Mental health services have been the hardest hit throughout the pandemic

A year ago, Carissa Etienne, director of the of the Pan American Health Organization (OPS), sent a strong message: the pandemic by COVID-19 is causing a crisis of mental health in the Americas on a scale never seen before. Today, when the global fight against this type of disease is commemorated, the outlook continues to be worrying; However, it is not too late to take the necessary measures and prevent the pandemic from leaving an indelible mark on the mental health of the population.

Significant impact

National studies from Argentina, Brazil, Canada, Mexico, Peru, and the US have documented high rates of psychological distress, anxiety and depression in the general population. Likewise, a survey conducted by the Ipsos company in the aforementioned countries, as well as in Colombia and Chile, revealed that, on average,.

Regarding the minors, anxiety and depression represent, according to Unicef’s “State of the World’s Children 2021”. It should be noted that before the pandemic, more than one in seven children and adolescents in the world suffered from a mental disorder and 46,000 committed suicide annually. Today, the situation is more serious, the report indicates.

Similarly, records from hotlines, police reports and other service providers indicate an increase in reported cases of domestic violence, in particular child abuse and violence against women.

“Mental health conditions cause great disability in the Americas. One third of all disabilities due to illness in the region are due to mental health conditions, ”says Renato Oliveira e Souza, head of the Mental Health Unit for the PAHO region. But despite these figures, state investment remains insufficient. According to the specialist, it is estimated that an average of 61% is directed to psychiatric hospitals, which are often places of human rights abuses.

To this must be added two other major problems, which have been carried since before the pandemic. The first is the treatment gap (the percentage of people requiring care but not treated). For some mental health and substance use conditions, this gap reaches almost 80%. The second is the deficit of specialized personnel: It is estimated that there are 10.3 mental health workers for every 100,000 inhabitants.

“We advise that the budget for mental health should be at least 5% or 6%, but it depends on the needs of each country. The important thing is not only to increase investment, but also that resources reach the community; that is, it is the first contact of people with the general health services ”, explains Oliveira e Souza.

Services interrupted

There is no doubt that the pandemic has increased the number of people with new mental conditions or worsened pre-existing conditions, such as schizophrenia, suicidal tendencies or addictions. However, it has also caused mental health and psychosocial support services to temporarily cease to function or to have their staff reduced. According to a survey by the World Health Organization (WHO), these types of services suffered interruptions in 60% of the countries of the Americas in 2021.

“When we analyze the state of the different health services during the pandemic, the mental health services are the ones that have received the strongest impact. These were closed as part of the public protection measures or many times the professionals who worked there were transferred as a rapid response to the COVID-19 emergency. It is true that there are good initiatives to combat this problem, such as the great expansion of services via Internet or telephone, but we also know that these do not reach everyone ”, says Oliveira e Souza.

A complete change

For the PAHO expert, it is essential that countries prioritize mental health now, not only to respond to current problems, but also to prevent them from continuing or worsening.

“Countries need to change their mental health systems, which are often based on psychiatric hospitals. Services need to be community-based. . There is a very big work that we have pending with the countries to continue a great expansion of mental health services to the community ”, says Oliveira e Souza.

Achieving this goal would imply four main axes: high-level political leadership and adequate investment (every dollar invested in mental health produces a return of four dollars); an intersectoral approach (including states, civil society, academic institutions, etc.); progress in the integration of mental health in all health services, promotion and prevention, and other health and social areas; and harnessing the lessons learned during the pandemic and investing in tele-mental health and new technologies.

Suicides in the Americas

When PAHO evaluated its 2015-2020 Mental Health Action Plan, it observed notable progress in areas such as reducing the role of psychiatric hospitals and developing prevention programs. However, the regional suicide rate showed very negative figures.

In the region, almost 100,000 people die by suicide each year. while the global rate and rates for all other WHO regions decreased.

“The increase in the regional suicide rate is an important factor that will make us place greater emphasis on technical collaboration with member states, in terms of increasing support for their national suicide prevention plans. The reduction of suicides is really an area in which we are getting worse as a region and we have to put more effort ”, says Oliveira e Souza.

PAHO points out that the main suicide prevention measures include limiting access to means to commit suicide (such as pesticides and firearms), early identification, management, and monitoring of those affected by suicidal thoughts and behaviors, as well as promote socio-emotional skills.

While it is true that there is still much work to be done, and little to celebrate on World Mental Health Day, it is of the utmost importance to make a call to unite and achieve the elimination of inequalities. Quality mental health is a human right.

* The Grupo de Diarios América (GDA), to which “El Comercio” belongs, is a leading media network founded in 1991, which promotes democratic values, the independent press and freedom of expression in Latin America through journalism from quality for our audiences.