by Diego (Psychologist, Secretariat of Health Mexico)
In Mexico, 1 in 4 people between the ages of 18 and 65 has a psychiatric condition. Many of these can represent a disability and very high medical bills. In spite of that, Mexico is still one of the countries with the highest levels of stigma around mental illness, which explains why many individuals seek professional care only after years of suffering, if ever.
Depression, addictions and anxiety disorders are currently some of the most common mental health challenges among the population, depression being one of the main causes of disability. Personality disorders are equally frequent; it is believed that 1 person in 17 complies with criteria for personality disorders (1).
Borderline Personality Disorder is one of these conditions included in the two most important statistical manuals of mental disorders in the world, the DSM-5 and the CIE-10.
The personal, social and economic consequences of this disorder include persistent functional disability (2) , a higher likelihood of dropping out of school, risk of unemployment, the presence of conducts of risk (examples: work problems, being in an abusive relationship, sexually transmitted infections, self-injury, suicide, drugs or alcohol abuse, becoming the victim of violent crimes, etc.) , self-injuries and suicide along with challenges in maintaining functional interpersonal relationships.
Although BPD usually starts between puberty and the early adulthood, a delayed diagnosis is still very common, which reduces the possibilities of full, healthy development for the people who live with it. Generally, a specific treatment is offered too late, or specialised services are inaccessible and / or very expensive.
So, what is the role of public policies around mental health? In a country, like Mexico, where only 1 in 5 people with disorders have received any kind of attention. It is fundamental to create detection mechanisms that allow early care. The biggest area of opportunity is universal prevention; the promotion of mental health during the first years of life.
It has been observed that traumatic or abusive experiences during childhood might lead to the occurrence of BPD, which is why promoting proper nurturing at home based on safe attachment is a good way to address these high-risk situations that is cost-effective.
Monitoring this and other mental illnesses is necessary to gather evidence and have records that promote public policies around BPD and focused on early attention. It will also help eliminate discriminatory practices both in private and public health systems.
Mental illnesses such as BPD are very often misunderstood by people and the stigma around them makes it harder for people to seek professional attention at early stages.
Education around psychology, the promotion of accurate information regarding mental illness, mental health campaigns, programs that raise awareness and reduce stigma are fundamental if we really want to make a change.
1 Benjet, C., Borges, G., & Medina-Mora, M. E. (2008). DSM-IV personality disorders in Mexico: results from a general population survey. Revista Brasileira de Psiquiatria, 30(3), 227-234.
2 A functional disability limits a person’s ability to perform physical activities, have a significant sensory impairment or mental illness, need long-term care, use assistive devices or technology and have developmental delays.