By: Klarissa Garcia Orellana- Diversity Chair
Throughout my training in the United States (U.S.) to become a psychologist, I have often viewed the U.S. as a role model when it comes to mental health training and services. We constantly hear that the U.S. has the best hospitals, universities, professionals, researchers and programs. In fact, I decided to move to the U.S. to receive my education because I believed it was where I was going to receive the best training. As part of the Latino Specialty Program that the Graduate School of Professional Psychology (GSPP) offers, I went to an immersion trip to Chile (Santiago and Concepcion) in December of 2017. As a Latina, I was excited to learn the role of psychologists and how mental health services work in a country, and a culture, more similar to mine. However, due to my belief that the U.S. is more advanced than Latin America, I found myself automatically assuming that the mental health services in Chile were going to be less than – less efficient, less advanced, less organized – than services in the U.S. However, it only took a couple of days in Chile to realize I was wrong.
Chile provides amazing mental health services from which the U.S. has plenty to learn. Some of the things that caught my attention were the benefits of a warm and more expressive culture, the systemic approach of mental health programs and the interdisciplinary contribution of a variety of professionals to the delivery of patient care.
Hospital Padre Urtado’s cardiology rehabilitation program incorporates the patient’s family and community in the care by providing workshops including cooking classes, lessons about how to support the patient, family therapy, and other opportunities. Moreover, the collaborative contribution of providers across various specialties (i.e., psychologist, psychiatrist, kinesiologist, nurse, cardiologist and social worker) to the treatment was incredible. They all worked as an integrated team and were well aware that none of their expertise was enough to provide the best care possible to the patient. The appreciation shown of mental health from non-mental health professionals was refreshing. In the U.S., I have interacted with multiple non-mental health providers that undermine the importance of mental health and the effect it has on patients. However, in Chile I saw the complete opposite. My professor and I shadowed a medical intake conducted by a nurse at the cardiology rehabilitation center, and by the end of the intake my professor told the nurse, “you are a psychologist without even realizing it.” The sensitivity of the nurse to the patient’s emotional state and situation was incredible, even though she was the one in charge of conducting “only” the medical intake and not the mental health one.
At the dementia center in Concepcion, this multidisciplinary and systemic approach was also seen. I shadowed a patient’s appointment with a neurologist, and even though the purpose of the appointment was neurological, the psychiatrist, psychologist, social worker, and geriatrician were also present. When the patient left the room, all professionals discussed the patient’s situation as a group. The contribution of their area of expertise to the conversation was incredible, exchanging points of views and appreciating the contribution of each other’s expertise. This interdisciplinary approach was also beneficial for the patient since she was able to see all of her providers in one appointment instead of going to separate appointments that, in the U.S., may have been many month apart and much more costly.
The warm nature of Latin American culture made patients feel at home and cared for. Interactions that would be considered unethical in the U.S., such as hugging and kissing were crucial in building rapport between professionals and patients as well as critical to the patients’ feelings of belonging. From my perspective, this warm and extrovert nature of the culture also contributed to a more kind and caring delivery of services not only from mental health professionals but also from professionals of other areas.
This caring, systemic and interdisciplinary care that was seen at the hospital and the dementia center was also seen in the prison, university clinics, forensic evaluation settings and all other centers we visited.
Upon arriving back to the U.S. after this trip, it has become clear to me that the U.S. provision of care has much to learn from this systemic, multidisciplinary, and warm approach. Moving away from, and ultimately beyond, the individualistic provision of care, health care providers would be able to more holistically provide a higher standard of care for their patients. We, in both Latin America and the U.S., are so used to thinking that the U.S. is more advanced than other countries, especially Latin American and other non-developed countries, that we forget that there is so much to learn from them. When anyone believes they are the best of the best they stop listening, learning, and being critical of their actions. The realizations that I had while traveling and studying in Chile do not have implications for just every patient professionals treat, but I believe these ideas are particularly important when considering the provision of culturally appropriate services to immigrants and individuals with different backgrounds in the U.S.