Keynote

Mental health problems and addiction know no boundaries, and are a shared challenge for the United States and Mexico, the Mexican National Commissioner Against Drug Addictions and For Mental Health told the Mental Health & Public Policy symposium.

Dr. Guido Belsasso gave a digitally recorded keynote address at the symposium at UC Berkeley and UCLA, connected via video teleconferencing.

Dr. Belasso said some 15 million Mexicans suffer from mental disorders and that President Vicente Fox has made mental health a major priority after seeing the condition of the nation's mental hospitals.

The people of both or our nations, he said, are inextricable linked since millions of Mexicans live in the United States and millions of people of both countries cross the border daily.

People who have mental disorders are extremely vulnerable to drug, alcohol and tobacco addiction and their problems become problems for both nations, he noted.

Dr. Belsasso spelled out the priorities of Mexico's Health Ministry as treating mental health and addictions, migration and neuroscience. He said Mexico has worked extensively within the World Health Organization to promote its major focus on mental health.

Mexico, he said, had the first mental hospital in this hemisphere back in the 16th Century, but today mental health is the most neglected area of public health.

Major problems he cited include the deterioration of the psychiatric hospitals, a low and inadequate quality of care, considerable backlogs and deficiencies, a high cost of disabilities and stigmatization.

"You need to address these mental health problems (of Hispanics) in the US and we need to address them when they come back to Mexico," he said.

"There are a lot of things we need together," Dr. Belsasso explained. "There is a lot of research to understand the problems, the vulnerabilities of these people."

He cited talks with California members of congress on cooperative effort and meetings between US Health and Human Services Secretary Tommy Thompson and his Mexican counterpart, Dr. Julio Frenk.

The two secretaries, he said, have met many times, recognizing shared problems and working to develop better health care for both.

A series of Power Point slides were presented by Dr. Gerardo Heinze, current Director of the Ramon de la Fuente Muniz National Institute of Psychiatry.

Dr. Heinze focused on an action plan to fight stigma, develop a diagnostic program focusing on early screening of children, promote mental health committees in the states and municipalities, create popular insurance to cover some 35 million uninsured Mexicans, strengthen academic and research, train personnel and build pro mental health committees among Mexicans in major Hispanic population centers in the US.

He said Mexico faces a formable challenge in that it has only half as many psychiatrist and psychiatric nurses per 100,000 persons and one third as many psychiatric beds as the US.

He said that the 11 million Latinos in the United States who make up 12 per cent of the population have the least access to health care. In California alone there are 34 million people, one third of them of Hispanic origin and 80 per cent of those with Mexican heritage.

Mexicans immigrants, he said, have one-half the prevalent rates of psychiatric disorders of the US-born population, including Mexican Americans, but US born or longer term immigrants have higher rates of mental disorders on a par with other US citizens.

Citing the importance of cross cultural research, Dr. Heinze said that the place of birth has a more profound influence on psychiatric risk factors than demographic factors such as age or gender.

The key difference, he said, has to do with family related factors such as the extended family and network which creates less vulnerability.

He said the findings support the negative effects of acculturation and the positive effects of retention of traditional Mexican culture.

Latinos in the United States, he said, are poorly connected to health care, many are uninsured, and most face cultural, language, distance and financial barriers.

But given the prevalence of mental disorders among Mexican Americans, he said, the inability to get care centers on lack of knowledge of where to get it, the lack of convenient treatment centers, the inability to get to the centers and the lack of professionals who speak Spanish.

Hope, he said, springs from the number of cross border programs and contacts including the cooperation of the health secretaries in both nations, bi-national health commissions, border cooperation agencies, agreements between research universities in both nations, cooperation to reduce drug demand, joint academic and technical events, and frequent high level contacts, citing specifically meetings between US President George W. Bush and President Fox.