Inequality and Mental Health • La Nación
Talking about mental health is not easy. Little is known about this topic, and although its importance to our quality of life is acknowledged, it remains taboo and generates stigma and inequality. In addition, there is a misunderstanding about what mental health is, and barriers to accessing appropriate support and treatment. For this reason, it is essential to start a dialogue on mental health, especially in the current context, when the Covid-19 pandemic has demonstrated not only its importance, but also its fragility.
That’s why, from Re-imagine, a project that reflects 30 forms of inequality in Colombia, we discuss inequality and mental health. The project is based on a dialogue between more than 150 young people, activists, and artists among various other profiles. This column is the result of the Knowledge Dialogue#14 Reimagining, which we shared: Sarah Rueda, Designer, Educator, Researcher in Social, Environmental, and Creative Issues from Santander; Carol Pinzon, a sociologist with an MA in Cultural Studies, Gender and Development; Carlos Candel, photographer and leader of the Muisca indigenous people; Juan Francisco Gómez, Political Scientist, MA in Political Science and Student in Sports Administration and Technical Football Management; and La Vanesso, a visual artist and muralist from Cali. We share here the main conclusions and ideas that emerged from this dialogue.
Mental health: understandings, barriers, and inequality
In Colombia, we’ve been talking about mental health for a relatively short time. A review of history illustrates the discrimination and inequality that occurred around this issue. Since the end of the nineteenth century, when psychological discourse appeared in Colombia, mental health has been associated with the idea of ”Racial decadence or decadenceresulting from the intermingling of generations. This discourse was developed by criminology, exegesis, and what we call a common language.madness”, as a “danger to society” and also refers to the “criminal potential” of people with mental illness. In addition to the word “madness“Associated with race, it was used as a strategy of stratification and social control.
It was only until Law No. 1616 of 2003 that the concept of mental health was included and framed in public policy, where it was defined as “A dynamic state expressed in daily life through behavior and interaction in a way that allows individuals and groups to deploy their emotional, cognitive and mental resources to move through daily life and work, establish meaningful relationships and contribute to societyThis definition is in line with academic approaches that highlight health as a clinical and social topic at the same time.
Therefore, it is necessary to take into account the various elements that affect not only our mental health but also the resources we have to access the appropriate care to treat it. These resources range from emotional to communication and also economic tools. One problem that exists is that not all of us have access to these resources, which leads to inequality in our opportunities for mental health treatment. In addition, the state does not have the infrastructure or sufficient professionals to cover the ever-increasing demand for care. Furthermore, differential care is not provided by life cycle (age), gender, disability, or ethnic group. These differential conditions reinforce the relationship between mental health inequalities and other inequalities. For example, getting good care will ultimately depend on our income level and whether we live in the country or in the city. Barriers exacerbated by stigma, discrimination and rights abuse, persistent barriers to accessing mental health services.
It is also important to realize that disparities related to mental health come not only from external factors, but also from the same understanding we have of them. In general, we misunderstand mental health as a condition that depends on the individual, arises from the individual, and is the responsibility of the individual. This view ignores that mental health, like health in general, has a social dimension in that it intersects with social causes that are derived from the environment in which we live, not only from the physical environment, but also from the emotional environment and the relationship between the two. Derived from causes external to the individual, mental health also implies a collective responsibility.
In line with this thinking, the World Health Organization defines good health as a state of complete physical, mental, social, environmental and cultural well-being (well-being). Specifically, the deterioration of mental health that has occurred as a result of the Covid-19 pandemic, illustrates how our mental health depends on external factors, for example, where we live, which determines our chances of going out to public places, generating income and interacting with others.
Reimagining mental health
One of the things we can do to reimagine mental health from a more holistic and less individualistic perspective is to expand what we understand as mental health and as legitimate alternatives to treating it. For example, recognizing that Western medicine is just one of many possible ways to think about and deal with health issues. Ancestral knowledge, indigenous practices and traditional medicine also have valuable elements to contribute, through an integrated vision based on spirituality and on the recognition of the relationship our minds and bodies have to context and, in particular, to the territory. The use of Ayahuasca, the word circle, purification, meditation, affirmations under the guidance of traditional physicians, is an example of the tools which, as stated by Carlos, the leader of Muisca, allows us to “We look inside ourselves, because everything mental has a spiritual origin… Sharing that TK the ability to say, this belongs to everyone; It has always been a property of all.”
Another necessary step to begin to reimagine mental health and the inequalities associated with it is to open up and make visible spaces for dialogue that allow us to think freely and talk about mental health, and reduce the stigma and taboos that currently exist around it. . As Carol mentionedOrality is essential…we must start the transition, because it’s not just about the absence of disease, it’s about understanding that we are all at risk“.
These spaces of dialogue should be supplemented with spaces for education, since the majority of people, Sarah explains, “We don’t know what emotions are, why they exist, how we can deal with them, and how they relate to thoughts. This is due to the lack of education and the lack of recognition of the knowledge of the ancestorsIn this regard, Carlos continues, we must also ask what we know about health (health) and how to interpret them, even from home, in terms ofWe understand what is good and what is harmful to health. For example, we know that stomach aches are fine, but mental illness is not.“.
However, actions like the above will not be sufficient if we do not democratize access to treatment alternatives, and even alternatives that allow living with mental health conditions. This is why it is important to open access to medical treatments, but also to practices such as sports, meditation, and art. Regarding the latter, we consider that there is a possibility of exploitation, because technical processes have the ability to connect, repair and heal.
That’s why, as a first step to open spaces for dialogue and healing about mental health through art, La Vanesso is inviting anyone to share their experiences and mental health issues. As an artist, I create pieces of art inspired by these stories, and post them on social networks in order to show, generate and open the necessary discussions in which we can connect with the other, and begin to address and reimagine inequality. about mental health. Get to know the pieces of art in this link!
Co-authors: Sarah Rueda. Juan Francisco Gomez Carol Pinzon Carlos Candel Vanesso.
publishing company: MustafaHosny Oh God, Amen
 We have adapted the practice of knowledge dialogue, common among indigenous and Afro-descendant communities, as a methodological tool that allows “to reflect on the processes, procedures, histories, and territories that define, enhance or impede the action of people, groups or entities.” Alfredo Gesu (2000). Enhancing Diversity: A Dialogue of Knowledge, a Collective Interpretive Practice. The Columbia Utopia Century. 21. 43-54.
 Thus, “madness” was associated with eugenic ideas (the study and application of the biological laws of heredity aimed at improving the human race)
 See, for example, parales-Quenza (2016).