What can wolves teach us about bonds, intuition, life, and death? When still a psychology student, Patricia Pasquín first stepped into the high-altitude desert of New Mexico, in the United States, she was not aware of everything she was about to discover. She had only arrived there to make one of her childhood dreams come true: to work with wild animals.

The Catalan Society of Clinical Psychology (SCPC-ACAPIR) published a devastating study last June based on the experience of professionals who attend to patients on a day-to-day basis. Its title is already quite significant: Mental health in Catalonia: between institutional discourse and actual practice. Or in other words, politicians sell us one thing but reality is something very different. The president and vice president of SCPC-ACAPIR, María José Miñano and Jesús López, respectively, speak bluntly.

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.

"We took Paula to the emergency room at least a hundred times," say Germán and Beatriz, the parents of Paula Baquedano Martínez, who for five years fought for someone to help her get out of the pit she was in. She suffered from borderline personality disorder and self-harm became her daily life.

Doctor Josep Tristany is the director of the Mental Health and Addictions Master Plan of the Generalitat, but just over two years ago he was on the other side, attending to patients. It is clear that he knows what he is talking about and that he is eager to improve the system, but he is also aware that it will not be easy at all.

The prisoner who committed suicide this weekend in a cell at Quatre Camins had been living in the intake module for months, separated from the rest. According to what ARA has learned, he was living in isolation as a measure to protect him from other inmates from whom he had received death threats. He had been in this situation since June, and although this measure allowed him to leave his cell for two hours a day, he had not left for about a month.

You have had an impossible week at work: one meeting after another, emails at all hours, a project that has become complicated, and a boss who asks for more than you can handle. Friday arrives and, instead of stopping, you tell yourself that you can still hold on a little longer. You work through the weekend, give up the gym, eat in front of the computer, and keep postponing rest until the situation improves. You might think you are being strong. But, according to neurologist Mónica Kurtis, you are doing exactly the opposite of what being resilient means.

You have just argued with your partner and are convinced that you are right. Instead of explaining it to a friend, you open an artificial intelligence application and describe everything that happened to it. The answer does not wait: it understands how you feel, validates your discomfort, and explains to you why your reaction is so understandable. It might even suggest a message for you to send to them explaining how you feel. When you close the device, it is easy to leave with the feeling that someone has truly listened to you and that, moreover, you were the one who was completely right.

Lindsay Clancy, a 36-year-old woman from Duxbury, worked as an obstetrics nurse at Massachusetts General Hospital when, on January 24, 2023, she murdered her three children, aged 5, 3, and 8 months. Her case, particularly complex, has returned to the forefront of current events following the trial against her, which took place this July and August and concluded on Thursday. A trial that, having become a viral phenomenon on social media, has reopened the debate on postpartum psychosis.What are the keys to the case?

The trial, which has been heard for sentencing, must determine whether the accused was criminally responsible for her actions at the time of the murder. Clancy's defense argues that she was not aware of her actions at the time of the events and therefore cannot have criminal responsibility. Lindsay Clancy was diagnosed with postpartum psychosis, a mental pathology so rare that the doctors who treated her before the fatal episode occurred were not familiar with it. Despite asking for help multiple times from family and professionals, no one detected the severity of the illness in time. In the months leading up to the crime, the accused visited several psychiatrists, voluntarily admitted herself to a treatment center, and took medication. During the trial, evidence has been presented confirming that Clancy was medicated – she ended up taking 13 different psychiatric medications in the months before the crime – and that she suffered from a severe psychotic episode aggravated by undiagnosed postpartum depression. Jose Carlos Fuertes, a doctor specializing in psychiatry and forensic medicine with over 40 years of experience in the field, explains that psychotic disorders can act in a "silent" way: "We have the image of a severely psychotic mentally ill person as someone who is shouting, disguised, disorganized. It doesn't have to be. A person can have relatively normal behavior, except in one aspect of their life where the delusional idea appears, which usually arises because there are hallucinations." Fuertes argues that Lindsay was "acting in a very important psychotic state." According to the expert, she had the belief that life was a disaster and that the best way to not make those she loved most, her children, suffer was to take their lives and then commit suicide.What went wrong?

Fuertes, with her extensive experience and with the information available on the case, argues that the woman is both aggressor and victim: “This woman was ill. She was asking for treatment. She expressed delusional, absurd, and irrefutable ideas through logical reasoning. They abandoned her and she acted”.Carla Vall, a lawyer and criminologist specializing in criminal law and gender, also argues that the case cannot be interpreted solely from the story of a mother who killed her children, but rather forces us to ask what went wrong before the events and what responsibility the system bears. “We are faced with a woman who asked for help from her entire environment, both personal and professional, and who, partly due to bystander effect, no one individually took responsibility to say: ‘Something is happening here and it needs to be stopped.’” Vall points out the obvious shortcomings of the United States healthcare system, which was unable to adequately track Lindsay's mental health status: “This teaches us many things about the United States healthcare system and the psychiatric system: the lack of coordination between professionals, the lack of specialization, the lack of family support…”, he points out. José Carlos Fuertes agrees with the idea of the multiple neglects of the North American health system: “There are multiple problems here. She was not treated; when she asked for help, she was not given it adequately; an admission was not proceeded with. And she was allowed to act,” he denounces. In Spain, there is one case of postpartum psychosis per thousand births, according to Fuertes, who points out that once these women receive adequate treatment and become aware of their actions, they cannot bear the feeling of guilt and some end up committing suicide. "I have the conviction that the feeling of guilt she will have when she is treated and improves from her hallucinations, from her ideas, will make her realize what she has done."To be or not to be responsible

It is not only experts who exonerate the woman. Throughout the trial, hundreds of women dressed in pink have gathered in front of the courthouse to show their support for the accused and highlight the responsibility of the medical system and health professionals in the case. They maintain that Clancy was not adequately monitored and that medical neglect would have led to the tragic outcome. A campaign has also been launched to raise funds to help Lindsay's parents cover trial expenses; they have already raised over $1 million. It is true that not everyone sees it this way: the mobilizations have also generated a wave of reactions on social media arguing that a crime of this magnitude cannot be defended. In any case, the mobilization in defense of Lindsay does not intend to exonerate the triple homicide, but rather to highlight the neglect by the healthcare system of mothers with mental health problems. “There is a part of gender blindness that consists of this idea that the figure of the mother must be able to handle everything and that, in the end, she has extreme responsibility. We have a very important blind spot, which is the mental health support for mothers,” argues Vall.  “Being or not being responsible is one of the central axes of any criminal proceeding, because what we are analyzing is whether the person, at the time of committing the acts, could have had awareness and control of their actions,” she explains. This should not be confused with being, or not being, the material perpetrator of the acts: “This does not mean that you are not equally responsible for the acts. It has to do with the consequences that the process will have for you. It is not a process of social irresponsibility. I believe that these two things must be separated,” details Carla Vall, who points out that there is a tendency to make this person a “scapegoat” and that there is a great social responsibility in this case: “The number of women who are gathering at the courthouse doors to support her are telling us about a social problem associated with the mental health of mothers in postpartum. I think there are public policies that must address this and that must be able to correct and accompany these dynamics of mental saturation, insomnia, psychosis, and severe depression.” The lawyer argues that the mental health care and attention of mothers is also essential for the protection of children, who in cases like this end up being the main victims. “What this scapegoat dynamic does is forget the central figure of all this, which are these three children who have been murdered. The way not to forget them and to put childhood at the center is to be able to identify where the system and the person fail at such a delicate moment as the postpartum period.”

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The consequences of the social media business model may be catching up with Meta, the parent company of Facebook and Instagram. The giant led by Mark Zuckerberg faces the first session of a trial this Tuesday that could place limits on what part of the US administration considers digital excesses. 29 US states, led by Colorado, California, New Jersey, and Kentucky, accuse the multinational of having introduced features and dynamics on its main platforms that generate addiction among children and adolescents.

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Hormones have often been used to explain any discomfort in women. But, according to psychiatrist Gemma Parramon Puig, head of the psychiatry section at Vall d'Hebron Hospital, this perspective has hidden another reality for decades: a medicine built by taking the male body as the standard and biases that have delayed diagnoses, medicalized social problems, and made women's health invisible. In "It must be the hormones (Vergara), argues that incorporating the perspective of sex and gender is essential for better medicine.

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We are increasingly better at understanding Alzheimer's. We know, for example, that dementia, which is its main consequence, is caused by the progressive degeneration of neurons due to an excessive accumulation of proteins called β-amyloid and tau. This has allowed us to design new ways to diagnose the disease and also the first specific drugs that can slightly delay its progression. But we still have many unanswered questions, and one of the most important is why women have a higher risk of developing it.

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When a woman dies during pregnancy or postpartum, we immediately think of hemorrhages, infections, thrombosis, or obstetric complications. But the records from countries with better surveillance systems have made an still uncomfortable cause of maternal death visible: suicide.The MBRRACE-UK report, an international reference in the analysis of maternal mortality in the United Kingdom, is conclusive: between six weeks and one year after pregnancy, suicide is the leading cause of maternal death. If we add deaths related to substance use, the scientific message is clear: mental health, addiction, and social vulnerability are today central determinants of survival for many mothers.In Spain, a pioneering study has published data on this reality for the first time: between 2016 and 2023, thirty women were identified who died by suicide during the first postpartum year, after a birth oran advanced gestational loss. The majority of these deaths occurred beyond the first 42 days. The quarantine is an administrative convention; a postpartum depression, a puerperal psychosis, a situation of gender-based violence, poverty, substance abuse, or lack of support do not disappear because a month and a half has passed since the birth.

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A recent report published in the United States (RAND foundation) states that the use of artificial intelligence chatbots for mental health advice among adolescents and young adults has increased by more than 40% in the last year, and that almost 1 in 5 report having used AI tools for support. 19.2% of young people between 12 and 21 years old said they had used AI chatbots (Gemini, ChatGPT, Meta AI, or Character.AI) for help or advice when they felt angry, nervous, sad, or stressed.

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Se tiene que morir mucha gente is a title that suggests a pessimistic view of life, a bad temper that denotes existential weariness and an extra dose of sarcasm. It fits with what the series released by Movistar+ proposes, created by the comedian, screenwriter, and writer Victoria Martín. Co-creator of the podcast Estirando el chicle, a successful phenomenon thanks to its irreverent and feminist content, Martín has acquired her own voice with a tendency towards self-parody and black humor that reflects the insecurities of her generation. She also turned this universe into a novel, which she has now adapted for the screen with a raw and acid style.A lot of people have to die works from a very generational perspective, especially with the female audience. It revisits the crisis of the thirties of three lifelong friends: Bárbara (Anna Castillo), Elena (Macarena García) and Maca (Laura Weissmahr). The first is addicted to benzodiazepines, the second is pregnant —unintentionally— by a millionaire much older than her, and the third has a tendency towards toxic relationships. Their love-hate bond and having to share an apartment will further complicate their existence.The best thing about the series are the witty and agile dialogues that give a lot of personality to the protagonists. The idea of including an alter ego of Bárbara as a child as another character to underline her immaturity is sensational, especially because it portrays the crueler and unfiltered nature of an indignant girl. But more than a discomfort against the world and the environment, the big problem the series wants to explain is the lack of self-esteem. They can't stand people, but above all, they can't stand themselves.Mental health problems are a constant in the series, but filtered through black humor. And here is where some of the most uncomfortable aspects emerge. Addiction to benzodiazepines is lightly integrated into the character of Bárbara, and the pregnant woman's behavior of drinking alcohol and smoking is hard to perceive as part of the comedy. There is a trivialization of these circumstances that, depending on how you look at it, is difficult to manage. The series trusts that humor will defuse the seriousness of the events, but ends up falling into the romanticization of mental health problems. Too often, some fictions that want to portray the female universe turn self-destruction into an attractive attribute of the characters, into an element of fascination. Addictions, anxiety, or risk-taking behaviors become the mark of their personality to endow them with charm and complexity. This happens very especially when these characters want to present themselves as irreverent, modern, and indomitable. There is a comical idealization of discomfort and emotional instability. It's as if mental health problems endowed people with charisma. And when this confusion is transferred to real life, then we are not talking about comedy, but about drama.

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Nearly 1.2 billion people worldwide live with a mental disorder, almost double the figure recorded in 1990. This is a blatant increase that places them as the leading cause of disability ahead of cardiovascular diseases and cancer, and they already account for one in six cases, according to a study by the Institute for Health Metrics and Evaluation (IHME) and the University of Queensland. The research findings are published in the journal The Lancet and indicate that they disproportionately affect adolescents between 15 and 19 years old and women. "These upward trends may reflect both the lingering effects of pandemic-related stress and long-term structural drivers, such as poverty, insecurity, abuse, violence, and declining social connectivity," explains Damian Santomauro, an associate professor at the Queensland Centre for Mental Health Research.

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The war between the United States and Israel against Iran and the consequent blockade of the Strait of Hormuz is beginning to have a direct impact on the mental health and working conditions of the sailors trapped in the area, who, according to data from the International Maritime Organization (IMO), number around 20,000. This pressure is confirmed to ARA by Amy Liebthal, spokesperson for the International Seafarers' Welfare and Assistance Network (ISWAN), an entity that operates a free, confidential, and multilingual 24-hour telephone assistance service (Seafarer Help), aimed at seafarers in situations of risk and their families.

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35% of Mossos d'Esquadra agents suffer from depressive symptomatology, 39% from stress, and 36% from anxiety. This is one of the main conclusions of a study conducted by the Universitat Ramon Llull, which has been published by the scientific journal Frontiers in psychiatry. Apparently, it might seem that the critical situations that agents must face on the street could be a significant trigger for mental health issues, but the study reveals that internal factors such as lack of institutional support or bureaucracy have an even greater impact.

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It's six o'clock on a Sunday afternoon, and Paco is heading back to the nursing home after having lunch at home with his family. The moment he steps out the door in his wheelchair, Antonia, his wife, collapses onto the sofa. "This breaks my heart," she says, unable to stop the tears from streaming down her cheeks. A recent decline in Paco's health has forced him to move into a care facility while she continues to live at home. Antonia has cared for her husband for years, even at the expense of her own health, and although the situation was no longer sustainable, they tried to postpone his move as long as possible to avoid being separated. Like them, many elderly couples are forced to separate after a lifetime together. While moving into a care facility is often the most logical decision at this stage of life, taking the step involves emotional difficulties. Paco is experiencing this change with some anxiety, because he says that many elderly people die in the center and that he would like to be surrounded by his family in his final days. "The centers are often the final destination; therefore, being admitted can bring with it a more existential loneliness, the feeling of never having been so close to death," acknowledge Laura Coll-Planas, a doctor with the Catalan Society of Geriatrics, part of the Academy of Medical Sciences of Catalonia, and Dolors Fitó, a member of the same society representing residents.

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A quarter of the world's population will suffer from a mental disorder during their lifetime, according to estimates by the World Health Organization (WHO), which considers mental health one of the major challenges for improving care. There is more data that explains this concern: 15% of adolescents will also experience distress; suicide is the second leading cause of unnatural death among minors. No one escapes falling into a state of anguish, depression, anxiety, or an eating disorder, although there are individual factors (low self-esteem, illness, or addiction) and socioeconomic factors (stress, unemployment, discrimination, injustice, or unwanted loneliness) that can contribute to suffering.

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