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The Degradation of Mental Health Care in South American Countries The mental health system in Puerto Rico, Maria’s country of origin, as the new decade began in 2000 consisted of primary care physicians—not mental health experts—who prescribed medication to treat mental health disorders (Dumit, 2012). But jobs were scarce in Puerto Rico, and health care, especially mental health care, was very limited. Doctors and hospitals were places where you went when you were sick; preventative care and outpatient mental health care was almost unheard of in the early 2000’s in rural Puerto Rico (Dumit, 2012). Primary care physicians and psychiatric hospitals provided the only mental health care that the majority of the population could access. The only treatment that Maria had access to was with her medical doctor or in a hospital. During this period, the pharmaceutical companies were attempting to market their products to primary care physicians around Southern America. They understood that general practitioners were busy, uneducated about mental illness, disinterested and therefore more amenable to persuasion to prescribe psychotropic medication than specialists (Dumit, 2012). In 2007, medical personnel without specific psychiatric training wrote 79% of all prescriptions for anti-depressants and 51% of all prescriptions for anti-psychotics worldwide (Dumit, 2012). The pharmaceutical companies marketed to nurse practitioners and to physician assistants, as these lower status professions began writing more and more prescriptions after the year 2002. Pharmaceutical companies have described these professions, along with primary care physicians, as very approachable and very interested in working with the pharmaceutical industry, a... ... middle of paper ... ...ical solution. With easy access to psychotropic medication, children now have the “means, opportunity, example, and encouragement to develop a lifelong habit of self-medicating” (Weiss, 2008, p. 2). The use of anti-psychotic drugs to treat children and adolescents for aggressive behavior and mood changes increased five times from 1993 to 2002 (Williams, 2009). Maria was not using illicit drugs, but she was continually asking for additional medication to handle uncomfortable feelings, and her use of her as needed (PRN) medication to manage her feelings is similar to a child who is using illicit drugs to manage her feelings. A lack of feeling comfortable with the feelings that accompany a life that includes relationships, successes, and failures leads many adolescents who are unable to self-soothe and live with sadness, and grief to use drugs to numb the body.

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