In Latin America poor mental health is a barrier to development.: It’s like a black dog that follows you around and won’t let you sleep or eat properly, according to a World Health Organization (WHO) film. Winston Churchill, a British statesman, had already made this description famous. Depression is the name of the black hound.
The most common mental illness in the world is depression. According to the WHO, it affects 5% of the adult population in Latin America, but most people do not seek – or receive – treatment.
In the worst-case scenario, depression can lead to suicide; an estimated 63,000 people in the Americas commit suicide each year. Depression can disrupt daily life, employment, and personal relationships, even when it is mild.
Mental and neurological illnesses account for over a quarter of the disease burden in Latin America and the Caribbean, demonstrating the scale of the problem. Depression, anxiety, and bipolar illness are among them.
“These disorders have an influence on people’s daily lives,” says Dr. José Miguel Uribe, a psychiatrist and World Bank consultant. “They affect their work, cognitive capacities, studies, family, and social activities.”
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Loss of productivity
Because mental illness is a primary source of disability, it can have an impact on a country’s growth in addition to personal life. “Mental illness is a leading cause of lost productivity both nationally (at least in Colombia) and globally,” Uribe argues.
“It’s a problem that impacts a lot of people and has a big impact on productivity,” says World Bank economist Roberto Iunes. “Many people miss work, and as a result, they produce less.” People frequently discuss the impact of physical problems on productivity, but mental health is rarely discussed, according to Iunes.
Poverty exacerbates the vicious cycle of inequality in Latin America by limiting access to effective mental health care. According to Paulo Rossi Menezes, a professor of medicine at the University of Sao Paulo, “there is a significant association between level of living and prevalent mental diseases.”
Because they confront more obstacles in life and have less access to adequate care, the poor are more likely to suffer from mental illnesses such as depression.
Despite this, the WHO estimates that mental health receives less than 2% of the region’s health-care budget. According to Uribe, the percentage of resources dedicated to mental health is insufficient to provide fundamental needs around the world.
As a result, the World Bank, whose primary mission is to promote economic development and poverty reduction, is trying to include mental health on the development agenda and to push member states’ economic and health officials to prioritise it.
Information against stigma
There are various barriers to appropriate mental health care, according to Uribe. “First, there is the stigma associated with mental diseases. Because they are humiliated or concerned about the therapies, this makes it much more difficult for people to get help.”
This attitude could be attributable in part to a lack of knowledge. “People lack information, which adds to the barriers to care,” Menezes says. “People are unaware that what they are experiencing could be depression, or if they are aware of it, they may find it difficult to tell others about it.”
Discrimination against the mentally sick has always been a problem. These folks have only recently been more public in their advocacy for their rights to health and social inclusion.
The World Bank’s SaluDerecho initiative promotes mental health efforts in Latin America because mental health is also a human rights concern.
“We need to restore some sense of normalcy in mental health patients,” says Nieves Domnguez González, a physician and surgeon at the University of Santiago de Compostela in Spain and a former manager of the Galicia Health Service.
“People need to understand that, under certain circumstances, these folks can live a normal life,” she says. According to the Spanish expert, health officials in Galicia, for example, employed film as a tool. Following the screening of a film about mental illness, a specialist would engage the audience in a discussion about the subject.
Other issues include a scarcity of psychiatrists with the required experience to treat mental illness. “We don’t have enough professionals,” Uribe argues. “Moreover, mental health has not traditionally been a priority in health-care systems.”
Strengthening primary care
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According to Uribe, international organisations have recommended measures to solve the problem, such as boosting primary care in health and mental health. This entails putting services in people’s neighbourhoods and ensuring that ordinary medical personnel are trained to spot mental diseases.
“Many common mental health disorders can be resolved by a primary care team,” he says. Referring increasingly complex cases to the appropriate experts requires coordination between primary care physicians and specialists.
Fortunately, in certain Latin American countries, things are changing. According to Menezes, whereas the focus in Brazil was mostly on serious mental disease and patients in psychiatric facilities 20 or 30 years ago, it has now been expanded.
“The country’s mental health policies changed dramatically,” he says. “Instead of hospitals, our mental health policy is focused on psychosocial support centres and the integration of mental health into primary and general health care.”
While numerous challenges remain, according to Menezes, attempts are being made to expand treatment availability to those who may be suffering from less severe mental diseases, such as the majority of cases of depression.
Experts say the goal is to improve mental health care in the region and give more Latin Americans the chance to overcome the dark dog that follows them around everywhere. In Latin America poor mental health is a barrier to development In Latin America poor mental health is a barrier to development.