The Impact of Ethnic Identity and Conflictive Intergroup Relations on Mental Health Outcomes in Chile

Longitudinal Evidence (2016–2023)

Matías Deneken
m.deneken@uc.cl

OLES

Pontificia UC Chile

Gustavo Ahumada

Pontificia UC Chile

Catalina Nuñez

Zurich

Alex Behn

Pontificia UC Chile

MIDAP

July 3, 2025

Introduction

  • Depression is the leading cause of mental health-related disability worldwide (WHO, 2017).
  • Affects 4.4% of the global population (~280 million people).
  • More prevalent among women (GBD, 2022).
  • In Chile (National Health Survey 2016–17):
    • Overall prevalence: 6.2%
    • Women: 10.1% | Men: 2.1%
  • In 2020, COVID-19 triggered a 40.6% increase in new depression cases (Celis-Morales & Nazar, 2022).

The Chronic Nature of Depression

  • Depression is often chronic and recurrent (Solomon, 2000).
  • After one episode: 60% chance of relapse.
  • After three episodes: 90% chance of recurrence (Bockting et al., 2015).
  • High personal, social, and economic costs:
    • $6,200 USD per year per person (Luppa et al., 2007)
    • Leading cause of mental health-related disability (GBD, 2019)

Depression, Culture and Inequality

  • Depression is influenced by cultural values, beliefs, and practices (Kirmayer, 2001).
  • Ethnic minorities face:
    • Higher risk of depression (Kirkbride et al., 2024)
    • Lower access to care (Missinne & Bracke, 2012)
  • Risk factors:
    • Discrimination, poverty, residential segregation
    • Cultural marginalization and acculturative stress (Van der Wal et al., 2024)

The Minority Stress Model

  • Explains how structural and interpersonal discrimination generate chronic psychological stress (Frost & Meyer, 2023).
  • Stressors among Indigenous peoples:
    • Historical trauma, discriminatory policies (Gone et al., 2019)
    • Internalized stigma and anticipatory stress
  • Cultural invalidation weakens group identity and resilience.

The Chilean Case

  • Few studies systematically examine Indigenous mental health.
  • Chile’s Ministry of Health acknowledges need for culturally sensitive care (MINSAL, 2016).
  • ELRI (2016–2022) provides:
    • Longitudinal data on depression symptoms (PHQ-9)
    • Measures on ethnic identity, discrimination, and social support

Research Questions

  • Do Indigenous people in Chile report higher depressive symptoms?
  • How do ethnic belonging and group identification influence depression?
  • What risk and protective factors shape mental health trajectories over time?

Descriptive Findings

  • Across four ELRI waves:
    • ~14% of Indigenous and ~15% of non-Indigenous participants show clinically significant depressive symptoms (PHQ-9 ≥ 10).
  • Slightly lower prevalence among Indigenous individuals — counterintuitive to minority stress predictions.

See Graph 1: PHQ-9 prevalence by group and wave

Depression Over Time

  • Among Indigenous people:
    • 2018: 15% show clinical symptoms
    • 2021: increases to 18%
    • 2022: drops to 9%
  • ELRI tracks:
    • Chronic cases
    • New onset cases
    • Recovery over time

See Graph 2: Transitions across waves

Multivariate Models

  • Sample: 5,367 individuals (2016–2022)
  • Linear regressions with and without fixed effects (Table 1)
  • Key predictors:
    • Ethnic belonging: ↑ risk of depressive symptoms
    • Group identification: ↓ risk
    • Negative contact with non-Indigenous Chileans: ↑↑ risk
    • Being female: ↑ risk
    • Having a job or a partner: ↓ risk
    • Social support: ↓ depressive symptoms

See Table 1: Models 1–4

Interaction Effects

  • Interaction: Ethnic belonging × Group identification is significant and negative
  • Meaning: Indigenous individuals who strongly identify with their group are less likely to report depressive symptoms

See Graph 3: Density plots by strength of identification

Discussion

  • No overall higher prevalence among Indigenous groups, but…
  • Statistical models reveal hidden vulnerabilities
  • Group identity acts as a protective factor
  • Aligns with literature on ethnic identity and resilience (Brance et al., 2023; Brown et al., 2025)

Broader Implications

  • Gender gap: Women show significantly higher symptom scores
  • Employment is protective, though loses strength over time
  • Romantic relationships gain predictive strength in longitudinal models
  • Discrimination-related experiences are the strongest predictor of depressive symptoms

Policy Recommendations

  • Foster positive ethnic identity and cultural belonging
  • Design culturally adapted treatments
  • Address structural inequities (residential, employment, education)
  • Recognize the impact of interpersonal discrimination

Limitations

  • PHQ-9 is based on Western diagnostic criteria
  • May miss culturally specific expressions of distress
  • Future research should include Indigenous worldviews and symptom narratives

Conclusions

  • Belonging to an ethnic minority is not inherently a risk— → the context of exclusion is.
  • Negative intergroup experiences are a key risk factor.
  • Strong group identity acts as a buffer.
  • Effective policies must reduce discrimination and support cultural resilience.

ISPP 2025 Annual Meeting