Between Colonial Hierarchies and Mental Health Care: Structural Racism in the Lives of Racialised Brazilian Women in Portugal

Mental health inequities affecting migrant populations stem from structural determinants that hierarchize access to resources, recognition, and social protection. Among these determinants, structural racism plays a central role in the experiences of racialised Brazilian immigrant women in Portugal, producing vulnerabilities at the intersection of race, gender, nationality, and migration status. Grounded in intersectional feminist and decolonial epistemology, this study analyses how structural racism operates as a health determinant through specific mechanisms traversing material conditions of life, distress trajectories, and experiences of psychological care, and it examines how these women navigate the limitations of mental health services, identifying conditions for a practice committed to racial equity. Fifteen semi-structured interviews were conducted with racialised Brazilian immigrant women and analyzed through Reflexive Thematic Analysis. The findings indicate that racism is manifested through professional devaluation, labour precarity, documentation instability, and linguistic racialisation, impacting access to rights and the production of psychological distress. Mental health inequities are not limited to barriers to access, as institutional and clinical dynamics tend to individualize distress and disregard its historical and social bases, operating as epistemic violence. The community-based strategies mobilized by participants challenge models centred on individual intervention. This study underscores the need for structurally competent approaches and for institutional reforms oriented toward equity and racial justice within mental health systems.