The shortcomings of the public mental health network make it a privilege to assume the emotional bill of the crisis

Stress, anxiety, fear, sadness, depression, emotional exhaustion … Who has not felt it at some point in the quarantine? The crisis has altered our daily life at all levels and it is a challenge for mental health. Restrooms to the limit, deaths without parting, take care and work At the same time, people who have run out of income or who are overwhelmed by confinement or loneliness … Many people will overcome, but others will have prolonged effects. How will Spain bear the emotional bill of the pandemic?

The experts’ conclusion is that the public mental health network can hardly bear the impact with current resources. The latest data reveals that in our country there are six professionals for every 100,000 inhabitants, three times less than the European average, which is at 18. The scarcity, structural and constantly denounced by the psychologists themselves, ends up turning psychological attention into something that depends on the economic capacity of the population.

According to a report by the Ombudsman, which updated the figures in January, in the public system the delays between consultation and consultation can reach up to three months. The agency focuses on the differences between communities and points out that, while some like Madrid or the Canary Islands have doubled the number of professionals in a decade, others like Aragon or Catalonia have hardly done so. In no case, however, is it sufficient, the Ombudsman ditches, who urges the Administration to increase the service “urgently”.

The General Council of Psychology warns of the situation and points out that if our health system is not “reinforced” with professionals and programs, the psychological care that the population will need in the coming months cannot be guaranteed. According to his calculations, they can be about ten million people. It does not mean that all those who are now suffering from symptoms develop problems, but part of it: “We know that they are normal reactions to an epidemic and that they can produce an increase in emotional distress that ultimately leads to pathological states of anxiety and mood disorders “

Pedro Rodríguez, clinical psychologist and member of the Board of the Madrid College of Psychologists, explains that human beings have mechanisms “to overcome really adverse situations” and therefore “many people are going to be able to manage emotional tension”, but ” another does not. ” The expert reflects that “the problem” arises when symptoms “begin to make life difficult” and there “psychological attention is required.” “You have to think that it is happening to many people at the same time and that they join others who already had problems that are aggravated. If in many places there were already waiting lists of up to six months, what will happen after now? “he asks.

How the economic and personal context influences

Experiences with other major catastrophes or collective crises make the increase in demands “foreseeable and expected”, admits the General Council. A study published in The Lancet in March it already pointed to the psychological impact of quarantines registered in epidemics such as SARS, Ebola, MERS or influenza A and recently several Spanish researchers have wanted to get closer to what happened during the first ten days of quarantine in Spain. To do this, they have carried out research based on a sample of 3,055 people.

The study Psychological impact and associated factors during the first stage of the COVID-19 pandemic in Spain It has not yet been peer-reviewed, but its findings coincide with the psychologists’ alert. 51% of people reported anxiety (30.4%, severe); 40.9% some level of depression and 42% stress. “In general, we are finding high rates of psychological distress equivalent to studies that have been carried out in China. They are traumatic events, although these figures are from the first phase and we have to see how they evolve,” says Rocío Rodríguez-Rey, researcher at the Comillas Pontifical University (Madrid) and one of the authors.

The study has also evaluated how different variables such as age, gender or economic situation, among others, interact with this symptomatology. “Not everyone is the same. There is more risk for certain vulnerable groups,” estimates Rodríguez-Rey, who has launched other research to analyze the prevalence in certain professions especially subject to stress, such as health workers or supermarket workers. In any case, they have already found that women, young people or those who lost their jobs are those who “show stronger negative symptoms”.

Those people who have lost their jobs during the crisis or are in an ERTE obtain a higher score on the scale set by the researchers in both stress and anxiety and depression than those who work. Those who reside in homes of more than 120 square meters or those who have children compared to those who do not also register less level. Those who have had some type of contact with the coronavirus or those who have a partner but do not live with it score higher on the scale and the two most pointed concerns are the economic impact and the fear that a loved one will become ill from COVID- 19.

Rodríguez-Rey points out that the idea is to deepen the results and that it should be taken into account that they are limited to the first moments of the state of alarm, but in any case, Pedro Rodríguez agrees, “this catches us in unique circumstances.” “It is not the same that it is with certain personal or economic stability that it is not”, that a family member has died or become ill, or that the person is a health worker or another type of worker especially affected by the pandemic, so “this will influence the effects “

The key: mental health is not secondary

The urgency is to prevent this impact from “crystallizing” in persistent problems of anxiety, stress, panic, obsessive disorders, agoraphobia or claustrophobia, general fear, post-traumatic stress … Rodríguez enumerates. And for that “you have to act with prevention.” The key” is to stop thinking that mental health is “secondary” or unimportant: “Maybe a demand does not require prolonged treatment, but must be heard by a professional. I can have a pain in the left side and if it does not pass I need a doctor to tell me if it is appendicitis or if it is just gas. This is the same “, he defends.

That is the objective of the telephones launched by the schools of psychologists from different communities – plus a state one in coordination with the Ministry of Health. Their figures support the warnings: Only the one in Madrid, which has already finished, has attended 300 daily consultations and the national one has been 8,000 in a month and a half. As noted, many of these calls are “derived” from other resources, including Primary Care or Mental Health, which accounts for the “shortage of resources” and “the possibility of an overflow.”

The “fundamental” tool of telephones has been conceived for “the emergency”, explains the psychologist, “and not for prolonged interventions” which are what will be required. For this reason, the General Council of Psychology requires administrations to get involved and dimension the problem. Thus, he describes as “essential” to strengthen the public network, implement generalized protocols in Primary Care, guarantee professionals in nursing homes and, ultimately, think of the population’s mental health as a real problem.


Source link