The President of the General Council of Psychology of Spain, Francisco Santolaya.
Whether you know it or not, surely someone close to you has a problem related to yours mental health right now. Will be depression, anxietya eating disorders, post-traumatic stress, ADHD or even wish to die or be hurtin all cases we are talking about mental health issues.
The numbers are huge: 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 (ED) (Niño Jesus Hospital, 2015); 1 in 10 Spanish students has been a victim of bullying at school (Anar, 2022); and in our country 10 people a day kill themselves, while another 20 try, that is, 3491 people die by suicide every year (INE, 2020).
However, it is important to note that mental health is understood not only as the absence of a psychological problem or disorder, but ultimately and even more importantly, as presence of psychological well-beinga fundamental right that should be the priority and goal of all administrations and governments.
What is good mental health?
The good mental health it is a condition that enables people to cope with life’s stressful moments, develop their skills and abilities, learn and work well and contribute to their community. It is about a essential component of health and the well-being that supports our individual and collective capacity to make decisions, relate and shape the world we live in, and which is absolutely necessary for personal, community and socio-economic development (WHO, 2022).
The lack of resources for prevention and careof a public health policy that considers mental health in a rigorous, comprehensive and comprehensive way has a huge impact on people and the economy and not only leads to avoidable suffering for people who suffer from it and their families, but also It cost Spain 4.2 percent of its GDP.
In reality, we are talking about an expenditure higher than that registered, since according to Hospital del Mar the expenditure in 2015 was 84,000 million euros and more than 45,000 million euros According to Organization for Economic Cooperation and Development (OECD, 2021) when, just by equalizing the ratio of psychology professionals in Spain to that in Europe, these costs could be significantly reduced.
So, zoom in mental health budget would represent a clear investment in the medium and long term. First of all, because of the unnecessary suffering that patients and their families are subjected to, who have to wait months to be seen by a specialist and who see problems and symptoms that could be prevented or addressed in the first instanceavoiding worse evolution are faced with medical approaches.
And secondly, because this investment would lead to significant savings in both direct costs – such as those received from abuse of psychoactive substances when it comes to dealing with mental health problems, excessive frequency of consultations or chronicling of completely preventable problems- as well as indirect ones – the costs of temporary and permanent sick leave, for example-.
Despite the efforts made in the past two years in relation to mental health care, the prevention of mental disorders and the promotion of good psychological and emotional health, the fact is that in our country access to psychological intervention services and programs continues to be a luxury and it continues to be more of a political discourse than a reality accessible to citizens.
An investment in mental health
Although in the last year, Government of Spain increased the economic resources allocated to tackling this serious public health problem with €100 million from the Mental Health Action Plan 2021-2024, increased the forecast for PIR places – which have gone from 204 to 231 by 2023. – and launched a 024 suicide prevention hotline, these measures remain completely insufficient.
For example, in your first month on the job, 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 that we continue to make efforts to meet the real demand.
Therefore, if the increase in demand unaccompanied by growth 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 last and according to the latest annual report on bullying published by the ANAR Foundation and the Mutua Madrileña Foundation, uNot every fourth student believes 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 decision, however, far from providing schools with educational psychologists to deal with this scourge that affects children and adolescents, has committed to include a new figure, a social care coordinator.
The weight of this new feature will fall on the shoulders of the teachers, a group punished with overwork and no training to deal with psychological problems. Organizations of parents, teachers and education unions are demanding, however, the inclusion of the educational psychologist in schools as a professional better equipped to care for the mental health of their sons and daughters.
The General Council for Psychology, as the highest representative body of the profession, is aware that steps are being taken towards more and better attention to mental health, but also that they are very timid steps.
The current system is not only inefficient because of the human resources it has, but it is unfair and hurts those who need it most. The citizen who does not have the resources not only does not have the resources to go into the private sphere, but they are the people who suffer the most from being in a situation of greater vulnerability.
And the system can hardly help them. As we have already indicated, there are not enough clinical psychologists in the NHIF to meet the current demand of the population. We say it every year. And we’re doing it again. The ratio of psychologists in Spain continues to be ridiculous: 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 receive little attention in the National Public Health System and costs will continue to rise.
Shortage of clinical psychologists in SNS
Join 7090 professionals at Clinical psychology which would be required in SNS to reach a ratio of 20/100,000 would not require much more investment than 350 million euros, while this measure would mean very large cost savings, as we have already indicated and as this Council once again conveyed to the Government and other political forces that wanted to hear us this year. Therefore, it seems to be a matter of will and not cost effective.
In addition, as the Council reminded you, the tailwind of the pandemic and the fear of a new economic crisis are affecting the emotional balance of Spanish men and women, especially among the youngest.
The mental health of children and adolescents is one of the main unresolved problems in Spanish health care, which urgently needs to be addressed and improved. The World Health Organization (WHO) is already warning: one in seven young people between the ages of 10 and 19 in the world suffers from a mental disorder.
is a priority is growingtherefore resources allocated not only to adults but especially to our young people and ensure mental health prevention and promotion, detection, diagnosis, treatment and monitoring of care.
The world mental health day, which is observed 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 strengthen psychological treatments that are highly effective and optional in primary and specialist care ensures the design of prevention and awareness campaigns to bring mental disorders closer to the population and citizens to have tools to detect these problems and timely request for help.
As a country and as a society, we cannot afford to turn our backs on those who cry for help. Mental health is everyone’s business. Mental health is everyone’s business.
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