7.5 Mental health
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Youth Suicide Prevention Plan:
In Spain there is no National Plan for the prevention of suicide, which targets specifically young people, although its prevention and treatment is established in the Mental Health strategy of the National Health System 2009-2013 (Estrategia en Salud Mental del Sistema Nacional de Salud 2009-2013). While there is no strategy specifically focused on the youth group, they are considered as part of the general population towards which the strategy is addressed, specifically in objective number two devoted to "preventing mental illness, suicide and addictions in the general population."
This strategy is monitored by the Committee of Monitoring and Evaluation (Comité de Seguimiento y Evaluación), which was set up by the previous national strategy on mental illness in order to implement and evaluate it effectively. For the monitoring of Mental Health strategy of the National Health System 2009-2013, the committee will still be in charge and will use the indicators, described in the page 70 of the strategy.
The Spanish interdisciplinary network for the PROmotion of mental health and EMotional well-being in the young (Red PROEM) gives a comprehensive argument for the prioritisation of emotional health and well-being in the adolescents. Their team have launched both a report and roadmap in English, Spanish and Catalan and a two-page document entitled as "No future without emotionally healthy adolescents". According to the WHO, adolescents have the right to grow up in the best environment possible to become healthy and responsible adults who will contribute to society and enjoy a happy and fulfilling life. Among all stages in life, adolescence is a particularly vulnerable period for developing mental health problems. In fact, it is estimated that 110 million young people suffer from emotional problems worldwide. However, these disorders are the least identified and undertreated mental health problems among this population, which places them at risk of developing related problems. PROEM Network report has detected limitations in health and emotional well-being in 7 main issues: • Poor adolescent health and emotional well-being literacy • Delay in the identification of mental health problems in schools and inadequate instruments • Lack of resources and coordination among different stakeholders and regions • Excessive medicalization of mental health and the associated costs • Lack of health and emotional well-being policies coupled with an insufficient budget • Lack of awareness towards certain vulnerable and social minority groups • Increasing unhealthy lifestyles among youth and abusive use of ICTs To cover this gap, four priorities have been consensued to address those issues: • To build adolescent health and emotional well-being literacy • To promote early detection in young people and effective, efficient and evidence-based psychotherapy inteventions and best practices • To develop an efficient network to improve early detection, early intervention and the evidence-based interventions for emotional and mental health problems in youth • To increase the budget for research into preventing and treating mental health problems and promoting mental health and emotional well-being
Overall, the document stresses the need for developing and/or implementing early detection and evidence-based psychotherapy interventions in schools and health interventions designed to treat and/or prevent emotional disorders in the young by specialist mental health professionals or by school and health workers, previously trained by mental health providers (ie, psicologos generales sanitarios).
This report and roadmap has also been cited at the document "Addressing the health needs of adolescents in Europe" approved by the Council of Europe in Feb 2016 and the White Paper launched by TREATme Action funded by EU.
Plans and strategies focused exclusively on the treatment of suicide are elaborated in sectorial plans of psychiatric assistance and programs in different Autonomous Communities. Among the most notable are the following:
It is the Plan of the Community of Catalonia introuced in 2014, its main characteristic is the improvement in the early detection of suicidal tendencies in health centres and emergency telephone lines for the community (061) and attends to the patients at risk, with a prolonged follow-up. The plan has priority projects for adolescents, which implements a comprehensive care plan, an action protocol and assistance programs in the educational environment. In terms of monitoring and evaluation, point 7 of this plan creates a specific committee in charge, that will analyse periodically the impact using the established indicators.
Protocol for the prevention and action against suicidal behaviors (Navarra) (Protocolo de prevención y actuación ante conductas suicidas (Navarra)):
Being a protocol for all citizens, it proposes models of action focused on the prevention of suicide within the educational system. This protocol proposes a series of models of action adaptable to each one of the schools. Within it, the intervention is pursued in accordance with the plan of the centre itself; the reception, listening and attention to the protagonist and the people close to them, as quickly as possible; coordination with different professionals and responsible people; the offer of support to the people affectively close and close monitoring of the evolution of the person involved and/or the affected students. In terms of monitoring, the Interinstitutional Committee for the Coordination of Prevention and Attention for the Suicidal Behaviour was created, which will report the results annually in order to improve and evaluate the protocol.