Position of the Order

There is no economic recovery without taking care of the Mental Health of citizens

10.October.2012

In the current situation of economic crisis, the containment of costs and the establishing of priorities based on cost-effectiveness criteria and based on evidence gain special relevance. The Psychological Intervention allows for a reduction in direct and indirect costs from health and disease and, in this sense, contributes to an improvement in the efficiency of health services. On the other hand, it allows for a substantial improvement in the health and quality of life of citizens which is reflected in an increase in productivity and a reduction in absenteeism from work.

The impact of the economic crisis on the health of citizens is known. In Portugal, its impact is reflected in an increase in the number of suicides and the consumption of anti-depressants and anxiolytics which has been rising in recent years.

There is evidence of the effectiveness of psychological intervention in the improvement of the health of the citizen and in the reduction of direct (reduction in the number of appointments, the number of days in hospital and the consumption of medication) and indirect costs from illness (reduction of absenteeism; reduction in costs to the State with tax benefits for the patient and less productivity ).

The Ordem dos Psicólogos Portugueses (OPP) published relatóriowhich brings together a set of studies which shows the contribution of Psychology to the reduction of costs and the improvement in the efficiency of health services.

Psychological intervention presents a cost-effectiveness which not only allows to pay for the intervention itself but also provides gains in health. This occurs because psychological intervention has reduced costs and high recovery rates when compared to the high costs of incapacity.

Evidence shows that psychological intervention allows for a saving of between 20 to 30% in direct health costs, through the reduction in the use of health care. A psychological consultation even allows for a reduction in family medicine consultations per patient. In patients with chronic pathologies such as diabetes, high blood pressure, cancer or asthma, psychological interventions aimed at depression and anxiety allows for reductions in total costs from patients of approximately 20%.

A study of psychotherapy in healthcare showed that 60.4% of participants reported having sought, in the past 3 years, some kind of psychological support. During the period to which the study relates (the last three years), 28% of the total sample sought professional help. The results from this study allow us to see that most consumers improved and are satisfied with the psychological intervention undertaken which includes verbal therapy. The intervention only based on medication is associated with the worst indexes for improvement and satisfaction. An improvement in the general emotional condition is found in 80% of cases followed by psychologists.

Recently, the General-Director of the European Committee for Health and Consumers, Paola Testori-Coggi, stated the relevance of Psychology for an improvement in the health and well-being of citizens and for the implementation of European health strategies such as “Health for all”.

Analysis carried out by the OPP has shows that there are qualified Professionals who are ready to contribute to an improvement in the mental health of the population and to the economic recovery of the country. However, this has been a missed opportunity because no political commitment has been made for the implementation of the psychological consultation nationwide.

The distribution of psychologists is asymmetric and does not meet demand needs, for example, the Alentejo is the region in the country with the highest number of suicides and with the biggest aging population, and is also the region with the least number of physiologists who are integrated in the National Health System. In this way, resources are wasted and the health of the population does not improve.

The absence of a strong investment in the creation of a good national coverage of psychological consultations in healthcare services, namely in primary healthcare, would have an immediate impact on the citizens and on the savings of the National Health System.

On this Day of Mental Health, the Ordem dos Psicólogos (OPP) advises that it is developing an action plan for the implementation of the figure of the Family Psychologists in Primary Healthcare. The Family Psychologist will be the first connection between the citizen and psychological care and will ensure a greater coverage of access and health needs of the population.

A better organisation of the psychological consultation in primary healthcare will allow for the development of more effective responses to needs and will answer to the expected increase in the search for psychological support.

This professional should work closely with the family doctor in the identification and early diagnosis of complex disturbances which require specialised care. Therefore, in addition to psychological intervention, which is already part of their job, the Psychologist may carry out activities of triage, refer patients to specialists when the complexity and specificity of the case so requires (example: psychologist specialised in children and adolescents). Through close monitoring, the identification and early diagnosis of situations of greater complexity, one can intervene properly and refer patients to specialised care, thereby contributing to a greater efficiency of the psychological intervention, to an improvement in the health of citizens and to the economic recovery of the country.

There must be a clear statement in which authorities and other health agents make a commitment to the promotion of the Mental Health of the Portuguese People. The Ordem dos Psicólogos (OPP) is available to actively contribute to the development of innovative solutions which allows for a quicker recovery from the crisis.

This position can also be consulted at here.