Lucía D (who has asked not to be identified by her last name) lived her childhood in a town in Cádiz and, now, at the age of 22 and about to finish her degree in Seville, she has begun psychological treatment. “It all started at school,” she says. Isolation from the rest of the group and the recurring feeling of loneliness and misunderstanding have today led to low self-esteem, a passive attitude and episodes of depression, anxiety and suicidal thoughts. “They ignored me. It was invisible,” she recounts. Her parents, farmers, did not know what was happening and, when they raised the problem at the school, they were given the wild card answer: “It’s children’s things.” Benedicto Crespo-Facorrodirector of the Mental Health Unit of the Virgen del Rocío hospital and professor of Psychiatry at the University of Seville, assures that the demand for assistance has doubled and, significantly, for suicidal ideas.
Lucia’s case is very common. Crespo-Facorro, who is also a researcher at the Network Biomedical Research Center for Mental Health (Cibersam), recalls that 70% of mental disorders begin before the age of 18. “Although the person does not realize it, there are non-specific changes that, many times, begin at these ages. They are not manifestations of the disease, but we can identify alterations at these ages that could or are connected to what happens in adulthood”.
Inform, train, erase the social stigma and warn adolescents that they can get out of these problems is difficult. Effective communication requires that sender and receiver tune in to the same channel, and this is not the case with mental health problems in adolescents. To palliate it, with the collaboration of the Spanish Foundation for Science and Technology (Fecyt), dependent on the Ministry of Science and Innovation, the psychiatry group PsyNal and Cibersam have developed a digital platform (menscopy) in which they turn to TikTok, Instagram, Twitter and podcasts to disseminate scientifically proven information on mental health, in the language that adolescents prefer.
The environment is essential for the brain to build properly
Lourdes Fañanás, Cibersam researcher
“QE [sic] this is not for you! You think it doesn’t affect you! You can prevent it” These messages occupy the screen of TikTok while Oriol Marimon, member of the popular science collective Big Van Sciencedance to the Latin urban rhythm of Sound, Morad’s theme. With rock in the background, in another multimedia message, she warns: “Everything that happens around you can also cause negative changes in your brain, predisposing you, in the long run, to suffer from mental illness.”
Lourdes Fañanás, also a Cibersam researcher, elaborates on this last aspect on the platform: “Neurodevelopment is as if we were building a very complex building and the general plan was written in our genes. It is the same for all human beings. How that building is executed will depend on other elements: on who builds it, on whether it rains while it is being built, on the temperature, on whether someone made a small mistake… genes dictate the epigenetic development of a very complex organ, but the environment is essential for it to be built properly”
What comes to you is distorted information. In the networks, anyone talks about suicide. The interest is that the kids become aware of truthful and accredited information
Benedicto Crespo-Facorro, psychiatrist and researcher at Cibersam
Crespo-Facorro explains that all the group’s research has had an echo so far in scientific circles and in conventional media, “but not among adolescents, who are going through a critical period, when mental illness begins.” “We have to work with them for prevention and prediction. What comes to you is distorted information. In the networks, anyone talks about suicide. The interest is that the kids become aware of truthful and accredited information”.
The platform is an information channel, but it is not intended to be a diagnostic or moralizing tool. It is not said that drugs are bad, but their devastating effect on neuronal connections is reported. Obsessive disorders are described and it is reported that, despite this anecdotal character reflected in some films where the character cannot step on a line, they become serious and invalidating. There is talk of obsession, but the pathology is different from people who are simply persevering in an idea.
“Stigma and taboo are also being fought against,” adds the researcher from Seville. “We want people to know what mental illness is, that we have to help, that people who suffer from it should not be alienated or outlawed.”
Healthcare demand multiplied
The platform is going to continue to feed because reality pushes. The psychiatrist warns that the demand for care has multiplied and many changes in behavior and anxiety and emotional instability come to consultations that produce, as he explains, “a poor adaptation of the individual and friction with his environment.”
Celia L., also 22 and Lucía’s classmate at the University (she also does not want her last name to be specified), is having a hard time returning to face-to-face classes. She shows an impeccable academic record, but lacks the social skills to relate to her classmates. She affirms that it has happened to her since she was a child, since her school years in a town in Seville’s Aljarafe. “What I liked least about school was recess, unlike the others,” she admits. She has not resorted to professional help. “It’s my way of being,” she argues.
According to Crespo-Facorro, “certain disorders are not consulted because people put up with it or say: ‘this is what happened to me’. There are patients who come with serious symptoms who have been there, silent, outside the circuit”.
“I’m not a psychiatrist”
The network initiative also aims to contribute to more talk about mental health, to lose fear. “Not long ago”, continues the researcher, “people said ‘I’m not a psychiatrist, I’m not crazy’. But not only serious cases of mental health can be alleviated, but also pathologies, let’s say, intermediate, with a good initial orientation. The sooner the better, because what evolves later is more difficult to recover”.
The inescapable condition of the platform is scientific support. The cybersam It is made up of 25 clinical, preclinical and translational research groups from eight Spanish communities. The goal is to distance itself from the proliferation of loose apps that try to take advantage of growing concerns about mental health.
Simon Goldberg of the Center for Healthy Minds at the University of Wisconsin-Madison has led a recent study in Plos Digital Health on actions in this field based on mobile phones. The conclusions are disparate. While some showed suggestive effects of anxiety, stress, depression or smoking, most showed “weak or insignificant” results. Goldberg and his team conclude: “No convincing evidence was found to support any mobile phone-based intervention.” “Nevertheless,” they add, “evidence of suggestive effects supports future research in this area, as well as consideration of these approaches as cost-effective means of reducing psychiatric symptoms as prevention tools or as initial interventions within a model of care.” staggered”.
In a previous study in NPJ Digital Medicine, of the Nature group, Kiona Weisel, a clinical psychologist at Friedrich-Alexander University, Germany, concluded: “While smartphone use is ubiquitous and the market for mental health smartphone apps is growing rapidly, evidence of its use to treat mental health symptoms is still unclear.” According to the work, the results were also disparate: a greater effect on depression and smoking, and less or no effect on anxiety, suicidal ideation, self-harm or alcohol consumption.
Mentoscopy’s proposal distances itself from these applications, not only because it has scientific support in all its aspects, but also because its objective is not to intervene, but to inform and educate. In this sense, Crespo-Facorro explains: “We do not want to go into the line of self-help, advice or guidance, but to give all the information. It is a debate that we have had, but our idea is to stay in the most scientifically rigorous part, that has credibility for young people and that reaches them”.
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