Pandemic effect: consultations for mental health disorders increased

It is still difficult to estimate the magnitude of the effects of the COVID-19 pandemic on global mental health. The social isolation of the first months, the uncertainty of contagion and the severity of the infection, coupled with the grief over the loss of loved ones, are just some of the elements that put the emotional balance of each individual in check.

In addition, for those who had already been diagnosed with a mental disorder before the outbreak of SARS-CoV-2, everything went uphill. The difficulty of continuing treatments, the abrupt cut of social routines and the abrupt changes in the small rules of the day to day, further destabilized those who were in mental health treatment.

Recently, a study, published in the medical journal The Lancet, looked at the worldwide prevalence of depression and anxiety disorders in 204 countries and territories in 2020 due to the COVID-19 pandemic. It found that mental health declined dramatically in that year, with an estimated 53 million additional cases of major depressive disorders and 76 million additional cases of anxiety disorders observed worldwide. It was found that women and younger people were more affected than men and older adults.

Dr. Susana Baldini, medical director of the Argentine Chamber of Medicinal Specialties (CAEME), stressed that “making mental health disorders visible is the first step for everyone as a society to become aware of their relevance and the importance of their proper diagnosis and comprehensive approach.”

“Undoubtedly, the pandemic has led to an increase in the number of adolescents who report having a mental health problem,” said José Benjamín Guerrero, head of Psychiatry and Mental Health at the Faculty of Medicine of the National Autonomous University of Mexico (UNAM). “We must not forget that depression is one of the main causes of illness and disability in adolescents in the world,” he insisted.

“According to the World Health Organization (WHO), mental disorders account for 16% of the global burden of illness and injury in adolescents,” he said, adding that poverty, abuse and violence in their different forms are factors that make young people more vulnerable to mental health problems.

In Argentina, a national CONICET study presented the impact of the pandemic on mental health problems. According to this research, 47.2% of the people consulted answered that they had some “anxiety disorder”, followed by “depression” (36.8%) and “psychiatric” conditions (14.0%). The report “Health, welfare, coronavirus and vaccines by region and religious affiliation”, was led by the doctor of Social Sciences, Gabriela Irrazábal (UNLP-UBA), from the CEIL-piette study center of CONICET.

The investigation corroborated that mental illness became a period disease during the last year of coronavirus. Participants stated that they had suffered three main difficulties in their health: mental health conditions topped the first place in the responses, and secondly, allergies (42.3%) and skin problems (34.7%), an issue with little place in public debate. The coronavirus ranked fifth, with 25% of those responding to having transited the infection.

Faced with this reality, questions are raised about how the health system can respond and what is the role of the State in containing and mitigating this exponential increase in disorders linked to mental health conditions.

The Mental Health Law in Argentina

Mental disorders and illnesses encompass a range of conditions that affect the overall health of patients, from anxiety, depression, to more complex conditions, such as schizophrenia, dementia or bipolar disorder. The medical treatment of all these diseases has a legal framework in Argentina, Law 26,657, enacted in 2010.

“Recently, professionals and relatives of patients with different pathologies have requested the revision of the current Mental Health Act, since it states that hospitalization should be an exception, when in fact it must be a habitual in the interdisciplinary team, it must be in the therapeutic arsenal, as well as outpatient treatment, contextual therapy and psychotherapy,” Mario Clemente, president of the Observatory Foundation for Prehospital Medicine, told Infobae.

Law 26,657, known as the Mental Health Act, guarantees the right to protection of the mental health of all persons, and the human rights of those with mental illness. It was sanctioned on November 25, 2010 and promulgated on December 2, 2010. The core of the law is deasycomialization, which implies that people with mental illness must be treated in common hospitals and that hospitalizations must be brief and notified to the judge.

The Association for Relatives of People with Schizophrenia (AAFE), highlighted aspects covered by the law that end up becoming an obstacle for families.

The association emphasized that involuntary internment requires “the existence of a certain and imminent risk of the proximity of harm, which is already known as true, safe and unquestionable that threatens the life or physical integrity of the person or third parties” according to the law, but “the certain and imminent and known risk e is undoubtedly a requirement of very difficult evaluation, but the dual responsibility scheme makes institutionalization almost impossible. Doesn't this block or hinder the human right to commit a person for their health to get them out of a crisis or to prevent them from falling into it? ”, questioned Rodolfo Campos, member of the Board of Directors of AAFE.

Article 27 of the Act provides for the closure of what it calls “monovalent”, that is, clinics and psychiatric hospitals, which it calls “asylum”. This is one of the biggest questions asked by associations of relatives of patients and specialists in psychiatry.

The placement, if necessary, must be brief and previously notified to the judge. “This is contradicted by reality because there are conditions that require a long time and it does not define what is short. The problem of the mental health law is not the application of it, but rather that infrastructures and the training of health professionals in hospitals or, where appropriate, multipurpose effectors are not created,” Clemente said.

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