Although the violent and repressive military dictatorship in Chile led by Augosto Pinochet officially ended in 1990, the psychological repercussions for the direct victims of human rights violations and their family members remain. PRAIS (the Program of Reparations and Comprehensive Healthcare), was created as a government response to the physical and mental health consequences of the human rights violations committed by the state. PRAIS beneficiaries include former political prisoners and their families, the families of those who were detained-disappeared or executed, people fired from their jobs for political reasons, and other victims of human rights violations committed during the dictatorship from 1973 to 1990. In addition to free public medical healthcare, PRAIS beneficiaries are also eligible to receive mental healthcare in the form of therapy (individual, group, family, and marital) and “self-help” groups. The aim of this investigation was to study the long-term psychological consequences of state repression during the dictatorship and to evaluate the mental health services of PRAIS that the government provides as a form of reparations for victims and their family members. The study focused on the PRAIS teams in Valparaíso and Viña del Mar: interviews were conducted with PRAIS beneficiaries, including directors of organizations of PRAIS beneficiaries, and PRAIS professionals (including psychologists and an administrator) from both cities. Research results found that nearly all of the victims (direct and indirect) of human rights violations included in this study continue to suffer from a diverse array of psychological consequences that have a negative impact on their daily lives. However, few had made use of the PRAIS psychological services and several were unaware that PRAIS offers psychological services at all. The investigation also found that overall, PRAIS beneficiaries are dissatisfied with many aspects of PRAIS, including the psychological services that PRAIS offers. In order to make demands of PRAIS, many beneficiaries have organized into groups of PRAIS users. The PRAIS beneficiaries in this study were especially dissatisfied with the self-help groups that PRAIS claims to offer: in Valparaíso these groups are not well-publicized or managed effectively, and in Viña del Mar they do not exist at all. In order to improve the functioning of PRAIS so that it most effectively serves its beneficiaries, what is needed are more specially trained mental health professionals, better communication between the PRAIS team and the groups of PRAIS users, and most importantly, improved self-help groups. Although therapy is accessible to those who want it, traditional psychotherapy may not be the most effective form of psychological support for PRAIS users because of a stigma associated with psychotherapy, an unwillingness to acknowledge a psychological problem, and a lack of trust in the PRAIS mental health professionals. Unfortunately, both the PRAIS users and professionals reported that as Chile’s “culture of impunity” continues, there is a limit to what PRAIS can achieve in terms of alleviating the victims’ negative psychological consequences of the human rights violations they suffered.
Hails, Kate, "Las Secuelas Psicológicas y las Necesidades en Salud Mental Para las Víctimas de la Dictadura: Una Mirada Crítica a los Servicios de PRAIS" (2009). Independent Study Project (ISP) Collection. Paper 714.