Paper short abstract

This paper examines mental health claims-making as key to shaping mental distress and chronicity in fractured health systems and social worlds. Based on ethnography in Chile, it shows how claims become sites where care, social recognition, and belonging are negotiated and continually conditional.

Paper long abstract

This paper examines claims-making as a key process shaping experiences of mental distress, chronicity, and care within fractured health systems and social worlds. It draws on ethnographic research from my doctoral fieldwork in Chile (2018–2019) on mental health claims within occupational health insurance and state regulatory agencies, alongside ongoing analytical engagement with psychiatric deinstitutionalisation and community-based care.

Rather than treating claims as a formal system, the paper approaches applications, certifications, and related medical and administrative practices as situated and relational forms of engagement embedded in Chile’s neoliberal health system, a fractured welfare landscape, and ongoing sociopolitical transformations that reshape moral expectations of care and responsibility. In this context, trajectories of care and recognition are dispersed and repeatedly interrupted across poorly coordinated public and private medical and administrative infrastructures. As cases move across institutions, people encounter delay, uncertainty, and persistent suspicion regarding the legitimacy of their claims.

Drawing on critical medical anthropology and the anthropology of the state and citizenship, the paper argues that circuits of mental health claims-making constitute a central site where not only care and welfare resources are obtained, but where people experiencing mental distress, health professionals, and state agents negotiate and contest social recognition and belonging, rendering them continually conditional. Claims-making thus emerges as a site where belonging is chronically tested rather than secured, revealing how fractured health systems and broader social polarisation reconfigure whose suffering matters and who is deemed worthy of social inclusion and care.