Depression, the “Silent Epidemic” Also Attacks in Cuba

By Pilar Montes

Photo: Juan Suárez

HAVANA TIMES — A recent medical event in Havana and particular indicators I picked up on in TV programs and social projects, stirred my curiosity about the impact of depression in Cuba.

According to statistics from the World Health Organization (WHO), depression affects 322 million people worldwide, 18% more than in the last decade.

Delving into the distribution of this so-called “silent epidemic” in the world, the WHO says that the relationship between this disease with rapid changes, war and migration isn’t clear and that this illness is more closely linked to addictions such as alcoholism and drug abuse.

In Latin America, Brazil is the country with the highest level of depression, followed by Cuba, Paraguay, Chile and Uruguay.

A new report from the World Health Organization (WHO) warns that over 4% of the global population suffers from depression and that women, young people and the elderly are more prone to its crippling effects.

While it’s true that the most immediate causes of depression can be found in alcohol and drugs, underlying root causes lie in war and regional conflicts, violence including domestic violence and families being separated because of migration or economic needs.

“Alcohol consumption is our number one problem,” explains Dr. Alejandro Garcia, director of the Mental Health Community Center in Central Havana, the most densely populated muncipality in Cuba, with over 160,000 inhabitants in a total area of 5.44km2.

“They aren’t alcoholics as such, but people who consume alcohol in an irreponsible manner, which leads to family violence, accidents and behavioural problems.”

Garcia explained that the response to this health problem is founded on a three-way strategy which consists in promoting health awareness and preventing diseases, medical care, as well as rehabilitation, the latter being closely monitored.

Meanwhile, Conner Gorry, the author of an article published by MEDICC magazine, which publishes articles by US and Cuban scientists, claims that the statistics could hit us hard: in Cuba, suicide is one of the ten leading causes of death and 25% of people who go to health centers are diagnosed with depression.

Photo: Juan Suarez

In her article published in 2013, Gorry claims that this health situation “isn’t any different to the global health trend, especially in Europe, the United States and Canada.” However, Cuba is facing specific challenges and since 1995 put its mental health system at the service of the community with professionals available to provide a coordinated national response to this problem.

Cuban experts agree that one of the greatest challenges the island is experiencing right now is the rapid increase in its aging population, Gorry points out. Life expectancy in Cuba is around 80 years, and the gross birth rate is the lowest within the region and has a lower fertility rate than what’s needed to replace the generations.

Based on government data, it’s estimated that by 2030, more than a third of the population will be aged 60 years old and over, he said. Cuba is on its way to becoming one of the planet’s eleven oldest countries.

The population sector to be most affected by depression and other health problems that derive from this disease are precisely the elderly. A lot of the time, the cause for this stems from families being separated, due to migration and even due to domestic violence.

War, conflict and migration

This situation isn’t exclusive to Cuba, not in the least, it is also evident in developed countries, where some don’t have universal health care and the country’s wealth is becoming more and more concentrated in fewer hands.

Ever since I was little, I was always struck by the fact that the highest rates of suicide took place in the richest countries with the highest levels of education.

The richest part of the planet make up 70-80% of the 800,000 annual suicides that take place in high-earning countries, according to a recent WHO report.

In spite of the increasing threat of this “silent epidemic” in the world, national health systems continue to dedicate pitiful resources to dealing with and treating this health problem.

And it’s obvious that when a human being suffers failure in their life goals, being mentally and professionally capable of reaching these goals, depression and despair take root.

In the biological, psychological and social make-up of every individual, changes to any of these components can influence everything and this disease appears as a result.

According to the Pan American Health Organization, there are 100 million new cases of depression in the world every year. Primarily in adults, depression is suffered by 15% of men and 24% of women. The greater percentage is understood to be in the 18-45 year old age group, which is when people are at the most productive stage of their lives.

People live and are driven by their interest to satisfy their needs, ranging from the most basic or simple to the most complex on a spiritual level, while also interacting with the rest of society, where questions like how to live, what the meaning of life is and even if it’s worth living or not come up.

One of the authors of the Pan American Health report, Dan Chisholm, warned at the Geneva Assembly that the majority of people who suffer from depression don’t have access to treatment.

“The number of people who access treatment in these countries is extremely low, it’s less than 5%. Around 95% of those suffering from depression don’t seek help and this is truly worrying,” the expert said.
Mental health in Cuba: some statistics

Psychiatric hospitals: 17
Admittanceto psychiatric hospitals per 100,000 inhabitants: 0.3
Psychiatric consultations: 899,075
Psychiatric consultations per 100,000 inhabitants: 79
Psychiatrists: 1051
Psychiatric interns: 167
Child psychiatrists: 297
Child psychiatrist interns: 72
Graduated Health psychiatrists (2010-2011): 26
Health psychiatrist interns: 49
Graduated psychiatrists in 2012: 491
Graduated psychiatrists since 19959: 28,745
*Mental Health Community Centers: 101

Sources: Annual Health Statistics, 2012. Public Health Ministry, Cuba;
*Dr. Carmen Borrego, director of the National Mental Health and Drug Abuse Program, MINSAP