Disability Problem In Mental Health

Disability problem in Mental Health

Throughout time accordingly to the milestones in the control of infections and other innovative health measures that have managed to improve the life expectations of the population;and of the change in life patterns (more and more sedentary), an increase in both morbidity and mortality charges, as well as the impact on public health of noncommunicable diseases (EV), with importance consequences, with importance consequences,that even cover the social and economic fields.

As the name implies, it is not transmissible or non -infectious disorders, which are usually characterized by a long duration, so they are usually called, chronic, and often present a slow progression, implying long -term treatments and care. They can also present multiplicity in their etiology, including modifiable risk factors, whose intervention translates into prevention of such pathologies.

Currently, noncommissible diseases are located as the first cause of morbidity, mortality and disability in the world, representing 95.15% of the total prevalent cases, 73, 41% of all deaths and 79.52% ofThe years lived with disabilities (AVD), according to figures from 2017. Now, among this group of diseases are mental disorders and mental health problems (such as the use of psychoactive substances, violence, among others). At this point it should be noted that when discriminated against, mental disorders and the use of psychoactive substances are among the first causes of morbidity and mortality;And the former occupy the second position in disability statistics.

There are various mental health concepts, so that it is a definition that has been built over time and where the clinical, cultural, social and needs context observed in each population have been taken into account. It has been considered that the concept includes both the absence of disease and a state of well -being where the person has the ability to assume the adverse situations of life, is productive and contributes in its community. When there are factors that have generated an imbalance in mental well -being to the point of causing pathological states, the concept of problem or mental disorder is reached. The Diagnostic and Statistical Manual of Mental Disorders (DSM 5, acronym in English) defines mental disorder such as’ a syndrome characterized by a clinically significant alteration of the cognitive state, the emotional regulation or behavior of the individual that reflects a dysfunction of psychological processes, biological or development that underlie their mental function ‘, thus understanding that mental problems differ from mental disorders in the severity of symptomatology and the degree the psychosocial dysfunctionality that originate. 

This public health problem has been covered by the United Nations Development Program (UNDP) where recommendations are made to guarantee protection and promotion within the framework of human rights and that these principles are included in policiespublic, thus influencing the improvement of population health conditions. Here, mental health is included as a crucial element in obtaining the benefits of these principles and all the strategies that promote free accessibility to the health system and decrease poverty and stigmatization, with the purpose of contributing in reductionof the charge of the disease and the implications that are generated on the functionality of the individual as well as the limitations that generates in his daily life.

Faced with the limitations and/or restrictions that can cause a mental disorder and what this implies for the usual development of the individual, it is important to take into account the aspects that the international classification of functioning, disability andHealth (CIF) on disability, where this broad concept is understood as the incorporation of all situations that affect any function of the body, and/or that this situation represents a difficulty in carrying out some task and/or that represents someRestriction to participate in your community, thus generating visible difficulties in the interaction of the individual who has disability with the environment in which it develops.

Returning to the topic of disability and the charge of disease, it is worth remembering a concept of importance, this is, adjusted years based on disability (Avad), in English known as Disability Adjusted Life Year (Dalys) and referred to by some authors such asyears of lost healthy life (warning);which is one of the synthetic indicators in this issue, whose calculation is carried out by the combination of the years of life lost due to premature death (APMP) and the years lived with disabilities, and accounts for health losses both by death, andFor disability. Its result is due to time and weighted based on life expectancy;points of great importance, when it is intended to compare pathologies that are chronic. It is also valid to note that among the applications of this measure are the determination of priorities in disease control policies and research management.

The aforementioned leads us to a topic discussed in the 2018 OPS report on the burden of mental disorders in the region of the Americas, which describes that 18% of the AVAD in Colombia are due to a compound betweenMental disorders, substance consumption disorders and specific neurological disorders, plus self-management (TMNS), and this places Colombia in the eighth place in terms of the highest figures in the disability fraction due to the TMNs, with respect toThe other countries of the region of the Americas.

Additionally, in the country there is a rising behavior of the rates of potential lost life (AVPP) for mental and behavioral disorders, with a first record in 2009 of 4.63 AVPP per 100 thousand inhabitants, which goes up to20.31 AVPP per 100,000 inhabitants in 2018. So that they are not only figures of high disease loads attributed to mental health, but the trend in relation to these is increasing.

In addition to this there is evidence in relation to the greatest impact of mental health problems compared to other noncommunicable conditions, for example, since 2007 it was estimated that depression produces a greater decrease in health if compared to other chronic pathologies such asangina, diabetes, arthritis and asthma;It was also found that health involvement in depression is more serious when a chronic condition is added, that when depression is presented alone. Although it should be noted that currently in Colombia this is the disorder of the highest prevalence, the above shows the need to prioritize, not only this diagnosis, but all associated mental disorders, in order to reduce the load of disease of this, of diseases of diseasesto which it is usually associated, and therefore also of disability.

Then, in the context of considering mental health disorders as a chronic noncommissible disease and, recognizing the great impact on public health and the imbalance that can generate having any mental health alteration, not only for the individual but also ingreat measure for the society in which he lives (according to what was mentioned above in terms of the mental health and development relationship). This issue must be recognized as a priority on the public agenda, not only as a component of health policy, but of a transectoral nature.

In that order of ideas, Colombia in 2018 adopts a comprehensive and intersectoral policy, drawn under the framework of the integral health care model and integration with other sectors. Within it, in its principles it is covered “to use the best possible evidence”, and among its axes you can find strategies aimed at strengthening knowledge management, including points such as the vigorization of information systems, the strengthening of linesof research, the recognition of cultural practices in order to promote factors that may be protective, the characterization of people with mental disorders, their family and their caregivers, among others.

So that both a need, as an opportunity for the generation of knowledge would be formed here. Taking into account that generating information, especially, of an analytical type that allow the explanation, prediction and/or control of the phenomena under study, and therefore contribution to estimate the determinants of the AVAD and the effectiveness of interventions in relation to the mainNervous system diseases, mental disorders, and various mental health problems;Not only does it generate a very important data, but it supports the ongoing policies and the development of the country. In such a way, that politics transcends letters. In addition, the strengthening of information systems such as health observatories, accommodates for the approach of studies whose methodological approach sources of secondary information are taken, which provide access to a relevant amount of data and a wide period of time,with which more appropriate readings of health situations are facilitated.

Now, it is important to note that this task must only be the health personnel dedicated exclusively to people with mental health problems and disorders, because first, its impact has gained recognition as a priority in public health, and second the human resourceFocused on this type of specialty, it is scarce, with figures of just 2 psychiatrists per 100,000 inhabitants. In fact, another of the barriers on this issue corresponds to the fact that an important proportion of the population that requires being attended does not receive these services, only 34.5% of those who were requested in 2018 were attended at least once inSome mental health service. But, this is not only a subject related to the little personal, but also associates with the patterns of behavior of people in the face of these problems, which are usually influenced by myths and stigmas.

In conclusion, the progressive increase in mental illnesses worldwide is of great significance, which affect the general population with important AVAD figures and especially AVD, where the disability that corresponds to a limitation in operation implies ainstability in the social environment in a generalized way at various levels, work, family and/or school;And thus generates impact on both health and socioeconomic context. Therefore, each of the actors must contribute in the solution, one of the forms being the generation of research around the subject, with an added purpose, which corresponds to giving it the relevance and scientific rigor that deserves in our usual dialogues and debatesIn health, it is unfortunate to demonstrate the high rates that occur from years of life adjusted for disability caused by mental diseases and problems, and the persistence of stigmatization and its associated problems.