There are far fewer psychiatrists in Spain per inhabitant than in many other European countries
A recent study carried out by the European Commission and the regional office for the World Health Organization (WHO) into mental health provision in 42 countries: the EU, seven non EU southern European states (Albania, Bosnia Herzegovina, Croatia, Montenegro, Serbia, Macedonia y Turkey), Israel, Norway and Switzerland and five ex Soviet Republic states (Azerbaiyán, Georgia, Moldavia, Rusia y Uzbequistan) found that mental health provision in Spain is below the average for all these states. Spain only has 6 psychiatrists per 100,000 inhabitants compared to 30 for the same number of inhabitants in Switzerland for example and the average for all the states included in the study was found to be 9 psychiatrists per 100,000 inhabitants.
The study looked at the number of beds available in mental health institutions, mental health funding and the number of prescriptions for anti-depressant drugs as well as the number of professionals working in mental health and their training.
In general, the report recognised that most countries have made progress with regards to mental health issues. However, it criticised the fact that the type and quality of treatment for mental health problems still depended on where a person lives. It also concluded that the type and quality of treatment did not only depend on the prosperity of a country but on politics, attitude to mental health issues and health systems.
Marc Dabzon, the director of the office for the WHO pointed out that while the quality of mental health provision could vary depending on money available for a country’s health system in general it was unacceptable that it varied due to the lack of commitment or understanding or good practice in the area of mental health.
One example of this diversity can be seen in the number of beds available in mental health institutions. The report on the study clearly identified countries where there wasn’t enough provision in this area (Albania and Turkey). It also looked at countries that opted for a system of social care where the mentally ill could remain living in society such as in Italy, some provinces of Spain and the UK.
In the case of Spain there are big differences in mental health provision between regions. For example in Extremadura, there are nearly 80 beds for psychiatric patients per 100,000 inhabitants compared to Galicia which occupies the last place on the list with only 20 beds. Murcia, occupies fourth place on the list for the number of visits to psychiatrists with 20,000 visits per 100,000 inhabitants (this number is only higher in Norway, Finland and Slovakia).
Belgium, France, Germany and Holland all have a high number of beds available in psychiatric institutions as well as good social care provision. However, which model to follow continues to be the subject of intense debate in many countries and there appears to be a move towards deinstitutionalization and care in the community for mental health patients. In the case of children and adolescents 31 out of the 42 countries had social institutions available for their treatment while only 4 had provision for special activities for the elderly (including Spain).
Matt Muijen, from the WHO highlighted the fact that one of the biggest difficulties in carrying out this study was the lack of information available in many of the countries included in the study. He stressed that this lack of information was a barrier to improving mental health care.
Related: Healthcare in Spain