Mental Health in Mexico
It seems that the topics of deportation and the matter of separating parents from their children has been everywhere lately. This made me want to explore (setting aside any arguments about the legal/political issues associated with this on either side) what is this really doing to these kids, these families, and what kind of mental health treatment is available in Mexico for these people? How is mental health treatment approached in Mexico?
So what really happens when a child experiences a trauma like being separated from a parent? Childhood is when a lot our core beliefs, patterns of thought, and coping skills develop. This is a time that really sets the stage for how we relate to others and the world around us. A trauma like this certainly could lead to depressive, anxiety or trauma related disorders as well as problems with attachment. When a trauma like this happens it may lead the child to view the world as an unsafe place, have difficulty trusting others, develop feelings of inferiority, or have difficulty establishing their own self-identity. It would not be unusual for the parents in these situations to develop extreme feelings of guilt, hopelessness and subsequent depressive, anxiety, or trauma related disorders.
I wondered if providers had been seeing an increase in people seeking mental health treatment specifically related to these issues. So I went down to Tijuana’s only psychiatric hospital, Hospital de Salud Mental de Tijuana and met with some of the providers to learn about the treatment and perspective of mental health in Mexico. While the providers I spoke with said they may have seen a very modest increase in hospitalizations/treatment specifically related to these issues it didn’t seem to have the major impact I suspected it would.
There is still a fair stigma about mental health issues in the U.S. and the providers I spoke with felt there was a similar if not harsher stigma about mental health treatment in Mexico. This stigma often discourages people from getting mental health treatment, frequently a person may be afraid to tell his or her family there is a need to seek treatment, or may be actively discouraged to do so if it is discussed. Mental health conditions are frequently seen as something that should can be managed by religious or family support. This puts individuals experiencing a mental health condition in a very difficult spot and seemed to be the primary barrier to seeking treatment.
I toured the facility for about two hours while the doctors I met with patiently answered my 1,001 questions. About five minutes into the tour it hit me like a Mac truck, these people have it right. There were some stark differences in how treatment is approached and I started to take note of what we need to bring to the states.
1. Length of stay. The average length of stay for inpatients is about 2 weeks. That is the average, frequently stays are 3-4 weeks. I compared this to the inpatient units I’ve worked on where the average length of stay is probably 2-3 days. If someone’s length of stay is approaching a week administration usually starts to sweat. Why is this? The most basic answer is insurance coverage. Generally speaking an insurance company will only provide coverage for a psychiatric hospitalization if a person meets one of three criteria: they are an imminent danger to themselves, others, or are gravely disabled (cannot provide for basic needs like clothing, shelter, food, or water, due to a psychiatric illness). This means that people are generally not hospitalized until their symptoms are so severe it becomes a liability if not treated. What’s more, the minute a patient no longer meets this criteria insurance coverage stops (some really good plans may authorize a few additional days, but this is pretty rare). This basically means we are using inpatient treatment as basically a means to stabilize someone to the bare minimum level, or until they are no longer assessed to be a liability.
2. Holistic treatment. This kind of goes along with the idea of what really is the purpose of treatment, to simply stabilize someone, or actually provide treatment of the symptoms. Most inpatient units in the states will offer things like group therapy, AA meetings, and maybe art therapy, these activities are fairly minimal and not the largest part of treatment. I was amazed to see at Hospital de Salud Mental de Tijuana they had displays of expansive works of art therapy done by patients, there were volley ball courts, a gym, yoga classes, even a garden that patients tend to and what is grown is used in the meals served that are specially planned by a nutritionist. We know that good nutrition, exercise, a sense of community and purpose are vital for our mental health and yet we put such a minimal focus on it.
3. Community outreach. As mentioned above the stigma about mental health treatment is prevalent across borders, these providers are rolling up their sleeves to fight it. They host meetings, and also visit schools and other community facilities to provide education about mental health to the community. Starting in elementary school these providers are actively working to change how the next generation perceives mental health.
I left the facility dumbstruck and with one thought. As providers, as a community and society we need to be better. I believe that the vast majority of providers do want to give the best care possible and heal their patients but become limited by administrative and financial barriers. like any other kind of medical issue, doing primary prevention is without a doubt the best thing we can do, we first need to start educating our kids about mental health treatment and and we need to be better about community outreach. We also need to fight for the ability to actually be able to treat our patients instead of giving them the bare minimum level of stabilization. It’s up to us to talk to our legislators, and to push for expanded coverage of treatment. Let’s be better.
The subject of exploring the paths taken by graduates feels more interesting when there is room for a reader to stop and ask their own questions. A career story can show the changes and decisions that a short job title leaves out. That connection helps me see why graduate career pathways can be worth a closer look. I am more curious about the process than a polished result, because the steps in between are usually where questions appear. Which questions would make an interview with a graduate useful for current students?
I find making maths understandable through clear examples easier to think about when there is a concrete question to start from. Following one worked example slowly can reveal the reasoning behind a method. This is why I would approach mathematics learning support with a specific question rather than a fixed expectation. I am still thinking through the details, and a small example would help me picture how this works in practice. What helps a learner move from copying a solution to choosing a method independently?
The topic of finding agreement through respectful discussion gives me a few things to think about, especially when the discussion moves beyond general advice. Listening for a shared concern can make disagreement easier to work through. It gives me a more concrete starting point for thinking about consensus building skills. The part I would like to explore further is what happens when the idea meets a real situation with its own limitations. What helps a group move towards a decision while keeping different views visible?
Thinking about keeping educational competitions enjoyable, I find the smaller practical questions more interesting than a quick conclusion. A challenge can be motivating when the experience matters alongside the final result. I would use that point as a starting question when considering student learning competitions. I would probably come back to this question after trying to work through one concrete example rather than deciding immediately. How can a competition reward curiosity and persistence as well as correct answers?
There is something approachable about discussing choosing books for a varied reading collection through situations people can actually picture. A balanced collection can include familiar interests and a few titles that invite something new. It also gives the phrase book selection ideas a clearer meaning than a label on its own. The part I would like to explore further is what happens when the idea meets a real situation with its own limitations. How do you choose books for readers with very different tastes?