The president of the General Council of Psychology of Spain, Francisco Santolaya.
Whether you know it or not, surely someone close to you is having a problem related to your mental health right now. Be depression, anxietyand eating disorder, posttraumatic stress, ADHD or even wish to die or be harmedin all cases we talk regarding problems related to mental health.
The figures are overwhelming: 1 in 3 Spaniards has a probable case of anxiety and 1 in 4 of depression (COP, 2021); About 400,000 people suffer from Eating Disorder (TCA) (Child Jesus Hospital, 2015); 1 out of every 10 Spanish students has been a victim of bullying at school (Anar, 2022); and, in our country, 10 people a day commit suicide, while another 20 try, that is, 3,491 people die by suicide each year (INE, 2020).
However, it is essential to point out that mental health is understood not only as the absence of a psychological problem or disorder, but, ultimately, and even more importantly, as the presence of psychological well-beinga fundamental right that should be a priority and an objective of all administrations and governments.
What is good mental health?
The good mental health it is a state that enables people to cope with life’s stressful times, develop their skills and abilities, learn and work well, and contribute to their community. It’s regarding a essential component of health and the well-being that sustains our individual and collective capacities to make decisions, establish relationships and shape the world in which we live and that is absolutely essential for personal, community and socioeconomic development (WHO, 2022).
The scarcity of preventive and care resourcesof a public health policy that contemplates mental health in a rigorous, comprehensive and comprehensive manner has an enormous impact on people and on the economy and not only entails avoidable suffering for the people who suffer from it and their families, but also It costs Spain 4.2 percent of its GDP.
We are talking, in reality, of an expense higher than that recorded since, according to the Hospital del Mar, the expense in 2015 was 84,000 million euros and more than 45,000 million euros according to Organization for Economic Co-operation and Development (OECD, 2021), when, just by equating the ratio of psychology professionals in Spain to that of Europe, these costs might be significantly reduced.
So, increase the mental health budget would represent a clear investment in the medium and long term. In the first place, because the unnecessary suffering to which patients and their families are being subjected, who must wait months to be seen by a specialist and who see problems and symptoms that might be prevented or addressed in the first instanceavoiding a worse evolution, are faced with medicalized approaches.
And secondly, because this investment would result in significant savings both in direct costs -such as those derived from the abuse of psychotropic drugs when it comes to dealing with mental health problems, over-frequency in consultations or the chronicity of perfectly preventable problems-, as well as indirect ones -the cost of temporary and permanent sick leave, for example-.
Despite the efforts made in the last two years in relation to mental health care, the prevention of psychological disorders and the promotion of good psychological and emotional health, the fact is that, in our country, access to psychological intervention services and programs continue to be a luxury and it continues to be more of a political discourse than a reality accessible to citizens.
Investment in mental health
Although in the last year, the Government of Spain has increased the economic resources allocated to solving this serious public health problem by 100 million euros from the Mental Health Action Plan 2021-2024, has increased the forecast of PIR places -which have gone from 204 to 231 by 2023- and has launched the 024 hotline for suicide prevention, these measures continue to be completely insufficient.
As an example, during its first month of operation, 024 answered nearly 15,000 calls and identified 290 suicides in progress. This not only gives an idea of the seriousness of the matter, but also tells us that it is essential to continue making efforts to cover the real demand.
Therefore, if the increase in demand is not accompanied by an increase in realistic and adjusted economic and human resources, little can be done to meet current needs. There is a lack of psychology professionals in hospitals, in health centers, in social and community services, in schools.
In fact, in the latter, and according to the latest annual report on bullying published by the ANAR Foundation and the Mutua Madrileña Foundation, uNot out of every four students believe that there is someone in their class who suffers from bullying. In the opinion of six out of ten, the school does nothing in a situation of bullying.
The Government’s solution, however, far from provide schools with educational psychologists To tackle this scourge that affects children and adolescents, it is committed to including a new figure, a well-being coordinator.
The weight of that new function will fall on the shoulders of teachers, a group punished by work overload and without the preparation to deal with psychological problems. Organizations of parents, teachers and education unions demand, however, the incorporation of the educational psychologist in schools as a professional better prepared to attend to the mental health of their sons and daughters.
The General Council of Psychology, as the highest representative body of the profession, is aware that steps are being taken in the direction of more and better attention to mental health, but also that they are very timid steps.
The current system is not only inefficient due to the human resources it has, but it is inequitable and harms more those who need it most. The citizen who does not have resources not only does not have them to go to the private sphere, but they are the people who suffer the most for being in a situation of greater vulnerability.
And the system can hardly help them. As we have already pointed out, there are not enough clinical psychologists in the National Health System to meet the current demand of the population. We say it every year. And we do it once more. The ratio of psychologists in Spain continues to be derisory: barely 6 psychologists per 100,000 inhabitants compared to 18 in the European Union and 26 in the OECD. As long as this continues, mental health will continue to be poorly attended to in the National Public Health System and costs will continue to rise.
Shortage of clinical psychologists in the SNS
Include the 7,090 professionals of the Clinical psychology that would be needed in the SNS to reach a ratio of 20/100,000 would not entail a much greater investment than the €350 million, while this measure would mean very important cost savings, as we have already pointed out and as this Council has once once more conveyed to the Government and the rest of the political forces that have wanted to listen to us this year. Therefore, it seems that it is a matter of will and not economically efficient.
Also, as the Council has reminded you, the tailwinds of the pandemic and the fear of a new economic crisis are taking a toll on the emotional balance of Spanish men and women, especially among the youngest.
Mental health for children and adolescents is one of the main pending issues in Spanish health that urgently needs to be addressed and improved. The World Health Organization (WHO) already warns: one in seven young people between the ages of 10 and 19 in the world suffers from a mental disorder.
is a priority increasetherefore, the resources allocated not only to adults, but, very especially, to our young people and guarantee the prevention and promotion of mental health, detection, diagnosis, treatment and monitoring of care.
The world mental health day, which is celebrated today, October 10, is a good opportunity to encourage not only the Government, but all the agents involved, to row together in this task. Work to incorporate and reinforce psychological treatments, which are highly effective and of choice in primary and specialized care, guarantee the design of prevention and awareness campaigns to bring mental disorders closer to the population and that citizens have tools to detect these problems and ask for help in time.
As a country and as a society we cannot afford to turn our backs on those who cry out for help. Mental health is everyone’s business. Mental health is everyone’s business.
Although it may contain statements, data or notes from health institutions or professionals, the information contained in Medical Writing is edited and prepared by journalists. We recommend the reader that any questions related to health be consulted with a health professional.
