Navigating Challenges: Mental Health, Legislation, and the Prison System in Bolivia

This conference will delve into the intricate intersections between mental health, legal frameworks, and the prison system in Bolivia. It aims to provide a comprehensive overview of the current challenges faced by mental health professionals working within the legislative and correctional landscapes. Topics of discussion will include the prevalence and impact of mental health issues among the incarcerated population, the effectiveness of existing mental health policies and legislation, and potential reforms to enhance the mental health support system within prisons.

1. Navigating Challenges: Mental Health, Legislation, and the Prison System in Bolivia Guillermo Rivera-Arroyo, MD, MHPS, PhD Chair, Department of Psychiatry and Mental Health Japanese General Hospital

2. Agenda 1 . Introduction 2. Mental Health Challenges in Bolivia 3. Research Findings 4. Efforts to Foster Mental Health Legislation

3. Gross domestic product (GDP) in current prices from 1986 to 2026(in billion U.S. dollars)

4. Health expenditure as a percentage of GDP, 2000 - 2018 Source : theglobaleconomy.com

5. Change in the prevalence of anxiety disorders after adjustment for ( ie , during) the COVID−19 pandemic, 2020

6. Change in the prevalence of major depressive disorder after adjustment for ( ie , during) the COVID−19 pandemic, 2020 The Lancet  2021 3981700-1712DOI: (10.1016/S0140-6736(21)02143-7)

7. From: Psychiatric Hospital Beds and Prison Populations in South America Since 1990Does the Penrose Hypothesis Apply? JAMA Psychiatry. 2015;72(2):112-118. doi:10.1001/jamapsychiatry.2014.2433 Numbers of Psychiatric Hospital Beds per 100 000 Population in 6 South American Countries (1991-2012) Figure Legend:

8. From: Psychiatric Hospital Beds and Prison Populations in South America Since 1990Does the Penrose Hypothesis Apply? JAMA Psychiatry. 2015;72(2):112-118. doi:10.1001/jamapsychiatry.2014.2433 Numbers of Prisoners per 100 000 Population in 6 South American Countries (1991-2012) Figure Legend:

9. Prevalence of mental disorders at admission the Palmasola Prison, 2017 Illicit drug and/or alcohol use disorders in the year prior to admission were present in 34% of prisoners. Current major depression was present in 32% of prisoners, Non-affective psychotic disorders in 4%. High suicidal risk was present in 26% of the sample Rivera et al, 2017

10. The World Justice Project Rule of Law Index 2018

11. Asociaciones de Personas con Discapacidad Psíquica; Instituto de Terapia e Investigación sobre las secuelas de la Tortura y la Violencia Estatal –ITEI; Servicio Internacional Británico – UNAIS; Pastoral Social Caritas – La Paz; MSMCB – Movimiento de Salud Mental Comunitaria Bolivia; Hospital Arco Iris; Fundación La Paz; Centro de Rehabilitación y Salud Mental “San Juan de Dios”; Asociación Boliviana de Comunidades Terapéuticas ABCT; Asociación de Usuarios, Familiares y Amigos de Personas con Trastorno Mental; Centro de Atención del Adulto Mayor de la Caja de Salud de la Banca Privada.

12. CAPÍTULO I.   DISPOSICIONES GENERALES CAPÍTULO II . MARCO INSTITUCIONAL CAPÍTULO III.   MODELO DE SALUD MENTAL DEL ESTADO PLURINACIONAL CAPÍTULO IV.   SALUD MENTAL EN LA ATENCIÓN GENERAL DE SALUD CAPÍTULO V  . SERVICIOS COMUNITARIOS EN SALUD MENTAL CAPÍTULO VI. SALUD MENTAL MÁS ALLÁ DEL SECTOR SALUD CAPÍTULO VII. PROMOCIÓN DE LA SALUD MENTAL Y PREVENCIÓN DE LOS TRASTORNOS MENTALES CAPÍTULO VIII. ESTANDARIZACIÓN DE PROCESOS Y PROCEDIMIENTOS EN LA ATENCIÓN INTEGRAL EN SALUD MENTAL CAPÍTULO IX . FORMACIÓN PROFESIONAL E INVESTIGACIÓN CAPITULO X. PRESUPUESTO CAPITULO XI. DISPOSICIONES TRANSITORIAS

13. Contact

14. Conclusions In Bolivia, mental disorders are common, and there is a lack of access to specialized services. Regional research has highlighted the need for change. A broad alliance of stakeholders, including academics, has developed a mental health project to ensure rights and services, which is currently awaiting discussion in parliament.

15. Contact [email protected]