Mental illness: A ground for discrimination

11/08/2018
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16:35
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Newsroom/EL UNIVERSAL in English
Mental illness: A ground for discrimination
According to the World Health Organization (WHO), victims suffering from schizophrenia, anxiety, depression, bipolar disorders, or addiction problems are vulnerable - Photo: File photo/EL UNIVERSAL

Mental illness: A ground for discrimination

11/08/2018
16:35
Newsroom/EL UNIVERSAL in English
Mexico City
Alejandra Riquelme
-A +A
One out of every four Mexicans between 18-65 years old have suffered a mental illness, but very few get treated

Denise, who is 27 years old and whose doctor diagnosed her with an anxiety and depression disorder in 2015, was traveling from Durango to Mexico City on a bus. She had never felt rejected or excluded among her family, co-workers, or friends. However, at the Central Prosecutor’s Office for Sexual Crimes Investigation of Mexico City, she was belittled due to her mental health status upon reporting that she had been a victim of sexual harassment.

The young woman had set out to enjoy her weekend in Mexico City after a 12 hour trip. She took the medication that was prescribed to treat her anxiety and exchanged a few text messages with her love partner; shortly after, she noticed that the man sitting next to her had fallen asleep and so, she decided to turn off her phone and get some sleep as well.

However, Denise woke up suddenly when she felt the stranger -she later found that his name was Esteban, and he was 38- put an arm above her waist; she removed his arm and assumed that he was still asleep. Afterward, she tried to go back to sleep, but in a few minutes, Esteban had put his right leg above her body. She moved away and growing more and more concerned, she attempted to call her partner on the phone, but there was no answer.

The trip continued and Denise fell asleep once again, covering herself with a blanket. She woke up once more, because Esteban was on top of her, grinding his penis against her leg. Completely shocked, she pushed away her aggressor, who returned to his seat, feigning sleep. She hit him on the chest, but he ignored her, as if nothing happened.

Denise told the driver about the assault; they woke up the bus manager and she recommended to report him with the police in Querétaro, since the bus was passing by the city, but the police indicated that, in order to file the report, the bus had to remain there along with all the passengers. Denise decided to wait until she arrived in Mexico City.

At the capital, there was a patrol car waiting for her at the station. The agents detained Esteban, who was taken to the prosecutor’s office, where the report seemed to run smoothly until Denise mentioned the medicine she had taken while on the vehicle, which led officers to manipulate her statement to a point where they “established” that Denise had not been aware of the assault due to her taking the medication. “It was a 12 hour trip, I was obviously going to sleep at some point, with our without medication,” Denise stressed, who refused to give her last name for this story.

At the branch of the Attorney General of Mexico City, the authorities questioned Denise and sent her with a psychologist, who asked her to talk about her life and her treatment. “Since the police had already put words in my mouth, I decided not to say anything. They used my mental health as an excuse, and at some point, it felt like they were defending him instead of me,” she said.
 

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"Come to an agreement"

Denis emphasized that she “felt rejected, they made me tell the same story every five minutes and they still didn’t believe me, they sidestepped the problem, said they had a lot of work on their hands, that it was better to come to an agreement with the aggressor. Since then, I haven’t had any news about my report, and it’s terrible that they should treat people as if they were crazy just because of the medicine they take.”

Discrimination towards people with mental health issues is more common than one might think. According to the World Health Organization (WHO), victims suffering from schizophrenia, anxiety, depression, bipolar disorders, or addiction problems are a vulnerable group.

According to WHO, around 151 million people suffer from depression, 26 million from schizophrenia, and 125 million from issues related to alcohol and drug abuse worldwide. 40 million more suffer from epilepsy; 24 million, Alzheimer’s and other types of dementia. One of the most alarming facts is that around 844,000 people commit suicide every year.

In Mexico, the mental health system evaluation called “Where should we focus on?” states that one out of every four Mexicans between the ages of 18 and 65 have suffered a mental disorder at some point, but only one out of five receives proper treatment. People usually have to wait between 4 and 20 years to receive medical attention at a Public Health institution, according to the official document. In turn, the report on the Mental Health Systems of Latin America shows that, in Mexico, resources destined to mental health treatments are insufficient, and most of them can only be found in psychiatric hospitals.

In an interview with EL UNIVERSAL, Evalinda Barrón, a psychogeriatric psychiatrist, explained that mental health disorders are usually caused by “Many intervening factors: One of them is genetics, meaning that our predisposition to develop these illnesses usually comes from family, and then there are social factors such as school and the violence that we currently experience in the country.”

Two of the main problems that a person with a mental health disorder faces are ignorance and prejudice, Barrón explained: “You may present symptoms of a physical illness; if you get very hungry and thirsty, you know it might be diabetes, so you go get tested for glucose levels. But if you are sad and you feel like crying, if you don’t feel like doing things you usually like to do, instead of seeking medical attention, people usually do all sorts of things like ‘trying harder’, going out, talking to people, or even recurring to witchcraft, anything but going to a psychiatrist.”

The mere thought of having a mental illness makes it harder for people to seek proper medical attention; the individual is ashamed to admit it and talk about it, because he or she often doesn’t understand what is happening. Today, we need to understand that the brain, as any other organ such as the heart or lungs, can also become ill, Barrón stated. Another problem that people who have been discriminated for having a mental illness face is the interruption of their treatment -such is the case of 25% of all patients- usually due to the stigmatization and social pressure. In order to overcome these problems, doctors usually take psychoeducational courses to help patients better understand their illness.

Mexico is currently undergoing a “polarized” epidemiological transition. Some of its most notorious features are a decrease of infectious diseases and an increase in chronic and degenerative disorders, including mental disorders, says the Report of the Mental Health System in Mexico, from Mental Health Systems Assessment Tool (IESM) and WHO.

Mariana Castilla, Master degree in Human Rights and Democracy, who worked at the National Human Rights Commission (CNDH), pointed out that people with psychosocial disabilities still suffer discrimination in political, economic, and working environments, as well as within their social circles and families. “They are discriminated because of the way that we have been approaching these illnesses and people choose to shut them out of society because they somehow think that this will make them better and that they will eventually reintegrate into society,” she stated.

In her experience, healthy people find it hard to understand mental health problems such as anxiety or depression; “they find themselves unable to empathize with their world and understand that, what may seem irrational and illogical to a normal person, is in fact a reality to them.”

At the CNDH, Castilla handled cases related to human rights violations. She often met people who couldn’t give a coherent speech, but once she understood their context and personal situations, she discovered that, at some point, their families had excluded them, leading to a situation of violence which often aggravated the mental disorder.

In other cases, these people would look for a job, but companies often denied them the opportunity once they found that they had been diagnosed with a mental illness. “What are the consequences of this type of discrimination? It causes their life to fall into a condition of poverty, they end up living on the streets or becoming economically dependent on their families and close friends,” she stressed.

A study on the social cost of mental illness regarding incapacity and lost work days, led by specialists María del Carmen Lara Muñoz, María Elena Medina-Mora, Guilherme Borges, and Joaquín Zambrano revealed that in 2017, depression and anxiety among Mexicans generated more incapacity cases and lost work days than several chronic non-psychiatric illnesses, considering incapacity as a downturn in an employee’s expected performance at work, in his or her home, social life, and among close friends.

Eleven years later, doctor Lara Muñoz, from the Psychiatry Department of the Autonomous University of Puebla, claims that the conclusions of the study remain valid. Although in Mexico, the data on mental health patients is not exactly up-to-date, “people all over the world are beginning to acknowledge the indirect costs of mental health disorders, such as loss of income due to absenteeism, or a decline in productivity, meaning that the employee at hand comes to work but doesn’t perform adequately.”

She explained that, since the 1990s, mental health disorders were identified as one of the main causes of work incapacities, which are one of the most important health indicators worldwide.
 

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Global costs

The World Health Organization predicts that the global costs of mental health issues will grow to 6 trillion dollars in 2030, while in 2010, they represented a 2.5 trillion expense.

However, since there are already effective treatments for depression and anxiety, should USD$147 billion be invested between 2016 and 2030 to address the issue, 43 million extra years of healthy living could be achieved in total, representing a USD$310 billion recovery, along with a profit in productivity of around 230 billion dollars if health organizations should decide to improve and increase their treatments for depression

Lara Muñoz concludes: “It is clear that discrimination is still one of the main obstacles for treatment access. Depression is still seen as weakness while anxiety is viewed as a mere personality trait that the person at hand should be able to ‘control’.”

Among young people, one of the main causes of death is suicide, which is often caused by depression. However, depression still hasn’t been addressed as it should for two reasons: People don’t recognize it as an illness, and patients often refuse to get treated because of the stigma,” she added.

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