“We have to keep moving”: perspectives on the challenges and opportunities in providing mental health services for people on the move in Latin America

TL;DR

This paper explores the mental health challenges faced by people on the move in Latin America and the efforts by Médecins Sans Frontières to provide tailored mental health services.

Contribution

The paper presents a novel approach to mental health care delivery for people on the move, emphasizing adaptation and holistic care in response to migration policy changes.

Findings

MSF provided over 17,000 mental health consultations to people on the move in Latin America since 2024.

Holistic care packages including brief therapy and cultural mediators are effective in addressing diverse mental health needs.

Migration policy changes and funding cuts threaten to worsen mental health outcomes for people on the move.

Abstract

Navigating considerable risk and uncertainty, including high rates of violence and recent tightening of migration policies, People on the Move (PoM) in Latin America face significant mental health challenges and barriers to care. From 2021 to 2025, Médecins Sans Frontières (MSF) has provided psychological and psychiatric services to PoM in Mexico, Guatemala, Honduras, Costa Rica, and Panama, conducting almost 17,000 consultations since 2024 alone. In our experience, patients face a complex clinical landscape characterized by limited patient-provider interaction time, constantly changing health systems, and inconsistent referral and medication availability, among other challenges. The urgent need to meet basic survival and protection needs often delays attention to mental health. The highly diverse patient population, both from the region and beyond, requires ongoing adaptation to different languages, cultures, and precipitating events and circumstances. In response, MSF adapts a holistic care package including single, brief therapy sessions; group psychoeducation sessions; pediatric recreational activities; cultural mediators; travel kits with psychiatric medication; and trainings for local providers through the Mental Health Gap Action Programme. Additionally, holistic care integrates mental health services with general medical care and social services, while telehealth and digital health promotion enable providers to reach PoM beyond in-person consults. Recent migration policy changes and funding cuts threaten to exacerbate both the mental health of PoM and barriers in service delivery. Ongoing innovation and adaption are essential to support mental health of PoM in a context of evolving and often punitive regional migration policies.