The PSM warns of the progressive and alarming deterioration in public mental health care caused by cuts in a context of crisis.
Barcelona, April 25th
The Platform for the Defense of Public Mental Health Care in Catalonia (PSM), a movement of professionals for the defense and improvement of mental health and quality of care, celebrated today, at the headquarters of the Official College of Nurses of Barcelona, its 1st Debate Day. More than one hundred professionals from different sectors, including mental health, primary health care, and social services, have attended.
The event has been scheduled to coincide with the first anniversary of the formation of the so-called Atocha Group and the Atocha Statement (April 26, 2014) and has included the participation of Begoña Olabarria, the greatest representative of Atocha Group, from which the formation of Platforms for the defense of mental health in the various autonomous communities of the state has been promoted. It has also been transferred from Madrid to participate in this Working Day Angeles Castro, Vice President of FEAP (Spanish Federation of Psychotherapist Associations).
During the Conference, the group's journey was revealed, from the formation of the Atocha Group, which emerged from the self-convocation of a series of professionals from all over Spain one year ago in Madrid, to the creation of the Platform for the Defense of Public Mental Health Care in Catalonia. All the work developed by the PSM during its first year of existence has been summarized: promoter group, internal organization, working groups, data analysis of the mental health situation in Catalonia, analysis of care practices, communication and dissemination, presentation of a Working document for the Health Committee of the Parliament of Catalonia, synergies with political parties, and organization of the Forum to promote debate among professionals.
A few minutes were also dedicated to emotional and grateful recording of Roser Pérez Simó, recently deceased, in recognition of her great personal and professional value and her immense work pioneer of community mental health in Catalonia since the 1970s, legacy of humanization and community revitalization built from scratch with enthusiasm and which current health policies are endangering.
This situation has been, precisely, the central axis of the 1st PSM Debate Day alert that, at the current time, the continued reduction of public budgets for attention to the Hi mental in Catalonia (with a 16% loss% in the last 5 years) is causing a progressive and alarming deterioration in attention (prevention, assistance, and rehabilitation) and is producing severe damage to the quality of care of patients and their families.
The PSM has highlighted the main difficulties with which the professional collective has to work and which directly affect the deterioration of public mental health care. One of the most important is the exorbitant increase in the patient-to-professional ratio and the stress, frustration, and deep distress of professionals due to having to respond to high care demands without sufficient resources to sustain dignified and rigorous care, nor having the basic requirements at hand to carry it out according to clinical criteria. Professionals who, moreover, have suffered a progressive loss of salary, a 20% in the last five years.
Public Mental Health care professionals state that 30-33% of the consultations carried out in Primary Care are related to some kind of psychological problem. The shortage of clinical psychologists (4.5 clinical psychologists per 100,000 inhabitants) and, therefore, the lack of adequate psychological care in the system leads to overprescription of psychotropic drugs -of consequences especially serious en the case of Childhood and early childhood– behaves like a Overload in family doctors from Primary Care centers, which, with the crisis, have been overwhelmed by the increase in mental health problems with symptoms of anxiety and depression.
Professionals, familiars, and users expressed their concern today about the «harmful» conditions under which treatments are being carried out for seriously ill patients, overmedicated young children, revolving doors (staff turnover), premature discharges, insufficient time, and inadequate listening for diagnoses.
The PSM was sent, in December 2014, to the Health Committee of the Parliament of Catalonia in document with specific questions to obtain more and better information on the spending and financing of mental health care and prevention activities, as well as on care activities and the conditions under which they are currently carried out. This request for information, which has not yet been answered, is fundamental for understanding how budget cuts are affecting public mental health services in a crisis context, as only general data is available. General data does confirm, however, an increase in suicides and an increase in aggressions by patients against professionals, for example.
The PSM has proposed various measures to improve public mental health care:
- Promote comprehensive patient care, giving greater importance to psychological and relational aspects.
- Reduce pharmaceutical spending, especially on medication for children.
- Increase investment in human resources, with specialized professionals who also receive continuous training.
- Avoid management by professionals not expert in mental health.
- Increase the ratio of clinical psychologists in Primary Health Care and mental health services.
- Promote interdepartmental preventive and community programs (health, education, social services, labor, among others).
This is the direction in which the PSM continues to work. As has been said after the musical interlude that gave way to the second round of discussion among the attendees, the debate remains open and requires the union of many minds and many hands in order to redirect and successfully bring the current situation of deterioration to a good conclusion. That is why, more than with closed conclusions, The day concluded with an open invitation to join and participate.
For more information, please consult the PSM Blog