World Mental Health Day, an initiative that aims to make visible, raise awareness and inform about the importance of mental health as an integral element of our health, and to better understand what it means to take a step back and focus precisely on what is understood by HEALTH.
WHO defines it as “a state of complete physical, mental and social well-being, and not merely the absence of disease or infirmity”. We erroneously assume that we are healthy when there are no illnesses, especially physical ones. That state of well-being that we need implies being able to face the normal stress of life, to work productively, to express feelings, to contribute to the community by interacting with others…
In order to enjoy good health a balance is needed between this “triad” of states, so if any of them is affected we lack complete health.
In short, there is no health without mental health.
Individual mental health.
Individual mental health is not a single entity that depends only on a variable, a moment, a situation, but is determined by multiple social, personal and biological factors.
Social factors such as socio-economic factors, work stress, unhealthy lifestyles, physical health problems, situations of social exclusion and/or violence, etc.
Specific personality and psychological factors that make a person more vulnerable to mental disorders.
And finally, there are also biological causes that may depend on genetics or brain biochemical or metabolic imbalances, for example.
How do I know I may have a mental health problem?
When your daily activity, your relationships, your performance are affected, there are changes in your daily life like sleeping very little -or quite the opposite too much-, when you put aside your friends and social relationships are annulled, you don’t feel like it or you directly stop going out as before, you break with routines, you suffer from unmanageable stress, anxiety patterns, etc. All these states involve alterations in thinking, mood and/or behavior and require intervention. When these problems become serious they become mental illnesses.
By 2030, the World Health Organization (WHO) estimates that mental health problems will be the leading cause of disability in the world. THE MAIN.
In Spain at least 25% of the population has suffered, suffers or will suffer some type of mental disorder, 1 out of every four people. This data should make us consider that at any time we could present a problem of these characteristics, us or someone from our environment.
In Spain, more than one million people have a serious mental disorder.
According to the ASEPP (Spanish Association of Private Psychiatry) the social stigma surrounding mental illnesses means that between 50 and 65% of those who suffer from them avoid going to a specialist, not recognising or denying their symptoms, interrupting treatments and/or hiding them from their environment. Thus, only between 35% and 50% of the people who suffer from them follow the appropriate treatment.
As an example, the most requested consultation hours in a first appointment are those outside working hours so as not to have to indicate this reason as absence from work.
Myths and stereotypes
There are numerous myths that have been perpetuated over time and that hinder the acceptance of mental illness not only on the part of the sufferer, but also on the part of society:
- This is rare. FALSE: As we have mentioned before, many people hide their state for fear of being discriminated against, which has a negative effect on their evolution. Social relations are difficult, people isolate themselves, which means that their environment does not know their situation.
- It is necessary to emphasize the importance of sharing, of talking about what happens to you and not only with the professional, since it will help to improve the understanding of this type of problems and to normalize a situation that is frequent. Ignorance is one of the causes of the emergence and perpetuation of stereotypes of this type. That is why information and visibility are so important.
- People who suffer from a mental health disorder are different. FALSE: Any one of us can have a mental health problem, just as we can have physical illnesses.
- They are violent and unpredictable people. FALSE: These are two aspects often associated in a wrong way, something that unfortunately the media have taken charge of perpetuating by providing, especially in the audiovisual format, a generalist and simplistic approach to the subject.
- According to Miquel Domènech, in the Report of the Observatory of Media and Mental Health, elaborated by the Group of Journalists Ramon Barnils and Obertament in 2015, “it is estimated that 51% of the news about mental health disorders are related to murders”.
- The explanation for this false belief is the difficulty in accepting evil, news that involves actions that involve extreme pain and damage and free of charge, so we seek justification. An action of these characteristics we cannot conceive of being carried out by a person “in their right mind”, so we resort to the cliché of “sure that it is wrong in the head”.
- It should be noted that there are people who suffer moments of unique violent outbursts and people diagnosed with psychopathy who are not mentally ill.
- People with mental disorders cannot work. FALSE. The reality is that society is a limiting factor for reintegration. As an example: 28% of employers would never interview a person with a mental health disorder.
- And this translates into the data provided by the INE in 2017 and collected by the Confederación SALUD MENTAL ESPAÑA (Feafes) which warns of the high unemployment rate among people with mental health problems. In fact 85.7% of people affected by mental disorders with recognition of degree of disability in Spain do not have a job.
- The reality is that a person with mental health disorder can be as productive as any other working person, receiving effective treatment.
Psychologist or psychiatrist?
It is a recurring question when seeking the help of a professional, who do I call?….
The psychiatrist is a medical professional, who diagnoses and treats these problems from a physiological perspective, with the ability to prescribe medication, fundamental in many cases. It is a good starting point to identify if there is any possible underlying pathology.
For example, there are occasions when a certain symptomatology ends up being the manifestation of some physical illness: a depressive state due to a metabolic imbalance, orientation problems due to the existence of a tumour, etc?
The psychologist on the other hand performs therapy focusing on assessing all psychological, behavioral and social aspects, providing strategies and involving the patient in their own process of change.
Both are complementary disciplines that can provide the help needed from two different perspectives, condemned to understand each other.
Patient perspective: stigma and empowerment
One of the biggest problems faced by people with mental illness is social stigmatization. The mentally ill person is thought to be crazy, unpredictable, violent and incurable, and in most cases this does not correspond at all to reality. This is emotionally damaging to each individual, who loses self-esteem, reduces their self-confidence and eliminates any possible initiatives they may have, leading to social isolation and limiting any social activity and participation in the community.
Great efforts must be made in prevention, in the promotion of mental health, in research into psychological and pharmacological treatments, in the knowledge of illnesses and, above all, in the reintegration of each person into society.
This stigmatization was manifested in a reference document prepared by the Spanish Federation of Psychiatry, the Spanish Society of Biological Psychiatry and the Spanish Foundation of Psychiatry and Mental Health in the Declaration of Oviedo against Stigma of 2011, and since then it has not improved much.
In the document they consider this stigma as a consequence of inadequate media treatment, the lack of knowledge that these are disorders related to abnormal brain function, the evolution, sometimes unpredictable, the taboo of suicide, and, above all, the fear of violence, always magnified.