Since the Ministry of Health presented the draft of its Mental Health Strategy, at the end of 2021, Psychiatry societies have been alerted to the conceptual errors with which policies are proposed to address one of the most important health problems in Spanish society. Since the first versions, The document already frontally attacked psychiatry as a science, and blamed it for the fact that Spain is one of the countries in the world where the most psychotropic drugs are consumed.
But not only did the Ministry never listen to professionals in this field, but Its festering has become more radical with the passage of time. During the Joint Commission to study Addiction Problems in Congress, which took place last April, the minister, Mónica García, said that The consumption of hypnosedatives, such as benzodiazepines, produces 1,000 deaths a year directly and another 2,000 related deaths. Shortly thereafter, the Commissioner of Mental Health announced that he was preparing a guide to reducing psychotropic drugs, and sent more than debatable messages such as “Long-term drug treatments kill. These people live 20 years less.”
In the face of such nonsense, Celso Arango, one of the most recognized psychiatrists in Europe and the world, director of the Institute of Psychiatry and Mental Health of the Gregorio Marañón Hospital, head of the pediatric and juvenile department of the same hospital center and member of the United States National Academy of Medicine, responded to the statements in a thread on the social network X.
In it, he made reference to a study of the incidence of first episodes of psychosis worldwide, recently published in the scientific journal The Lancet Psychiatry, of which he is co-author, and pointed out the following: “While some worry about people with mental disorders taking treatments, the world worries that the main mental health problem is that the majority of people do not have access to these treatments.. ¿Can you imagine a Minister of Health sharing that the drugs her Ministry has approved kill and if you don’t take them you live longer, contrary to all scientific evidence? And I say against it because it is exactly the other way around,” he says.
“For example,” he continues, “people with schizophrenia who take medication are twice as likely to live with a twenty-year follow-up, especially if they take clozapine. For a Minister of Health to promote false data that is contrary to the evidence and, even worse, the abandonment of treatment, is more than negligence. “Antipsychotics have substantially improved the quality of life and morbidity and mortality of patients with schizophrenia, as well as those around them.”
Hence, both he and the Spanish Society of Psychiatry and Mental Health (Semps), the College of Psychiatry of Madrid and dozens of private professionals wonder Where is the coherence in a Ministry that mercilessly attacks pseudosciences while defending those that fit its ideology.
No evidence, only ideology
Recently, The Commissioner of Mental Health, Belén García, made her public debut with statements to the media in which she defended the deprescription of psychotropic drugs. “The idea is that sports groups can be prescribed instead of rubifen, feminist associations instead of sertraline, or a union instead of lorazepam.”
Statements that, in addition to being dangerous for people with mental illnesses, were a cold shower for psychologists and psychiatrists who work in psychotherapy.
And it is that Neither joining a union nor joining a feminist association has any scientific evidence to prevent or treat emotional disorders, But some of the therapies they have included in their “Health Protection Plan against Pseudotherapies” do have it. Specific, autogenic training, a psychotherapeutic technique based on passive concentration on natural bodily sensations. In countries such as Germany, Russia, Canada, Japan and Italy this technique has official recognition along with other psychotherapies, such as cognitive-behavioral. In United Kingdom is recognized and recommended by the National Health Service (NHS).
Although the document does not put it directly into the bag of pseudotherapies, it says that although “it has shown benefits in improving psychological and physical symptoms (significant effects in reducing levels of anxiety and depression, as well as headaches), , atopic dermatitis, irritable bowel syndrome or fibromyalgia), the conclusions cannot be definitive due to the low number of studies for each health condition and their risk of bias high or unclear. “It is necessary to continue evaluating the safety of these techniques.”
Given these statements, the Spanish Society of Psychosomatic Medicine (SEMP) has been mobilized and has sent to Health several letters and reports detailing the evidence of this type of psychotherapy, accompanied by writings from several experts to request “the urgent review and modification of the report, the withdrawal of autogenic training from the group of therapies ‘under suspicion’, and the complete review of the Plan.”
“The ministry’s report is based on an error of concept when classifying autogenic training within ‘techniques for inducing bodily sensations’, an unusual label in medical literature,” he comments. Luis González de Rivera, Professor of Psychiatry and President of the SEMP. “Autogenic training is neither ‘induction’ nor ‘mental representation’, but rather training in perception and concentration of attention on natural sensations that are always present,” he points out. “None of the professionals who research and teach the method have been consulted or had knowledge of the preparation of this report prior to its publication” adds the expert, who learned autogenic training during his training as a psychiatrist at McGill University in Montreal, and has taught it during his stay as a professor at McMaster University in Canada, and, already in Spain, at the University of La Laguna, the Autonomous University of Madrid and the National University of Distance Education (Uned).
Without funds to increase the number of professionals
One of the aspects on which almost all agents involved in addressing mental health agree is that the effort must be put into increase the number of health professionals, both psychologists, psychiatrists and specialized nurses. Along these lines, the Community of Madrid censured last Friday that Funds for human resources are not included in the Mental Health Action Plan. “We believe that, in mental health issues, the high technology is psychiatrists, clinical psychologists, mental health nurses, and there we have asked that there be specific funds, please,” said the Minister of Health of Madrid, Fatima Matute, after the plenary session of the Interterritorial Council of the SNS.
The solution is to increase the number of places for these professionals, with the aim of fixing the deficit, which has accumulated for more than a decade, in a few years. Without this or, for example, creating more day hospitals, Health’s delusions of deprescribing medication could have dire consequences in the psychiatric population.