The year that ‘go to the doctor’ put the focus on mental health

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The mental health never had the prominence of other classical themes in the Congress of Deputies. Catalonia, ETA, the emeritus king, the CGPJ, now the pandemic or before Venezuela are the great ‘hits’ that have appeared repeatedly in political debates. The bombastic headlines, controversies, hyperbole or confrontations between leaders took the media spotlight and mental health has traditionally gone unnoticed except for exceptions. But in March 2021, after a year in which the pandemic He had put the mood and mental state of the Spaniards to the test, one of those controversies fully touched mental health and put it on the map. Three words were needed: “Go to the doctor”.

It happened in a session of control of the Government in the Congress of Deputies, like those that usually take place on Wednesdays. The leader of More Country, Íñigo Errejón, had registered the following question to the Prime Minister, Pedro Sánchez: “Do you have a government crash plan to tackle the mental health problemHim? “A question that apparently would have gone unnoticed if it had not been for some laughter in the Hemicycle and the cry of one of the PP deputies while Errejón presented his arguments: “Go to the doctor”. Three words that caused indignation among other political leaders, who criticized the behavior and finally the PP deputy publicly apologized by the tone output.

A PP deputy yells at him “Go to the doctor!” to Errejón after requesting a mental health plan

Since then, the political focus on mental health has intensified (by all parties, more involved in this issue) and has made some progress. One of the last, earlier this month, when Spain has approved the first mental health strategy in 12 years with the support of all the autonomous communities. It will be focused on preventing suicidal behaviors when in the country almost eleven people per day die for this reason, one approximately every two hours. And it is that the suicide rate increased in 2020, the year of the coronavirus.

Mental health strategy, 24-hour telephone against suicide and 100 million in three years

Sánchez has also incorporated in his speech more space for this issue and last October publicly announced a 24-hour phone call against suicide and a plan of 100 million euros (transferred to the General State Budgets) for mental health for the period 2021-2024.

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Just one day later United we can, a partner in the coalition government, registered in Congress his mental health law, which is in the processing phase and which aims to increase the minimum ratio of specialists in psychology and psychiatry to 18 per 100,000 people and up to 23 nurses. And it is that according to the report “Headway 2023 – Mental Health Index”, Spain is at the bottom in Europe with a total of professionals dedicated to mental health, adding psychiatrists, psychologists and specialized nurses, 25 per 100,000. The Ombudsman has also made it clear, according to data from the Ministry of Health of 2018, that in Spain there are only six public health psychologists for every 100,000 inhabitants.

Apart from the measurements, initiatives and debates on mental health have increased in Congress and also in regional parliaments. This same Tuesday, for example, there was a full monograph on mental health in the Parliament of Catalonia. In summer, the Madrid Assembly approved the request to the regional government to promote a Shock Plan in Mental Health “comprehensive and urgent” measures.

It is not that these issues went unnoticed before but they have not been given light except in moments of crisis

“It is not that these issues previously went unnoticed, they were simply in the dark, they have not been given light unless there are specific moments of crisis” such as that of the coronavirus, explains to RTVE.es María José Méndez, doctor in Sociology and Political Science and professor at the Complutense University of Madrid.

“A controversy that catapulted the issue on the public agenda”

Sector or public policy issues seldom have space in the media Communication. But a political controversy led to the issue being catapulted onto the public agenda, “says political scientist Mireia Castelló. He emphasizes that there have always been debates, interpellations and questions to the Government on mental health, but until then they did not “transcend”. “It happened before with the gender violence. It was addressed but there was not a broad public debate ”until there was the “Trigger” of the case of Ana Orantes, murdered in 1997, explains Castelló.

What Errejón put on the table in March, among other issues, was that society has normalized psychotropic drugs. “Diazepam, Valium, Lexatin … At what point have we normalized that we have to live on medication?” He asked himself. The power of his speech then, Méndez points out, is that “We all have or know people who have depression or friends who have a hard time and there is no space within the national program of health for all ”. So that “go to the doctor” was “a departure from tone” that gave “Visibility” to the problem. Were some words that “Implied exclusion” of a part of society that it is affected by mental problems, something that “is contrary to the interests of all Spaniards and what the Constitution says.”

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In March 2021 the CIS revealed that 21.5% of the Spaniards questioned claimed to have felt “down, depressed or hopeless” during the pandemic and that the prescription of psychotropic drugs doubled. Despite the seriousness of the data, the doctor in Sociology and Political Sciences and expert in Public Health Ana Rico highlights the importance that the pandemic has had for society to have “Destigmatized mental health patients”. It has been “shown that people who function perfectly stop doing so because they are confined to their homes and that it is not something only genetic “.

Still, the “go to the doctor” stance reflects the position that a part of society could have. Thinking ‘shut up, go to the doctor and do not give us the tabarra with that subject ‘”, Exposes the sociologist and political expert of the UCM Jaime Ferri, who highlights how important it was that the public apology was produced to normalize mental problems in society and that help could be sought. Because “The visibility of the political class reverses that society can speak” of these questions, since it is something that it is “fed back”.

There is part of the political strategy on “who flags” this issue

It also happens when politicians are in solidarity with public figures who have openly stated that they have a mental health problem. The most recent example has been the death of the actress Veronica Forqué, who had already talked about it on several occasions. The messages from the political sphere were generalized to show their affection and condolences, but some also highlighted the need to improve mental health policies to prevent suicides.

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But although the experts consulted by RTVE.es value the involvement of politicians On this issue and they believe that the measures are here to stay, in part of the discourse, Castelló points out, there is a certain “strategy.” “The issues related to caring for people and social issues in general have been classic flags of the left ”.

In the case of mental health, “all parties address it, but They enter the competition of who is the maximum defender, who champions this question or who gets the credit ”, something that is evidenced by the fact that“ the Prime Minister is directly involved ”in this matter,“ with all the power that has to announce an investment and more resources to alleviate the serious deficit ”in mental health.

A focus that is not yet on some mental health problems

But despite the fact that it has gained visibility and political repercussion, Rico points out that “There are two clear things that nobody gives enough priority to” policy regarding mental health. One, relating to practices that still occur in psychiatry, such as involuntary admission to a psychiatric center, which continues to occur on exceptional occasions and under the supervision of a judge when the person poses a serious risk to himself or others, despite to have been declared unconstitutional by the Constitutional Court. Or tying patients to the bed to contain them, a practice that today is legal and that also applies in residences. And it calls for politicians to tackle these issues or disability benefits for people with mental problems more determinedly.

The law that United Podemos has registered, for example, does refer to the fact that people affected by mental health problems have the right to “an intervention that protects them from iatrogenesis” (damage caused by the health professional to patients in a way that unintentional, which can cause mild emotional distress to death itself.).

And it establishes that all services provided in this area for this group must adopt treatments with a “freely given consent.” It also establishes that “no person may be” subjected to electroconvulsive therapy if it is thus stated in the advance directive document. “

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George Holan

George Holan is chief editor at Plainsmen Post and has articles published in many notable publications in the last decade.

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