, launched the Ventanillas de Salud (VDS) strategy, which was subsequently reinforced through the Mobile Health Units (MHU) care model. Both the VDS strategy and the MHU care model are intended to contribute to the development of initiatives, projects, and actions in health that will benefit the Mexican community living in the United States, which lacks or has difficulty accessing health services. This article provides a descriptive, analytical analysis of the VDS strategy and the MHU care model, as unique collaborative models, which can be replicated, and have achieved a positive impact on the health of Mexican and other Hispanic communities in the United States, at both the individual and community level.

Together for Health: An Initiative to Access Health Services for the Hispanic/Mexican Population Living in the United States.

A disproportionately small percentage of the Hispanic/Mexican population in the United States has adequate access to health services, which decreases quality of life at both the individual and community levels. In addition, it increases risk for preventable diseases through insufficient screening and management. The Mexican Section of the U.S./Mexico Border Health Commission, in efforts to address barriers to accessing preventive health care services for vulnerable populations, launched the initiative Juntos por la Salud (JPLS) that offers health promotion and disease prevention services to Hispanics living in and around 11 U.S. metropolitan cities via mobile health units. This paper presents a descriptive analysis of the JPLS initiative and potential positive impact it has had in reducing barriers faced by the Hispanic population. JPLS screens and provides referrals to primary care services to establish a medical home and has the potential to reduce health care costs in a high-risk population through education and timely health screenings.

La afiliación al sistema de salud de personas migrantes venezolanas en Colombia / The Affiliation to the Health System among Venezuelan Migrants in Colombia

Resumen: Introducción:El acceso de las personas migrantes venezolanas al sistema de salud es fundamental para su supervivencia y bienestar futuro. El objetivo de esta investigación es analizar los niveles de afiliación a dicho sistema de las personas venezolanas en las áreas urbanas de Colombia por periodos de arribo, así como los factores sociodemográficos y laborales asociados. Metodología: Se realiza análisis cuantitativo de tipo estadístico descriptivo e inferencial, a partir de la Gran Encuesta Integrada de Hogares 2018, la cual aporta datos representativos para Colombia y sus 13 ciudades más importantes. Se utilizan los módulos de migración, de variables sociodemográficas del hogar y de ocupación relativos a la población de 14 a 65 años. Resultados:Únicamente 24,5 % de dichos migrantes están inscritos al sistema de salud en contraste a 93 % de las personas colombianas. Los niveles de afiliación se redujeron de 82 % entre las personas venezolanos que arribaron en 2013 o antes a 10 % entre los que llegaron en 2017-2018. Las personas venezolanas afiliadas al sistema de salud son una población selecta en términos sociodemográficos; más joven, más educada, con mayor participación laboral y mayores ingresos que la población nativa en Colombia. La baja inserción de las personas migrantes venezolanas en empleos con contrato escrito restringe dicha afiliación. Conclusiones: Las personas venezolanas en Colombia tienen muy limitada la inscripción al sistema de salud. A pesar de que este es un derecho protegido por los marcos jurídicos internacional y nacional, estas personas enfrentan barreras económicas, políticas y sociales para ejercer ese derecho en Colombia.

Abstract: Introduction: Venezuelan migrants' access to the health system is fundamental to their survival and future well-being. This article aims to analyze the level of affiliation to the health care system of these migrants in the urban areas in Colombia by arrival periods and the associated sociodemographic and labor factors. Methodology: To this end, quantitative analysis is done based on descriptive and inferential statistical analyses of the 2018 Gran Encuesta Integrada de Hogares, which is a representative survey for Colombia and its 13 more important urban areas. We use the modules on migration, sociodemographic variables of the household and occupation relative to the population aged 14 to 65. Results: Only 24,5% of Venezuelan migrants are affiliated with any health care provider in contrast to 93% of Colombians. The levels of affiliation diminished from 82% among Venezuelans who arrived in 2013 or before to 10% among Venezuelans who arrived in 2017-2018. Venezuelans registered in the health system are a select population in sociodemographic terms; younger, more educated, with more labor participation and higher income than the native population in Colombia. The low insertion of Venezuelan immigrants in jobs with a written contract restricts this enrollment. Conclusions:The Venezuelans in Colombia have a very limited affiliation with the health system. Even though this is a right protected by international and national legal frameworks, Venezuelans encounter economic, political, and social barriers to exercise it in Colombia.

Grupo psicoeducativo en cuidados paliativos para el paciente cardiópata y su familia / Psychoeducational group in palliative care for cardiac patient and his family

El presente artículo tiene la finalidad de compartir la experiencia que ha tenido la Unidad de Cuidados Integrales Avanzados (UCIA) con la conformación de grupos a los que se les brinda atención psicoeducativa, como parte de los cuidados paliativos ofrecidos por el Instituto Nacional de Cardiología Ignacio Chávez. En la atención directa con los pacientes en situación de terminalidad y su familia se identificaron situaciones que afectan directamente su calidad de vida, razón por la cual se diseñó un programa para realizar intervención psicoeducativa con enfoque biopsicosocial a través de un equipo de salud transdisciplinar con el objetivo principal de ampliar el repertorio de afrontamiento del paciente y del cuidador principal a través de la orientación respecto a la enfermedad, síntomas y cuidados paliativos específicos que puede realizar en el hogar. Dicho programa cuenta con las políticas, normas y lineamientos de operación que considera el contexto actual de los pacientes en situación de terminalidad y de su familia. Se destacan aspectos importantes observados posterior a la psicoeducación tales como: identificación de conductas adaptativas, ampliación del repertorio de afrontamiento, disminución de las consultas en los servicios de urgencias y del número de hospitalizaciones.

This article aims to share the experience of the Comprehensive Care Unit (CCU) with the formation of groups that are given psychoeducational care, as part of the palliative care offered by the National Institute of Cardiology Ignacio Chavez. In direct care with terminally ill patients and their families, situations that directly affect their quality of life were identified, that is why a program was designed to carry out a psychoeducational intervention with a bio-psycho-social approach through a team of transdisciplinary health, with the main objective of expanding the repertoire for coping with the patient and the main caregiver through orientation regarding the illness, symptoms and specific palliative care that can be done at home. This program has the policies, rules and guidelines of operation that considers the current context of terminally ill patients and their family. Important aspects observed after psychoeducation are highlighted such as identification of adaptive behaviors, expansion of coping repertoire, reduction of visits to the emergency services and number of hospitalizations.