Javier Prado (Tarragona, 1984) is the president of the Spanish Society of Clinical Psychology, the entity that is holding its annual congress in Cádiz until tomorrow, bringing together more than 1,000 specialists. Destined at the Miguel Servet hospital in Zaragoza, a center that he considers his “training cradle,” Prado analyzes in this interview the current moment of mental health in Spain and the demand for a medical specialty that has a lot to say in the future of the society.
–How to briefly explain what clinical psychology is?
–It is a health specialty, of a medical nature, with a four-year training program in the national health system, and basically it is the discipline that is dedicated to the evaluation, diagnosis and psychological treatment of mental disorders, as an alternative psychosocial to other types of treatments such as medical ones, more based on psychopharmacology or other types of formulas. Basically, all our work is through words, conversation, seeking solutions to emerge from that process.
–Different from the psychiatrist.
–The psychiatrist would be another specialty complementary to ours, often based on the same type of devices, with which we share many spaces and work as a team. Especially in very serious disorders we need both types of tools, the more pharmacological and biological of that discipline and the more psychosocial or psychological of ours that also involve other types of professionals, such as social work. Above all, there is a very marked relationship, which we want to vindicate in this congress, between mental health problems and the social aspects in all these issues in which mental health now seems to be so in vogue. It seems that all these situations related to this matter are beginning to be made visible and uncovered and that they are often very determined by the social determinants of health: work problems, difficulties with housing, this kind of precarious situation that we are entering. progressively in the last 20 years in our country, especially through stress, and that influences whether people have strong mental disorders or there is an increase in what is there and we do not know how to locate, which is people’s discomfort. It is not exactly a mental disorder, but it is telling us that people are not well, that their lives are difficult, that things hurt people, that we are in a time where suffering seems to be more in the foreground than in other times. generations.
–And what is the reason for this greater visibility of mental health problems compared to a previous time?
–I think there are different elements. Obviously there is greater awareness that makes us more sensitive, we consult more and, as a consequence, things are detected that were previously hidden or that were managed by other mechanisms. Mental health is now beginning to be a normalized topic of debate, but it was often a topic in which people who suffered from it had great difficulty feeling that it was legitimate to talk about these issues. There is an increase in awareness and, consequently, help is demanded. And then, all the social problems that we have pointed out before make people feel worse, they have a future horizon that is more difficult to see, life is more complex, it is more liquid, before it was more orderly. And, at the same time, with the individualism that is being generated, the loss of natural support networks, traditional families, community places where processes were often resolved naturally, people see the need to resolve their own problems individually.
And that is why one of the mottos of the congress is to return to the community and link the community with quality. We are not going to solve this situation that we have with more clinical psychologists, even if they are needed; We are not going to solve it with more specialists in psychiatry, nursing, social work, although we need them because we are clearly underfunded, but we also have to rethink how we deal with things as a society, to what extent we support each other, how we are separating and individualizing ourselves on these issues and what effects that is having. Before there was more social support, much more community and that was a social buffer against discomfort. These things are also being transformed and influenced.
–And it also seems that going to a psychologist is becoming more normal.
–It had a certain taboo, it has become normalized and we have even gone to the other extreme, in the sense in which being not necessary or relevant or being contraindicated, the feeling is that not doing therapy is like… But it is fashionable! ! Between invisibility and this… We complain a lot about the overmedication of suffering, we have to do something about it. We must work on alternatives, which cannot always be changing medication for therapy because, no matter how well equipped a system is, resources always tend to be finite. You have to be efficient and responsible.
–Generalizing a lot: there is talk of depression, childhood trauma… But is suicide what we should be most concerned about as a society?
–Suicide should worry us because since 2020, year after year, the numbers are rising and each year we set the historical record in our country. It is true that when you analyze the number of suicides per inhabitant compared to the European average, we are not so bad. But it shouldn’t serve us. More than 4,000 suicides a year, knowing also that many times the number is higher, should make us aware that we must create a National Suicide Prevention Plan that involves the autonomous communities. It is complex, but it is a country challenge. But with good judgment, without politicizing, understanding which are the places where it is most needed; The data is very clear: Asturias, Galicia and Andalusia are the ones with the highest suicide rate per one hundred thousand inhabitants. We have to evaluate it and see what is happening in these places. Not all suicide prevention is going to be resolved with health measures, which are the last link. When faced with a request for help, there must be an effective resource. Here there is prevention, social policies, territorial policies… And politicians must work for the common benefit of the country.
–I don’t know if you know that article 13 of the Constitution of Cádiz of 1812 says: “The object of the government is the happiness of the nation.”
–La Pepa! I didn’t know him… (laughs). He knew about the United States Constitution, which says something similar. What we do know is that article 43 of the current Constitution speaks of the right to health protection, including mental health, and that it is up to governments, public powers, to govern and create policies that allow this to be done. I don’t know if so that people can be happy, but at least find themselves in a situation that allows them to go down that path, try it.
A record attendance of more than 1,000 specialists
From yesterday until tomorrow, more than 1,000 specialists in clinical psychology will meet in Cádiz, a medical specialty in charge of dealing with the treatment of mental disorders through words. The Secretary of State for Health, Javier Padilla, was in charge of opening this meeting, ensuring that his department “picks up the gauntlet” launched by the congress in its motto this year: ‘Quality, rights and community’, in a commitment to “ respond” to the reality of mental disorders from public health. Padilla also defended the need to address psychological suffering and its treatment “in a transversal way”, involving ministries that, for example, must face the effects of job insecurity, the climate effect or sexist violence.