ABSTRACT
The scarcity of information and psychiatric research for the South American region is alarming (Seale et al., 2002). Although there are pioneering studies of psychiatric disorders using conventional instruments (see Chapter 20), these do not always ensure validity across cultures; for example, there is very little information on indigenous illness categories or indigenous healing practices. According to reports from the 1970s and 1980s, comprehensive mental health services are lacking in Latin America and often have the lowest priority both politically and socially (Argandoña and Kiev, 1972; Alarcon, 1986). A transition now under way in these countries involves a move away from the use of large urban psychiatric hospitals towards establishing psychiatric beds in general hospitals, and ultimately towards the integration of mental health care with primary health care (Murthy, 1998; Larrobla and Botega, 2001; Saldivia et al., 2004). The process of restructuring psychiatric care in South America began in the 1980s and escalated during the 1990s. Although these structural developments in mental health care are laudable, they neglect the mental health care needs of the indigenous peoples of South America. In the context of limited resources,
Introduction 185 Poverty and social exclusion 185 Indigenous peoples’ poor health 186
The South American countries’ response 187 Traditional mental health resources – the future 188 References 189
resource-starved mental health services, and social indifference to the mentally ill, it is ironic to attempt to describe South American mental health services for the indigenous peoples.
