Mental health has taken on greater prominence in recent decades given the decline that is being observed in the population. The COVID-19 pandemic, the uncertainty due to the economic crises, the increase in the cost of living, unemployment, stress, job exhaustion or its precariousness or the unwanted loneliness of older women and adolescents is having consequences on their health. mental. The organizations that make up the Canary Islands Mental Health Federation are celebrating various activities this week on the occasion of World Day next Thursday, with the intention of defending an approach that puts people, their recovery, their social and work integration, and the defense of their rights as citizens. During 2023, in the Canary Islands, 71,121 people were treated for mental and behavioral health problems in the Canarian Health Service, of which 55% are women (39,000), and 318,194 Canarian citizens underwent consultation, of which 163,520 were women. . The entities served approximately 9,000 people directly, in different services and programs aimed at promoting psychosocial rehabilitation and personal autonomy of these people and their families, and reached approximately 35,400 people indirectly through awareness-raising and volunteering actions. .
-How many associations in the Canary Islands are linked to mental health?
“The Canary Islands Mental Health Federation is an organization founded in 2001 to respond to and represent the regional associative movement, which brings together the seven most representative mental health associations of the Islands and there are others that are in the process of integration. Thus, in 1982, AFES Salud Mental was born in Tenerife and later in the nineties El Cribo (Lanzarote), Salud Mental Atelsam (Tenerife), Salud Mental AfeSur (Gran Canaria) and Salud Mental La Palma (1998) were created. Asomasamen (Fuerteventura) and TLP Impulso (Tenerife) complete the current relationship of the Canary Islands Mental Health Federation. Initially as a movement we have worked on serious mental disorders, and that has been the objective of the associations of people with mental health problems and especially their relatives who for years, especially after the closure of psychiatric hospitals, found themselves at home without knowing what to do, with a lot of problems and they began to come together to implement social and health resources to respond to these people, because they had no other alternatives or that support that should have been provided in the community before they left.”
-Wasn’t this paradigm shift planned in the care of those patients who were previously referred and confined?
“It was little planned. The truth is that as a philosophy it was great and it was what we needed, that is, community work for people with mental health problems, but the community was not prepared for that leap. So that was why the family members had to come together to start having those resources, at that time not so much health but social.”
-Have one of the mental health problems been the stigmas, prejudices and taboos that were given to them in psychiatric hospitals?
“Likely. People with a series of prejudices came from being confined to suddenly going out into the community. After many years, prejudice and stigma continue, and sadly it is one of the Federation’s most important lines of work, normalizing mental health. Mental health is an area in which social exclusion has a particularly harsh impact. From the moment of diagnosis, the person is placed in a helpless situation. And in cases of severe mental disorder and during admission to psychiatric areas, the use of coercion, violence, abuse, mechanical and chemical restraints was often tolerated.”
-Since 2010 we began to talk about Mental Health, but was its push as a result of the pandemic?
“It is confirmed that with the pandemic many of us realized that perhaps a mental health problem could happen to us, and we began to talk normally about mental health and people speak a little more openly, but they are still those prejudices. Before, there were athletes who spoke about the great pressure they suffered and society was surprised, saw their achievements and said, How can they have mental health problems when they are famous and have money? These elite athletes, role models for a lot of people, spoke openly that they had gone to therapy and then it began to become normal. We stop talking about ‘those crazy people’ and that stigma to saying, well, it can happen to anyone, that today you may be fine, but tomorrow there are a lot of factors that can lead us to have a mental health disorder.”
-Mainly they are economic, cultural factors, the pressure of social networks…
“There are problems with access to housing, poverty, job insecurity…, there are a lot of structural factors that in the end when we go to the doctor to ask for help, he will give us medication that will momentarily improve our symptoms, but we have not removed the cause, so it remains latent. These prejudices have also influenced the fact that the affected person does not dare to verbalize that they have a mental health problem because they point it out to me, so on the part of the entities there is a task to continue training and raising awareness among the population. It is very important to ask for help as soon as possible, once I identify that I am wrong, but it is not done because perhaps a weight, a mark or stigma is going to fall on me, because sometimes the label itself weighs more than the health problem. mental”.
-There is an excessive consumption of anxiolytics and antidepressants in the Canary Islands. Is it due to the lack of clinical psychologists in the health system for effective referral to the family doctor?
“Surely, right now the lack of professionals is a big problem, both for psychologists and psychiatrists. But we must not only look at Primary Care, let’s look further, in Educational Centers there is a lack of psychology professionals who can deal with early cases. We understand that a lot of preventive work is necessary, that is, everything we can do before reaching the health system, because in the end Health is a funnel, and what we are referring from Primary Care to the Mental Health Units, which are specialists in serious mental disorders. Having professionals in educational centers is necessary to address and tackle mental health problems early because they have grown a lot among young people. A study by the Spanish Confederation indicates that 35% of people with mental health problems are not in the system, or are not well cared for and do not have treatment, for example they go once and have no follow-up.
-Is there still a long way to go to normalize the need to see a specialist?
“For us it is the most basic thing, right now as a Federation we ask to make it easier for people to speak openly that they have a mental health problem, it is necessary as when we have any other type of pathology, and it is also the main thing to be able to ask for help. The labels and stigma that continue to weigh on mental health, despite what we have advanced in other aspects, remains almost more problematic than the illness itself. In the end there is a slight rejection that if we normalize it it would surely be much easier to ask for help.”
-What opinion do you have of the General Directorate of Mental Health and Addictions?
“This General Directorate of Mental Health and also Addictions began in 2023, which is the most innovative thing and we think it is more than necessary that they go hand in hand because I believe that we cannot work in a differentiated way. It was a step to improve the care and resources available for mental health and addictions in the Archipelago. We hope that important achievements can soon be achieved in terms of mental health policies and programs that promote community care and prevention. It is true that today we need more resources for the Strategic Mental Health Plan, but we believe that as a line of work mental health cannot be separated from addictions. Both Federations have understood that we cannot go in a differentiated way, we believe that it is necessary to put more effort and work hand in hand. The colleagues of the Association of Canary Islands Addiction Entities (Aecad) urgently demanded a fifth Addictions Plan in the face of the 14% increase in cases, especially in women and young people, and we see that in the end the dual pathology (mental health and addictions ) is on the table, since greater consumption is related to people and families with economic problems, and this generates anxiety or depression. We must work hand in hand to implement actions that concern both of us and we are condemned to understand each other.”
-The Canary Islands Mental Health Plan 2019-2023 has been extended. How can it be improved?
“The plan is active and was one of our demands last year during World Mental Health Day. After the change of government, its temporary period has been extended and its lines of action have been maintained. Next Thursday we will again insist above all on the necessary financing. At the Federation we like to talk not only about Mental Health from the perspective of Health but also about the entire social part, which has to do with structural factors. Health cannot continue to prescribe psychotropic drugs to treat the symptoms, when the causes are still there. So what would be appropriate would be for there to be coordinated work between all areas: Health, Education, Social Welfare, or Employment. It is important to insist on this work in a coordinated manner so that it truly provides comprehensive care to people. Furthermore, this year’s motto is Work and mental health, a fundamental link, because between 11 and 27% of mental health problems in Spain are attributed to working conditions and many are due to precarious employment, stress, harassment, fatigue or burnout, which have led to a tripling of casualties. We must also insist on the difficulties of accessing a job for people who have suffered from mental health problems, eight out of ten are unemployed.”
-Another area with which they interact is with Social Welfare, asking for resources and personnel. What happens with disabilities?
“From the Mental Health Federation we are always in contact with the General Directorate of Social Welfare to tell them everything that is missing, especially resources and professionals. The next step must be the differentiation of mental health and disability. Mental health covers a wide spectrum of conditions that affect the emotional and psychological well-being of people, while disability refers to limitations in carrying out daily activities, due to a physical, sensory or intellectual condition. Therefore, it is essential to differentiate them and we demand that it become the General Directorate of Disability and Mental Health, thus allowing the development of programs, resources and specific policies for mental health, which respond appropriately to our needs and be integrated into the management. of disability.”