The forsaken mental health of the Indigenous Peoples - a moral case of outrageous exclusion in Latin America

The Pan American Health Organization's sponsored workshop "Programas y Servicios de Salud Mental en Communidades Indígenas" [Mental Health Programs and Services for the Indigenous Communities] in the city of Santa Cruz, Bolivia on July16 - 18, 1998, appeared promising. However, eleven years later, no specific mental health program has been designed nor developed for the Indigenous Peoples in Latin America. This paper makes four specific recommendations for improvements in the approach of the Pan American Health Organization: (1) focus activities on what can be done; (2) build partnerships with the Indigenous Peoples; (3) consider traditional healers as essential partners in any mental health effort; and (4) conduct basic research on the mental health status of the Indigenous Peoples prior to the programming of any mental health service.The persistent neglect of the Indigenous Peoples' mental health in Latin America raises serious concerns of moral and human rights violations. Since the Pan American Health Organization' Health of the Indigenous Peoples Initiative 16 years ago, no mental health service designed for them has yet been created.According to the World Health Report 2001 of the World Health Organization, at present, 450 million people suffer from a mental or behavioral illness worldwide. Yet most countries allocate less than one percent in budget expenditure for mental health. Advances in biological and behavioral sciences have underscored the firm relationship between social, physical and psychological well-being, further confirming that the current state of neglect of mental health is unacceptable. The situation is even more alarming for the Indigenous Peoples of Latin America, for whom there are no specifically designed mental health programs at all.Today, the Indigenous Peoples of Latin America, estimated at around 48 millions, remain poor, powerless, and excluded from a society which consistently neglects their healthcare needs[1,2]. During nearly 200