SAN JUAN, Puerto Rico — Experts say that mental health among Puerto Rico’s youth is getting worse at an alarming rate, exacerbated by compounding natural disasters, faltering infrastructure, and a lack of mental health resources.
“Puerto Rico has an overall mental health crisis in general, and youth mental health certainly falls within that,” said Dr. Alice G. Pérez Fernández, professor of psychology at the Inter American University of Puerto Rico-Fajardo.
Multiple experts have pointed to uncertainty about the future as one of the causes of increasing rates of depression and anxiety among young Puerto Ricans.
Over the last five years, children and adolescents have grown up amid two Category 5 hurricanes, earthquake swarms, the COVID-19 pandemic, and almost monthly blackouts. These situations have hung a dark cloud above the lives of many Puerto Ricans.
But it can be especially hard for children to deal with such situations due to rapid changes to their social and physical environments that are hard to explain, says Wilmayra Villafañe, director of children, youth and their families at the Puerto Rico Mental Health and Anti-Addiction Services Administration (ASSMCA in Spanish).
Puerto Ricans “have seen a lot of trauma,” said Dr. Eduardo Lugo, a professor of psychology at the University of Puerto Rico, Mayagüez Campus, and executive cirector of Proyecto Juventud. “It has transformed into complex trauma, one on top of another.”
Faltering education and healthcare infrastructure issues have plagued young Puerto Ricans, negatively affecting their mental health.
On the first day of school this last Wednesday, over 240 schools were not ready to offer services to students because they were in “critical condition” and were still undergoing necessary improvements.
Additionally, education budget cuts have forced many schools to close in a campaign to “consolidate” school districts, with more than 400 schools having closed since 2017. According to the Centro de Periodismo Investigativo, the Department of Education’s (DE) “vision for the future” proposes closing 83 more schools by 2026, which would affect 18,644 students.
Schools not only function as socialization centers for children where they can learn many important life skills, but also as pillars of their community. When a school closes, a community is dismantled, says Dr. Lugo.
According to a study conducted by Dr. José Caraballo Cueto, director of the Center of Census Information, there was a negative causal relationship found between “school consolidation” and academic achievement in displaced students. The study, which tracked student data from 2017 to 2019, found that students who were displaced by school closures had a higher probability to obtain lower grades on standardized tests when compared to their non-displaced counterparts.
The study also found that while 78 percent of students in public school systems lived under the poverty line, displaced students had a higher rate of suffering from major poverty.
When questioned if school closures have had a major impact on mental health among youths, Villafañe said that ASSMCA has “not attended cases related to that.”
Alongside a decreasing number of schools, there are also fewer teachers for students, with over 2,500 teachers quitting earlier in the year. More than 100 employees of the DE submitted “unexpected resignations” right before classes started for the 2022-2023 school year, according to Secretary Eliezer Ramos. However, he held that the DE typically sees 700 vacancies between October and November.
Schools are not the only institution that has experienced closure over the last few years. The Mental Health Center in Bayamón, one of the few public units that specialized in psychiatry for minors, was closed more than two years ago with no plan for how to deal with its patients. Currently, three hospitals have wings specifically meant to deal with the mental health of children and adolescents across Puerto Rico, Villafañe confirmed.
The Mental Health Center in Bayamón was scheduled to re-open last February, but it remains closed.
“Resilience is very important,” said Dr. Lugo. “Nevertheless there can not be resilience without resources.”
While mental health infrastructure for youths stands out among the broader failing health infrastructure, mental health facilities for adults are also in poor condition.
A video report by Rayos X revealed the “third world” conditions at the Dr. Ramón Fernández Marina Hospital of General Psychiatry in Rio Piedras, among them a room filled with improperly discarded biohazard waste and only one medical professional per 30 patients.
Following the report, Dr. Hiram Rodriguez made an Instagram post calling out both the ASSMCA and Gov. Pedro Pierluisi for their silence on the issue.
“Are you seeing how they disrespect and play with the mental health of Puerto Ricans?” said Dr. Rodriguez in the video, then urged mental health professionals around the archipelago to “pressure” the government to act to solve the crisis.
“Population-wise, there exists a decrease in the amount of young people using (in-person mental health) services,” said Villafañe. “However, the number of cases can be noted as more severe.”
ASSMCA recently started bringing in-person services directly to communities in hopes of meeting them in places they might feel more comfortable. Villafañe wishes “more people used the service.”
In comparison, calls to the mental health crisis hotline run by ASSMCA, Línea PAS, have shot up dramatically.
According to data shared with Latino Rebels by ASSMCA, Línea PAS received more than 230,000 calls during the 2021-22 period and has received more than 110,000 calls so far in 2022. According to publicly available data on the ASSMCA website, Línea PAS received more than 300,000 calls in the 2019-20 period.
These numbers are marked increases from the 2018-19 period, when the line only received a little over 80,000 calls.
Latino Rebels has requested available data concerning youth mental health rates of depression and anxiety but has so far not received any.
A person familiar with ASSMCA told Latino Rebels that data for youth mental health rates of depression and anxiety has not been collected since 2017.
“Puerto Rico suffers from a lack of statistics, a lack of data collection throughout,” Dr. Pérez said.
According to the Anne E. Casey Foundation 2022 Kids Count Databook, 57 percent of children in Puerto Rico live in poverty, 54 percent of children’s parents lack secure employment, and 83 percent of children live in high poverty areas—all of which have been negatively linked with higher rates of depression and anxiety in youths, experts say.
Combined with the failing infrastructure across Puerto Rico, these rates forecast a rise in rates of anxiety and depression among Puerto Rican youths.
The Puerto Rico Department of Health did not answer Latino Rebels’ request for comment.
Carlos Edill Berríos Polanco is a freelance journalist, mostly focused on civil unrest, extremism, and political corruption. Twitter: @Vaquero2XL