Life in a nutshell
In an article recently published in the Journal of Medicine by Ólaf B. Einarsson, project manager at the Directorate of Health, it is revealed that 17.6% of adults in Iceland (18 years and older) dispensed antidepressants in 2019. In the OECD report on the state of health issues in member countries, Health at a Glance, it is reported that the use of antidepressants has been the highest in Iceland for some time. For the year 2019, it was 147.1 daily doses per 1000 inhabitants (DDD/1000 inhabitants per day) and during the year 52,000 Icelanders dispensed antidepressants. Thus, the relative number of those who dispense antidepressants here in the country has increased by 35.4% over the past 10 years. Surveys, however, suggest that the prevalence of depression is 3.8% - 4.8% in Iceland, which is comparable to the other Nordic countries. How is this possible? Could one explanation be that access to subsidised evidence-based psychological treatment has been minimal if not non-existent in recent years?
Pandemic threatens mental health
For those of us who work in the mental health service daily, these figures arouse real concern. The figures are striking in themselves but not least in light of the fact that the pandemic we are currently grappling with significantly threatens the mental health of the public. We feel the burden is getting heavier. The state resulting from the pandemic can have multiple effects on people's mental health, and a certain group becomes directly ill because of the pandemic or its serious consequences regarding health, income, social status, lifestyle, and many other aspects related to our daily lives and welfare.
Need to accelerate the development of a tiered mental health system
What can be done here in the country? In my opinion, various positive steps have been taken in recent terms to improve the mental health system and increase access to psychologists as well as trying to strengthen teamwork. It is also my opinion that given the situation we are facing in a pandemic, the momentum needs to be multiplied and the necessary changes expedited. The development of psychological services in primary healthcare needs to be expedited with the aim of avoiding waiting lists. The services of self-employed psychologists need to be subsidised. Support must be provided to community organisations and other institutions (the third sector) that work in mental health issues. We need to build a genuine tiered mental health system where services at each tier work as intended.
Challenge to the government
I am one of those who have fought for these changes since 2010, both in my work as a psychologist and also in the political arena. I challenge parliament and the government to show in practice that we intend to change this situation and build a good mental health system. Funding must be secured for the bill that was recently passed in parliament regarding the subsidy of psychological services, along with significantly increasing the allocation intended for the mental health system. There is truly life at stake!
Kristbjörg Þórisdóttir, substitute member of parliament for Framsókn and specialist in clinical psychology for adults.
The article was first published on visir.is 26 October 2020.
