Let's speak clearly, World Mental Health Day

For a number of years, psychology has been socially recognized as one more healthcare profession, as well as a resource for the care and improvement of the mental health of individuals, families, organizations, and also on a community scale. In this line, that politics echoes the importance of mental health, and that they signed in 2023 the Balearic Pact for emotional well-being and mental health in a unified manner, is a complete success. Just like the creation in this legislature of the General Directorate of Mental Health.

Despite the progress made in terms of social recognition of the importance of mental health and emotional well-being, the concrete implementation of these public mental health policies has shortcomings. As demanding professionals, we cannot leave them as they are without proposing constructive improvements.

The Platform of clinical psychologists of the Balearic Health Service –signatories of this article– was constituted in 2017 with the purpose, among others, of monitoring the activity of the competent public administration in health matters and, specifically, the provision of clinical psychology health services. Since then, we have worked hand in hand with the Administration and have achieved important challenges, such as consolidating a system of stable clinical psychology competitive examinations, increasing the number of clinical psychology residency positions, creating the regional commission of clinical psychology, as well as greater direct involvement of clinical psychologists in areas of responsibility.

As a platform, when we refer to speaking about mental health, we do so from the perception of the tendency towards simplification in the way the public mental health network has been attended to and managed in recent years with proposals and initiatives.

- Everyone understands that psychiatry and pharmacological therapy, by themselves, do not cure mental illnesses.

- Everyone understands that doing psychotherapy with people with severe mental disorders on a monthly or bimonthly frequency and in half-hour slots is not effective.

- Everyone understands that working side by side as clinicians, in Primary Care and in Mental Health units, with a service portfolio from the year 2007, implies being outdated.

- Everyone understands that hiring a psychologist in every health center without coordinating, clarifying, and defining functions, while overlapping with the functions of other professional categories, is destined to aggravate the difficulties in the coordination of the public mental health network.

- Everyone understands that an important part of mental health consultations are not strictly mental health problems, but rather problems derived from economic precariousness, lack of housing, problems derived from violence (gender-based, workplace...), and difficulties in coexistence. In this sense, they can result in economic, social, etc., problems that require homes, adequate wages, affective-sexual education at all educational levels, and more efforts to achieve real and effective equality. To address this distress, which worsens if not attended to, regional, island, and local resources require much more personnel; we need more coordination, etc.

- Everyone understands that launching a new mental health care model that lacks a serious study justifying its necessity, budget, and implementation plan, and has not been agreed upon with professionals in the field, is born with significant shortcomings.

It is for all these reasons that the Platform of clinical psychologists of the Balearic Health Service, in these days when we commemorate World Mental Health Day with various events on all the islands, persist in demanding from the Health Service of the Balearic Islands:

- Establish a fluid and constructive dialogue that allows us not to deal judicially with what the established bodies and channels fail to address with diligence.

- Make proposals for model change and create new professional categories based on evidence.

- Broaden the perspective regarding the actors operating within the mental health network (IB-Salut, DGSM, island councils, municipalities, the third sector, and the private initiative), evaluate programs, processes, duplications, shortcomings, and emergencies. All this, with a sufficient provision of clinical psychologists at IB-Salut and professionals from other fields who also work with suffering and severe mental pathologies.

- Advance in the implementation of a stepped care model in which clinical psychology in Primary Care becomes a guarantee of management and efficacy, as demonstrated by international initiatives such as the EFPA white paper.