Translated by Tammy Nolan
Violence, kidnappings and witnessing aggression and deaths, along with illegal drug use, has caused a 30 percent rise in the prevalence of mental illness, stated Maria Elena Medina Mora, director of the Ramón de la Fuente Muñiz National Psychiatry Institute.
This expert asserts that although there is no statistical evidence to corroborate, it is evident that the life experiences between the different age groups have notably changed in the past 30 years.
This has, without a doubt, influenced the population’s mental health. One concrete phenomenon, associated with a greater presence of central nervous system disorders, is suicide, the frequency of which has doubled between 1990 and 2011. Among youth ages 15 to 19, the rate almost tripled, going from 4.9 to 13.6% [of deaths].
Medina Mora emphasizes that 70% of people who take their own lives suffer from depression.
She points out that we have gone from a country with a low prevalence of self-inflicted deaths to now being at mid-level, with 7.6% of total violent deaths being suicides.
Information from the National Statistics and Geographic Institute confirms the above and that in 1990 that percentage was 3.3.
Add to this the fact of many instances that are not officially recorded because “medical insurance companies have won”, and policies don’t cover mental illness. So, families don’t report it as a suicide in order to get the insurance company to pay.
In an interview, the researcher said that the National Psychiatry Institute has documented the effects of violence on the population. It has been proven that kidnappings are associated with post-traumatic stress, which also leads to depression in most cases and, in the more severe cases, to suicide.
Other evidence is the increase of illegal drug use. As documented in the National Survey on Addiction 2011, this problem has doubled in just a decade, going from 0.8 to 1.5% of the general population of 12 to 65 year olds.
Among men, the indicator was at 2.6%, well above the national average, but in adolescents, it went from 0.9% in 2002 to 1.5% in 2011.
The facts are there; however, mental illness is not and never has been a priority in governmental policy. The evidence: the cost of attention to this problem is equivalent to 12% of the health budget, but only 2% is assigned to it.
Medina Mora commented that spending has been diverted to avoid mortality caused by various diseases, such as childhood infections or chronic illness such as cancer and heart attacks.
Nonetheless, in 2000, the World Health Organization issued a guideline modifying their vision and incorporating disorders that aren’t a cause of death, but of loss of healthy days of life. These are mental disorders.
Today, she explained, “Of the ten main causes of illness in this country, at least three are psychiatric maladies.” In addition, chronic diseases like diabetes and cancer are also associated with problems like depression, which, if not treated, can affect the effectiveness of treatments for glucose control or malignant tumors.
Therein lies the importance of widening coverage for mental illness care and changing situations such as the fact that only 2% of psychiatric beds are found in general hospitals.
The majority of spaces are located in third level hospitals, like the National Psychiatry Institute, or the Fray Bernardino Álvarez Psychiatric Hospital, located in Mexico City.
Medina Mora commented on the necessity of having a reliable integrated system of mental illness treatment, which would include referrals and cross referrals between first level entities, hospitals and highly specialized entities.
It is important to improve efficiency and only take the gravest cases to the third level. The majority should be treated in first contact clinics, quickly and before the problem evolves and severely affects the person and their family.
The Institute has a proposed care model to be used in Mexico City. It consists of mental health teams in health centers accompanied by a medical psychiatrist who reviews diagnosis and treatments, and, when necessary, refers patients to the corresponding next care level.
Medina Mora assures that the model has proven its efficiency by achieving timely diagnosis of mental illnesses, which is why it is the basis for agreements soon to be signed between the federal health system and the government of the capital.
The beneficiaries will be those affiliated with the Popular Insurance, with coverage for medical attention and pharmaceuticals for 80% of illnesses at the first care level, as well as two hospital stays a year.
Another issue is the education of medical psychiatrists. A survey of UNAM reported the existence of three thousand specialists; the majority are concentrated in the cities, while entities like Colima and Nayarit only have two or three each. Spanish original