Sandra (not her real name) is 23 years old and works doing heritage studies. Some time ago he decided to go to therapy for reasons of sexual assault, and he did it by knocking on the door of public health. He says that everything happened “abruptly” and that he needed attention as soon as possible. He could not afford a private psychologist due to lack of resources, so he went to the family doctor. There they “qualified” her after what happened. They told him that his case was not urgent, that he had to wait five months for the appointment. “The world fell to me. I felt that they were condemning me,” he adds.
The risk of fighting mental disorders with pills and not with therapy
Sandra looked for alternatives and found an answer in another health center. He explained what had just happened and the professionals this time decreed his referral to the mental health unit by fast track. But in this sector talking about “urgent” or “pressing” cases is complicated. The SCS (Canary Islands Health Service) psychologists can find multiple name sheets before specifying any date and time. It is not a matter of paperwork, it is a matter of workload. After all, Sandra was given the appointment for a month later. “I felt the same,” he laments.
The consultation arrived. Then he went to a sexologist and another appointment at the hospital. In the latter, she began to speak, but after half an hour she was interrupted by the specialist due to lack of time. The session was over and not even 40 minutes had passed. “I understood it, but it is not a care that is benefiting. Some of my friends go to private psychologists and they can do it once a week or twice a month and be there for an hour. I have to write things down in the notebook to express them every two months in half an hour, “he adds. “At that moment when they cut you off the story is hard. But we can’t blame the toilets either. If they have to attend 50 people a day …”.
It is not going wrong. According to official data provided by the Ministry of Health of the Government of the Canary Islands to this newspaper (after much insistence), the Islands register a total of 127 public psychologists, an average of 6 per 100,000 inhabitants. At the state level the figure does not improve eitherTherefore, both the Archipelago and Spain are very far from the European average (18).
Before the pandemic, it is estimated that more than 670,000 canaries suffered from some type of mental disorder. The strict confinement of March and April has only aggravated this situation. According to a study carried out by researchers from the Center for Biomedical Research in Mental Health Network (CIBERSAM), the Carlos III Health Institute, among others, 65% of Spaniards had symptoms of anxiety or depressive symptoms, most of them mild, due to restrictions. From January to October, the Canary Islands have increased their staff of psychologists by 9%, but professionals feel stifled and consider that a boost should be given to strengthen the service.
“I know the case of a child who needs urgent attention and my partner cannot give him an appointment until April,” says a specialist who prefers not to give her name. “Yes I have had welfare pressure in my unit, especially since September, but since the summer … And reinforcement of staff is going to be that no,” laments another. “I have the feeling that we still do not fully appreciate the real effect in the consultations. Right now it is true that we do not see more people than we saw before, but my impression is that after these situations it takes a few months until we can see really the impact on waiting lists and healthcare pressure. The reinforcement? Neither has there been nor will there be, “analyzes a third.
The pandemic has widened the cracks in the Canarian mental health system. The regional government approved in 2019 a specific plan to mark the roadmap on this matter and “promote emotional well-being in the different stages of the life cycle”, as well as “prevent the incidence of mental disorder in the general population and in risk groups”. The almost 500-page document makes a very broad X-ray of all this and details the number of professionals who worked in each Mental Health Unit (USM) in 2016. In a center in La Laguna, for example, only two psychologists were practicing and many other psychiatrists. In Santa Cruz de Tenerife there are two units, with three psychologists and five psychiatrists on the one hand, and four of each on the other. The dean of the Official College of Psychology of Tenerife, Carmen Linares, maintains that this cannot be continued.
“For every psychologist in the Canary Islands there are about 17,000 people. It is outrageous. How can we give an answer like this? The pandemic has put the finger on the sore. A person comes to the service and they call him for six months,” he summarizes. “We are having a lot of demand and the outlook looks ugly. We have to think that we have been deprived of freedom during this crisis. That has consequences. And they do not give us opportunities because the fastest way is a psychoactive drug.”
In the last National Health Survey of Spain, 110 canaries (out of 1,836 questioned) acknowledged having taken stimulants or antidepressants in the last two weeks. The percentage rises to 6%, somewhat above the national average (5.59) and other communities such as Madrid (4.45) or Catalonia (4.98). According to figures from the Ministry of Health, Spain is together with Portugal the country that consumes the most anxiolytics, sedatives and hypnotics. Linares suggests that medicating people with mental disorders should not be the first route, and that reinforcement should be emphasized in Primary Care. “In this way we can offer strategies for patients to deal with these symptoms and the symptoms do not become chronic,” he insists. The Canary Islands proposed a “Strategy for the promotion of Primary Care” in 2019 and coordinated the hiring of 617 professionals for the next three years. Of all of them, only five psychologists.
The Deputy of the Common, Rafael Yanes, has asked for more psychologists. The Canary Islands Mental Health Federation as well. The Canary Association of Neuropsychiatry and Mental Health more of the same. The Minister of Health, Blas Trujillo, announced that the Mental Health Plan will receive 2,725,480 euros in 2021, 0.08% of the expenditure allocated to the SCS. And the President of the Government, Pedro Sánchez, announced that 1,001 places of resident internal doctor (MIR), nursing and pharmacy were going to be summoned. No sign of psychologists. “We are used to this job from precariousness, we are dragging it”, concludes a clinical psychologist.
Claudia (not her real name) is 24 years old and studying an English course. He assures that he has been treating since he was 16 and that they have arranged appointments that may take between three and four months to arrive. “It makes us a world,” he says. “They took a long time to give me a date, they got confused and sent me from one place to another … They are very few specialists for all of us.” He has indicated that he filed a complaint for this. “My psychologist told me it was a very good idea. So maybe they realize the problem ”.
Confinement in specific mental health units
The patients at these centers, who suffer from so-called severe mental disorders, have “lived” in the psychiatric hospital since the pandemic began. A clinical psychologist tells this newsroom that many of those admitted are just enjoying freedom away from four walls. Before, he says, they used to go out and play sports for a few hours. Now they spend their days inside and only receive one visit a week (and always from the same person). “The measures are very restrictive,” he stresses.