What is happening with mental health?
The Catalan public mental health system, especially for young people and adolescents, is under great strain. It is no consolation that, compared to the rest of the State, Catalonia is better off in this care field. It is not, because the professionals, who in recent months have raised various alarms in the form of reports and manifestos, still cannot cope. And families have to endure long waiting lists or, if they can, opt for private care –a visit with a psychologist or a psychiatrist costs between 50 and 120 euros–. Although the Generalitat has allocated more resources in recent years, the shortcomings remain notorious.
The fact that a large part of the care is outsourced to a wide variety of entities hinders integration, coordination, and planning. The providing entities often compete with each other. Both professionals and the administration itself are aware that it is not viable to do everything directly from the public sector, but they ask to clarify the map and continue adding resources to it. Above all, there is a lack of specialized professionals, primarily clinical psychologists. Improving shared information about patients is another essential objective.
In today's newspaper, we explain some serious and sad cases. It is true that if a minor has a serious mental disorder, they will likely be visited quickly at a CSMIJ – child and adolescent mental health center – and will be correctly attended to at the beginning, in the acute phase. For serious cases, there are day hospitals and sub-acute units, with 110 acute beds and 67 sub-acute beds. Those who manage to get in are well cared for. The follow-up, however, will relax. Especially when the minor is no longer a minor. When it is time to become independent and enter the labor market, the situation becomes complicated again.
In any case, when the system really fails is when it comes to addressing these issues before they become serious. Basic care fails. The CSMIJs are overwhelmed: the goal of lowering the average wait time from 90 to 45 days has led to faster and lower-quality visits, when psychotherapeutic processes are complex. Medicalization is the quick way out. In fact, the ombudswoman warned in the 2024 report that the prescription of antidepressants to children under 15 had tripled in Catalonia in three years.
What is the social change behind the rise in child and adolescent mental health problems? The pandemic finally opened the floodgates. In the background, there is the economic precariousness of many families, migratory grief, difficulties in accessing housing, the abuse of screens and social networks, childhoods and adolescences without well-established limits, the pressure on minors to be successful and happy, the lack of social tolerance for discomfort, the educational crisis... And to all this, we must add a positive element: the destigmatization of mental illnesses, which has brought to light cases that previously remained hidden.
Child and adolescent mental health is today a serious, growing social problem that must be addressed in a serious and priority manner.