[ad_1]
A survey published by the World Health Organization (WHO) on World Mental Health Day, which takes place on October 10, reveals that the Covid-19 pandemic interrupted or suspended essential mental health services in 1993. % of the countries of the world. world, at a time when the demand for this medical care is increasing.
For the director of the National Mental Health Program (PNSM), Miguel Xavier, the study indicates that what happened in the mental health area happened in most medical specialties where there was a decrease in the provision of care associated with the pandemic .
“Unlike other countries, in Portugal in the first months of the year, several of them already in a pandemic, the number of consultations in psychiatry and child and adolescent psychiatry has not decreased, it has increased”, observed the psychiatrist, adding that there was express ”so that the care of patients who are followed in psychiatric services is not interrupted.
In this regard, he recalled the rule of the Directorate General of Health related to hospitalizations of patients with covid-19 that warned of the need for psychiatric services to remain as they were to respond to what the health authorities thought “would be the increase in needs of the population “.
This was so much that the number of consultations increased compared to last year ”, he stressed, referring to the population that is not followed in psychiatric services, but that during the pandemic phase suffered psychological suffering, symptoms of depression, anxiety, insomnia. , was followed in health centers.
“If you ask me if Portugal’s response was enough to increase the needs (…) in relation to primary care, I cannot give you a complete answer,” said Miguel Xavier, adding that this answer will be known in a few months.
For Miguel Xavier, “the most expected thing was that, as happened in the other fields of medicine, there would be a retraction in the number of consultations”.
“This is not an issue that only concerns psychiatry and Portugal, this has to do with all medicine and with the whole world”, but “it is indisputable that there is a growing need derived from the psychological suffering of people,” he said.
But, he said, not all psychological suffering needs medical attention, it is part of life and it is important for the population to realize this in order “to be calm and there are no dramatics in this area.”
“There are longitudinal studies carried out from the beginning of the period of confinement to the end that show that the depressive and anxious symptoms of the population were decreasing,” because people are getting used to facing suffering, said the director of the PNSM.
However, there is a group of people in whom “there was not such a marked decrease” in depressive and anxiety symptoms, namely those who were unemployed.
This situation warns of a “very important” aspect already known: “the impact of the economic context on the psychological suffering of people”.
Poverty, unemployment and social inequality are “determining factors, not exclusive, but important and relevant, in the appearance of psychological suffering”.
For this reason, Miguel Xavier defended, “the response to mental health problems caused by a crisis, such as the pandemic, must be framed from the point of view of health, but also in terms of social support for people who are in a more precarious situation. “.
Investment in mental health is very disproportionate to its impact
“As in many countries, in Portugal there has been a chronic underinvestment in mental health,” Miguel Xavier told the Lusa agency about World Mental Health Day, which is celebrated on Saturday and has as its motto this year “Greater investment, greater access”.
For the psychiatrist, “there is a huge disproportion between the impact of mental health problems and what is invested in primary care and specialized services.”
“The mental health of the populations cannot be expected to be good if there is no proportional investment,” he warns, considering that this will be “one of the greatest challenges in the coming years, but already in the short term.”
Currently, it is possible to compare the impact and social burden in terms of direct and indirect costs that the various areas of health and dementia have in societies and what is proven is that “mental illness always appears first or second” with a total charge of 10% to 15%.
This amount should represent the financing of the National Health Service in this area. However, estimates point to funding of between 4% and 5%, “which is very little.”
Miguel Xavier argues that this value should “rise a little” each year, “in a weighted way, but making the right bets”, that is, where the “biggest flaws” are: in the proximity care and in the responses in the care primary. , where “most of the financial bet” should go in the coming years.
Regarding the support that the Ministry of Health has provided to the National Mental Health Program, Miguel Xavier affirmed that they are “in a phase of great harmony and great overlap.”
“We are working together and significant investments are being made, but some are lacking, for example in primary health care,” he said.
Most of the responses that are available in health centers for people with psychological distress are fundamentally pharmacological in nature, due to the lack of psychologists and programs implemented in the treatment of mild to moderate depression and anxiety.
“It is necessary that there are many more psychologists in health centers throughout the country”, says Miguel Xavier, recognizing that “this is not going to be done overnight, but you have to start”, because otherwise ” Portugal will inevitably appear with a country with a high consumption of psychotropics ”.
Miguel Xavier also defends that the services will work “much better” in proximity, emphasizing the importance of creating the first five adult community teams, which will be followed by many others for children and adolescents.
“These are absolutely crucial steps for teams to be close to people. The closer they are, the easier it is to access treatment ”, he defends.
According to the World Health Organization (WHO), around 1 billion people live with mental illness worldwide and one person dies every 40 seconds by suicide.
