According to the Spanish Society of Psychiatry and Mental Health (SEPSM), mental health has become an urgent public health challenge driven by the rising demand for care and shortage of clinicians.

Speaking with Univadis Spain, part of Medscape Professional Network, Marina Díaz Marsá, MD, PhD, Department of Psychiatry, Hospital Clínico San Carlos, Instituto de Investigación Sanitaria San Carlos, Madrid, Spain; President of SEPSM, said that the “pandemic brought mental health to the forefront, which is a positive element, but it is also true that the population has confused mental disorders with the discomfort of daily life and sometimes compete for a psychiatry appointment.”

“This confusion and the pathologizing of life’s problems, as a result of a less resilient society with lower frustration tolerance, have worsened the care provided for serious mental disorders, which compete with these everyday discomforts for psychiatric attention. Everyday discomfort can be a negative emotional reaction to grief, illness, or worry and should not be confused with people who have major depression, symptoms of schizophrenia, obsessive-compulsive disorder, bipolar disorder, or a serious eating disorder,” said Díaz Marsá.

Díaz Marsá added, “suffering is part of life. It has been claimed that well-being is total happiness, which does not exist. Negative emotions can last for a brief time; they can be faced with one’s own resources and with support from close friends. Mental illnesses that require specific treatment so that the individual can be functional are different. Depression and sadness are two different things. Major depression is associated with a risk for suicide and can be a severe disorder.”

Workforce Pressures

SEPSM reported that mental health problems affected 29% of the Spanish population, underscoring the growing prevalence of these conditions and the urgent need to strengthen specialized care. The SEPSM noted that this situation required immediate action. Spain has approximately 4400 psychiatrists working in the public healthcare system, equivalent to 9 professionals per 100,000 inhabitants, a ratio markedly lower than the European average of 18 per 100,000 inhabitants. In addition, 20% of psychiatrists in Spain are expected to retire within 5 years, a trend that threatens to deepen the existing shortage.

“This shortage also applies to clinical psychologists. In Spain, we had approximately 6 per 100,000 inhabitants, while the European average was 18. This ultimately led to longer waiting lists, less time devoted to each person, and significantly longer intervals between appointments than before the pandemic. It also made it difficult to structure specific programs for different mental disorders,” said Díaz Marsá.

The SEPSM estimated that Spain would need to add 370-565 psychiatrists annually over the next 5 years to reach European standards. The same applies to clinical psychologists and nurses.

Díaz Marsá noted that one solution is to “create teaching units so more psychiatrists and clinical psychologists can be trained, then retain talent with desirable working conditions and accelerate the recognition of some specialist titles from outside Spain, so that those who meet Spanish standards can practice here.”

Primary Care and Prevention

Referrals to mental health specialists originate in primary care, and the SEPSM emphasizes the need to provide the public with skills to manage everyday distress. “We,” Díaz Marsá said “advocate including them in education since they would allow better emotional management and the identification of emotions. Life is like a puzzle, and in it, you must devote time to leisure, rest, work, friends, family, and self-care.”

If you devote too much time to one piece of this puzzle and too little time to others, it will not fit. We must keep this balance in mind, allow ourselves to rest from the work world, to have time for family and for diverse connections.”

She identified additional contributors to mental health problems, including work stress, poor diet, and personality traits such as perfectionism and high self-demand. When sustained over time, these factors can increase the risk for depression. She also noted the rising rates of childhood and adolescent mental disorders linked to excessive screen time, social media use, cannabis consumption, and unwanted loneliness. “The lack of conciliation is leading our society to have young people alone, just like older people. Anxiety and insomnia are bases for the appearance of mental disorders.”

Distress in daily life vs mental illness: what to do in each case according to SEPSM

If you experience distress in daily life:

• Acknowledging and identifying negative emotions.
• Speak with friends or family because social contact often helps in reducing stress.
• Maintain healthy routines, including regular exercise, a balanced diet and leisure activities.
• Use strategies to manage frustration and stress. In this context, distress is usually temporary.

If you suspect a mental illness:

• Seek professional help, if necessary, especially from psychiatrists and psychologists.
• Follow the recommended treatments, whether pharmacological or psychotherapeutic.
• Be patient because recovery is often gradual.
• Do not hesitate to ask for assistance. Individuals with mental illnesses can lead full lives, succeed at work, and plan for the future.

Díaz Marsá reported having no relevant conflicts of interest. 

This story was translated from Univadis Spain, part of the Medscape Professional Network.