A country where mental health is not included in the budget
The Mexican government has spent less than 30 pesos per capita on mental health in the last decade. Doesn't it seem crazy to allocate such a paltry budget to this problem? We're talking about something that affects at least 15% of the population. Instead of naming an abstraction called mental health, let's say clinical depression, anxiety, schizophrenia, autism, post-traumatic stress, addictions...
Short-sightedness? Insensitivity? Pettiness? Stinginess? Stupidity? Call it what you want. The fact is that what's happening in Mexico is in line with what's happening around the world. Rich countries allocate $65 per capita of their budget to mental health. Poor countries, four cents on the dollar, according to the World Health Organization's 2024 Atlas of Mental Health report. Mexico's public budget dedicated to mental health is approximately 40 times greater than that of poor countries and 40 times less than that of rich countries. Average or mediocrity? Take your pick. Spending on mental health has been between 1.2 and 1.6% of the total health budget, according to a study by the Center for Economic and Budget Research. According to experts, it should be three times greater. Instead of 3.4 billion pesos, it should be closer to 10 billion pesos.
The low public budget puts pressure on personal or family finances. Personal therapy costs between 450 and 2,500 pesos. Add a similar amount for medications. That's a lot of money in a country where the average salary is around 600 pesos a day. In practice, the vast majority of people don't receive the care they need. It's the sad budget, but also the shortage of specialists. The WHO recommends at least one psychiatrist for every 10,000 inhabitants. In Mexico, it's 0.3. When demand exceeds supply... there is unmet demand and can lead to lower quality of care.
How many people need care... how to care for them? It's difficult to accurately count, due, among other things, to the extent of underreporting. There were (were?) many, and they multiplied with the pandemic. One of the most telling data is the suicide statistics. According to the INEGI (National Institute of Statistics and Geography), the number was 5.1 per 100,000 inhabitants in 2014. In 2024, it reached 6.8 per 100,000. A 30% increase in a decade.
How much does mental health cost us... or rather, how much do mental illnesses cost us? Worldwide, depression and anxiety cost us a trillion dollars a year (million million), according to the WHO. This is equivalent to 0.9% of global GDP. If it had a similar impact in Mexico, 0.9% of the national GDP, we would be talking about a figure close to 31 billion pesos annually.
It seems like a lot, but it's probably higher. Remember that there's underreporting. In Mexico, three out of 10 people experience a major mental health episode in their lifetime, and two out of three don't receive care, according to the Mexican Social Security Institute (IMSS).
Experts distinguish between direct and indirect costs. Direct costs relate to spending on medicines and treatments. Indirect costs include other aspects, the most studied of which is the impact on work-related activities.
There is a loss of productivity and a reduction in labor force participation among those suffering from mental illness or experiencing a crisis. The loss of productivity can be close to 30% and manifests itself in absenteeism or presenteeism (being in the workplace doing almost nothing).
Mental disorders can make it impossible to participate in the labor market. According to the National Occupation and Employment Survey, there are approximately 41 million people of working age who do not work. They are economically inactive in Mexico. A year ago, there were 1.3 million fewer.
Some of them work in household chores and others study, but we don't know how many are out of the labor market due to mental health issues: depression, anxiety, addiction, autism, schizophrenia, post-traumatic stress disorder. What do we do? Can we have a budget that's more empathetic to mental health issues... less sick?
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