Congreso_Educar_para_Cuidar:UT_Salud_Mental_03_10_25

So, so you think they can tell heaven from hell, blue skies from pain, can you tell a green field from a cold steel rail, smile from a veil, do you think they can tell? 00:00:03

And if they get you to trade 00:00:28

Your hero is for ghosts 00:00:32

Hot ashes for trees 00:00:35

Hot air for a cool breeze 00:00:39

Whole country for change 00:00:43

Did you exchange 00:00:46

A welcome party in the world 00:00:49

Or really grow in a cage 00:00:52

I wish, I wish you were here 00:00:57

We're just cool as all 00:01:36

Swimming in a fishbowl 00:01:39

Year after year 00:01:41

Riding over the same old ground 00:01:43

What have we found? 00:01:48

The same old fears 00:01:51

Wish you were here 00:01:52

Muchas gracias. 00:01:56

Moon river, wider than a mile, I'm crossing you in style someday. 00:02:52

Oh dream maker, you heart breaker, wherever you're going, I'm going your way. 00:03:12

Two drifters off to see the world The sad salad of world to see 00:03:29

We're after the same Rainbow sand waiting round the bend 00:03:43

My Huckleberry friend 00:04:00

Moon River and me 00:04:04

River, wider than a mile 00:05:35

I'm crossing you in style someday 00:05:41

Oh dream maker 00:05:48

You heart breaker 00:05:52

Wherever you're going, I'm going your way. 00:05:56

Two drifters off to see the world. 00:06:03

The satellite of world to see. 00:06:11

We're after the same 00:06:15

Rainbows and 00:06:23

Waiting round the bend 00:06:26

My huckleberry friend 00:06:29

Moon, river, and me 00:06:33

Gracias a la vida 00:06:42

Que me ha dado tanto 00:07:28

Me dio dos luceros 00:07:33

Que cuando los abro 00:07:38

Perfecto distingo 00:07:43

Lo negro del blanco 00:07:48

Y en el alto cielo 00:07:52

Su fondo estrellado 00:07:56

Y en las multitudes 00:08:01

La mujer que yo amo 00:08:05

Gracias a la vida 00:08:10

Que me ha dado tanto 00:08:14

Me ha dado el oído 00:08:19

Que en todo su ancho 00:08:23

Cada noche y día 00:08:27

Grillos y canarios 00:08:31

Martillos, turbinas, ladridos, chubascos 00:08:35

Y la voz tan tierna de mi bien 00:08:45

Gracias a la vida que me ha dado tanto 00:08:51

Me ha dado el sonido y el abecedario 00:09:01

Y con él las palabras que pienso y declaro 00:09:09

Madre, amigo, hermano y luz alumbrando 00:09:18

La ruta del alma de la que estoy amando 00:09:26

Gracias a la vida que me ha dado tanto 00:09:34

Me ha dado la marcha 00:09:42

De mis pies cansados 00:09:47

Con ellos anduve 00:09:51

Ciudades y charcos 00:09:55

Playas y desiertos 00:10:00

Montañas y llanos 00:10:04

Y la casa tuya 00:10:08

Tu calle y 00:10:11

Y tu patio, gracias a la vida que me ha dado tanto, 00:10:14

me dio el corazón que agita su marco. 00:10:27

Cuando miro el fruto del cerebro humano, 00:10:35

Cuando miro el bueno tan lejos del malo 00:10:41

Cuando miro el fondo de tus ojos claros 00:10:50

Gracias a la vida que me ha dado tanto 00:10:57

Me ha dado la risa y me ha dado el llanto 00:11:05

Así yo distingo, dicha de quebranto, los dos materiales que forjan mi canto y el canto de todos que es el mismo canto. 00:11:14

y el canto de ustedes, que es mi propio canto. 00:11:39

Gracias a la vida, gracias a la vida. 00:11:50

Thank you very much. 00:11:59

Distinguished attendees, it is an honor to welcome you to the Vistalegre farm, 00:13:01

un espacio que en sus jardines invita a la calma y donde se encuentra este lugar emblemático, el Palacio Viejo, 00:13:08

que alberga la sede del Instituto Superior Madrileño de Innovación Educativa. 00:13:16

Permítanme comenzar con una reflexión que nos transporta a las raíces mismas del pensamiento occidental. 00:13:22

Platón, el gran filósofo, enseñaba paseando y su academia se erigía en un bosque sagrado. 00:13:29

Aristotle, his disciple, taught his lessons in a park, and his school, the Lyceum, owed its name to the shaded tree that housed him. 00:13:36

This veneration for the gardens, for nature, was not a coincidence. It remained alive throughout all classical philosophy. 00:13:48

La conexión entre los jardines y el bienestar humano es profunda. Los jardines, como fortaleza contra las distracciones, fusionan la humanidad y la naturaleza, ofreciendo un refugio donde la mente puede encontrar sosiego. 00:13:58

En este sentido, la finca de Vista Alegre, declarada Bien de Interés Cultural en 2018 en la modalidad de Jardines Históricos, representa un preciado legado y un ejemplo de la armonía entre el hombre y el entorno natural. 00:14:15

Hoy nos encontramos aquí para celebrar el Congreso Educar para Cuidar, Comunidad Educativa y Salud Mental, Dificultades y Retos. 00:14:32

Este evento es un testimonio de nuestro compromiso con la salud mental y el bienestar de nuestra comunidad educativa. 00:14:42

Quiero expresar mi agradecimiento al viceconsejero de Organización y Política Educativa, José Carlos Fernández Borreguero, y a todas las autoridades aquí presentes. 00:14:51

I would also like to thank José Antonio Luengo and Raquel Llévenes for their dedication in the integration of the research unit and mental health training and the impulse of initiatives such as mental health dialogues, resources, programs, publications and research. 00:15:01

A special recommendation also to the speakers for their valuable participation, to the unit of coexistence and against school harassment, and, of course, to you, the teachers, fundamental pillars of education, and to the Lismie team for their professionalism and commitment in the organization of this congress. 00:15:19

I hope that this training, in this natural environment, is a space for learning and reflection, 00:15:41

where they can find a breath and where nature reminds us of the importance of calm and well-being. 00:15:47

Without further ado, I give the floor to our Vice-Counselor, José Carlos Fernández Borreguero, 00:15:55

for the inauguration of this Congress. Thank you very much. 00:16:00

Very good afternoon to all. Dear President of the School Council, who is with us, Pilar Ponce, Director of Territorial, Madrid Norte, who is also with us, 00:16:04

Subdirector General of Innovations and Training Programs, Javier Sobrino, who is also with us, Subdirector General of Educational Inspection, Luis Abad, 00:16:21

to the Assistant Director of Hospitals and Coordinator of the Regional Office of Mental Health and Addictions of the Community of Madrid, Doña Mercedes Navío, 00:16:29

una referencia sin duda en la sanidad madrileña, directora del ISMIE, querida Eva, gracias por cuidar tanto de nuestro ISMIE 00:16:39

y de coordinar este tipo de actividades, coordinador de la unidad de formación e investigación de salud mental, 00:16:47

José Antonio Luengo, de la que nos sentimos tan orgullosos, Raquel Lievenes, que nos ayudas mucho también en todas estas labores, 00:16:54

jefes de servicio de hospitales, otros profesionales de la psiquiatría que nos acompañáis, también de la psicología, 00:17:01

y sobre todo muchos docentes de la Comunidad de Madrid 00:17:08

que van a dedicar todo su fin de semana a formarse 00:17:11

y por eso no podía de otra forma que venir alguien de la consejería, 00:17:16

en este caso, simplemente el viceconsejero, 00:17:20

a acompañaros y agradeceros de corazón 00:17:23

que un viernes por la tarde os metáis en el ISMIE 00:17:26

y el fin de semana, gran parte del fin de semana, 00:17:30

que lo dediquéis a esto. 00:17:33

They say a lot about you, a lot about your vocation, and a lot about the quality of the educational system in Madrid. 00:17:34

Thank you very much. 00:17:42

On behalf of the Education, Science and Universities Council, which is sent to me by Emilio Viciana, 00:17:44

and on my own behalf, I convey to you the enormous satisfaction that it produces to participate in this opening of this Congress. 00:17:48

A meeting whose objective is to raise awareness and mobilize the educational community 00:17:55

on the importance of care and emotional and psychological well-being. 00:17:59

For this reason, we congratulate all of us and congratulate the Mental Health Training and Research Unit of ISMIE, 00:18:03

coordinated, as I said, by Don José Antonio Luengo, a reference in the psychology of Madrid, 00:18:10

and the entire team of the Superior Institute of Educational Innovation of Madrid for the impeccable organization of this act. 00:18:15

Thank you for promoting the enriching debate on a topic that is fundamental for the Community of Madrid and the Consejería de Educación, which is mental health. 00:18:23

And also my recognition, of course, to the General Directorate of Bilingualism and Quality of Education for its constant work in front of the training of teachers and families, an essential task for the quality of our educational system. 00:18:32

Javier, I ask you to transfer this to our dear Director Beatriz. 00:18:46

Your unbreakable commitment to innovation is what allows our teachers and teachers to always be at the forefront. 00:18:50

The promotion of emotional and psychological well-being cannot be addressed only with workshops. 00:18:58

It implies a paradigm shift in which we make an effort and create friendly and safe environments, 00:19:06

we promote the creation of links with and among students, and we devote time to teaching self-care and mutual care. 00:19:15

Our role as teachers, as teachers, is to transform the educational context into an ecosystem of care 00:19:24

where emotional and psychological well-being are as important as academic performance, 00:19:31

setting the foundations for the integral development of the student. 00:19:37

And, above all, in a context as difficult as it is to live in all the educational centers. 00:19:40

Because it is heart-wrenching every time we receive news in the advisory office, 00:19:45

Noticias como la triste noticia esta semana del fallecimiento de un niño en una localidad de Madrid, 00:19:49

que por supuesto que se estaba trabajando todo el asunto del protocolo en su colegio y sus docentes lo estaban haciendo bien, 00:19:57

pero aún así siguen pasando cosas muy graves, muy graves en la adolescencia y en la infancia, 00:20:03

y desde los colegios algo tenemos que hacer. 00:20:10

For this, multidisciplinary work is essential. 00:20:13

We cannot charge all the teachers because we are all day with the children, logically. 00:20:17

The attention to the minors requires collaboration between the different professionals. 00:20:22

And you know that this is being worked on in recent years. 00:20:27

On the one hand, education, but on the other hand, mental health. 00:20:31

We are very grateful to the Ministry of Health and to the psychiatrists who accompany us today. 00:20:34

That speciality has also been created recently in the community of Madrid for mental health, for children's psychiatry and for other specialists who also work. 00:20:39

And, of course, we must also take into account, of course, families in the emotional education of the youngest, 00:20:48

in order to seek an adequate psycho-educational and social adjustment in the different contexts in which they are involved. 00:20:54

In short, the mental health of a child and an adolescent is not the responsibility of the school, 00:21:00

but the educational community, in its broadest sense, 00:21:08

must become a community of support for the child and, above all, for the child who has mental health problems. 00:21:12

That is why I want to highlight and reiterate the coordination that has been being carried out for a few years 00:21:21

and that we must continue to do, because of course we have not reached the end of the road 00:21:28

with the Consejería de Sanidad, with the Consejería de Educación, Ciencia y Universidades 00:21:31

and with the Consejería de Familia, Juventud y Asuntos Sociales. 00:21:36

We appreciate everyone's involvement in this work. 00:21:39

The Consejería de Educación, Ciencia y Universidades de la Comunidad de Madrid, as I said, 00:21:43

is very aware of the crucial role that educational centers play in the lives of children. 00:21:47

How can it not be like that if it is the place where children and adolescents spend most of their time? 00:21:52

Sometimes they spend more time with you than with their parents. 00:21:58

The classrooms are therefore and must be an ideal space for both learning, which has been throughout life, 00:22:02

and for emotional skills training through overcoming challenges and continuous social interaction. 00:22:08

For this reason, our priority is, and it must be every year or more, to provide the educational centers and educational teams with the necessary resources and training as is necessary today. 00:22:17

And there is still a lot of work to be done. We are aware of this. 00:22:29

Especially the specific training in literacy and indicators in emotional well-being and mental health that contribute to early detection of cases and to create a positive and safe school environment. 00:22:32

And that is where the partners of the Ministry of Health play a very important role, in all those centres where we can already be working as a team. 00:22:45

And we are doing it, putting in place very diverse actions in collaboration with health and social protection institutions, 00:22:53

addressing early prevention, early detection and the promotion of mental health from a systemic and comprehensive point of view. 00:23:00

Among many other actions, we are simply going to highlight that programme of which we are very proud 00:23:07

y que debemos hacerle crecer cada vez más ese programa de enlace clínico de salud mental de la Comunidad de Madrid, 00:23:14

que en el curso pasado llegó a 146 centros escolares, como sabéis, 119 de carácter ordinario, 00:23:20

y 27 colegios de educación especial que tanto necesitaban este apoyo y que aún tenemos que seguir apostando más. 00:23:26

Por otro lado, los diversos programas de formación para el profesorado sobre bienestar emocional, 00:23:34

healthy use of digital environments, and prevention of suicide and self-harm, which concern us all so much. 00:23:39

And also the advice and intervention of you, the team of the coexistence unit, which help the centres so much. 00:23:45

And, of course, I do not want to forget that regional plan against drugs, which do so much damage to our young people. 00:23:55

Just a year ago, our president announced the creation of the Mental Health Training and Research Unit as a pioneering initiative. 00:24:02

Thanks to it, today we are celebrating this congress and we will continue to bet on your work. 00:24:13

But all this, and I am finishing, would not be effective without the involvement and good deed of the teachers of Madrid. 00:24:20

Madrid de los profesionales que intervenís en los centros educativos por eso nuestra más sincera 00:24:31

gratitud en primer lugar a los equipos directivos que tanto trabajo tenéis en este sentido y no 00:24:37

digo solamente con los protocolos que debemos seguir trabajando en ir desburocratizando para 00:24:43

que sean un elemento no solamente de protección jurídica sino que sea un elemento pues importante 00:24:48

para el centro y que nos genere tanta burocracia los maestros los profesores los tutores que 00:24:53

with the children, the specialists and, very especially, a recognition to our 00:24:59

community orientation network of Madrid. For their dedication, support and commitment 00:25:05

when it comes to minimizing risks, we do not always achieve it, and maximizing opportunities 00:25:11

to develop mental well-being. In an accelerated and saturated environment of stimuli, we must 00:25:16

buscar el sosiego que nos permita reconocer en los niños y en los adolescentes detalles 00:25:24

que a menudo nos pueden pasar inadvertidos en su vida cotidiana y que son tan importantes 00:25:30

en su salud mental. Es condición indispensable para conseguir que la escuela sea realmente 00:25:35

un espacio de aprendizaje, pero también de convivencia de forma saludable. 00:25:40

Y termino como empecé. Gracias de verdad por dedicar vuestro fin de semana a formaros 00:25:46

en este tema fundamental que sea muy fructífero muchas gracias 00:25:53

gracias vice consejero ahora cedo la palabra a luís abad merino 00:26:00

su director general de inspección educativa 00:26:10

muchas gracias muchas gracias se va a directora del ism y vice consejero 00:26:17

presidente del consejo escolar su director general es director directora 00:26:23

I would like to first of all congratulate LISMIE for this initiative in which experts will be able to agree and debate on an issue of as much interest as mental health in the educational field. 00:26:27

First of all, I would like to thank José Antonio Luengo for this initiative and for the work he is doing in the unit, as Eva was saying. 00:26:44

As responsible for the educational inspection in the community of Madrid, I would like to point out that the educational inspection is entrusted with the supervision, evaluation and analysis of the coexistence in our educational centers. 00:26:55

So, coexistence in a broad sense, because I think it also has to cover a very important aspect, which is the emotional aspect. 00:27:09

We must not forget the very law of organic education, which tells us that one of the functions of the teacher is to watch over intellectual, psychomotor, social, moral development, 00:27:17

and an aspect that we sometimes forget, affective, the affective aspect of the student. 00:27:30

Therefore, in that sense, the role that prevention and training can and must play in the improvement of coexistence and the social climate of the centres must be essential. 00:27:36

For this reason, initiatives such as this Congress are so relevant. 00:27:47

The Community of Madrid has autonomous coexistence plans based on the Programme for the Improvement of Consistency and the Fight Against School Abuse, 00:27:51

which was approved by the Government Council of the Community of Madrid on a date as distant as 2016. 00:27:59

And also, all our actions have to do with the integral strategy for school coexistence. 00:28:05

All these actions have a purpose, which is to create and consolidate a coexistence culture in our centres. 00:28:12

A coexistence culture that is consensual, that is global, so that our educational centres can promote a change 00:28:18

based on awareness, but also on training and, above all, on the active involvement of the entire community. 00:28:25

in the resolution of the most peaceful way possible of the conflicts. 00:28:33

I want to highlight that the Community of Madrid, since 2016, and I do not want to miss the opportunity to highlight, 00:28:39

it is not an expression that I like, to highlight, to highlight a pioneer unit in Spain since 2016, 00:28:49

the unit of coexistence against school harassment. 00:28:56

as I say, pioneering, a unit that has worked and that works in the coordination of the different services and units that intervene in all conflicts of school coexistence. 00:28:59

And in the very relevant situations, which was the beginning of the unit against school harassment. 00:29:10

But notice that from the 2020-2021 course, practically at the same time as the creation and promotion of the new protection laws for childhood and adolescence, 00:29:16

We have a part of the unit dedicated to counselling in socio-emotional matters. 00:29:26

The Consejería de Educación, through this unit, through this team of professionals, 00:29:33

is permanently attending situations related, among others, to the student's mental and emotional health. 00:29:38

It is a unit that moves to the centres to carry out the appropriate counselling 00:29:45

to management teams, to guidance departments, to counselors and to any teaching team 00:29:51

on the planning of adequate educational responses, especially in individual training and intervention plans 00:29:57

and through the development of coordination processes with families and with specialized services, 00:30:06

as well as with specialized mental health services. 00:30:11

Through the unit of coexistence against school harassment, we act directly in the centers. 00:30:15

I give you some figures that can make you reflect on the volume of actions and the relevance of the problems that the unit is dealing with. 00:30:20

Last year, the unit intervened in more than 5,000 phone calls and direct telephone attention, 00:30:32

both from families and professionals, on issues related to harassment, violence or emotional health of students. 00:30:40

more, he made more than 100 face-to-face visits to the facilities of the centers to 00:30:49

attend, interview and deal directly with the problems that had been detected. 00:30:54

Likewise, the unit, as the vice-counselor highlighted before, has been occupied with 00:31:01

the design and development of the protocols aimed at detecting any type of violence in 00:31:05

children and adolescents, with special attention to cases of mistreatment, and to things between 00:31:11

and other behaviors, such as self-criticism, 00:31:17

which affects the emotional well-being of students. 00:31:21

In the same line of detection of emotional problems between students, 00:31:25

we have implemented a tool called Socioescuela, 00:31:32

which, in addition to working specifically on school harassment, 00:31:35

also helps us to detect situations of emotional difficulties in students. 00:31:39

It is very important, as the Vice-Counselor said, that congresses and training sessions such as this one, this weekend, 00:31:45

must be recognized the effort that you are going to make and the importance of the work that you are going to do in training, 00:31:55

because it is one of the priority lines in the improvement of coexistence and in the prevention of phenomena such as school harassment. 00:32:03

The training aims to provide directives, teachers and families with the necessary strategies to address the detection, prevention and peaceful resolution of conflicts, 00:32:09

both inside and outside the classrooms, because we also want to reach families. It is an essential element for coexistence. 00:32:21

I would like to take this brief moment to mention just a few of the measures, initiatives and interventions that demonstrate the commitment of the Comunidad de Madrid and, in particular, of the Consejería de Educación, 00:32:31

more specifically, of the Subdirección General de Inspección Educativa, of which depends the Unidad de Convivencia, 00:32:44

initiatives for the constant improvement of conviviality and emotional well-being of students in educational centers. 00:32:50

in a conviction that these actions and the work between all of us and these training sessions and this Congress 00:32:55

will contribute to the construction of a more free, more solidary and more committed society. 00:33:03

The quality of our educational system also resides in the attention to the emotional and mental health of our students. 00:33:10

Les deseo un Congreso que les resulte muy productivo y que las experiencias, los conocimientos que van a adquirir en estos dos días les sean muy útiles en su vida profesional. Muchas gracias. 00:33:19

Bueno, y ya para terminar, muchas gracias, Luis. Nuestro querido compañero, José Antonio Luengo, por favor. 00:33:36

Vice-Chairman of Political and Educational Organization, President of the School Council of the Community of Madrid, 00:33:48

Director of Area, Territorial Madrid Norte, Sub-Director General of Education, Sub-Director General of Innovative Programmes and Directorate Formation of the Superior Institute of Madrid of Educational Innovation, 00:34:06

members of the LISMIE team, colleagues of LISMIE, 00:34:20

thank you for your exquisite collaboration in the organization of this Congress 00:34:26

and participants of this Congress Educate to Care. 00:34:30

I remember the call that in July of last year 00:34:35

me hizo el viceconsejero, nuestro querido viceconsejero de Política y Organización Educativa, 00:34:43

anunciando la posibilidad de creación de esta unidad que él, tan amable y generosamente, ha abonderado y ha valorado. 00:34:51

Ciertamente, me hizo mucha ilusión. Antes, nuestro subdirector general de inspección me había adelantado algo. 00:34:59

me hizo mucha ilusión porque escuchar en voz de nuestro viceconsejero esta posibilidad de trabajar en un área como el de la investigación y la formación en materia de salud mental en contextos educativos, indudablemente, era un auténtico real. Muchísimas gracias. 00:35:06

Mental health and emotional well-being have become, especially after the long experience of the pandemic, conceptual and practical references in the political agenda, 00:35:26

the social debate and, of course, the reflection of all administrations on the consequences evidenced in the population and the consequent design and implementation of plans and programs for their appropriate management and response. 00:35:38

It is well known that in the context in which this Congress is located, 00:35:52

that is, the educational system as a whole, with the involvement of all its agents and protagonists, 00:35:56

namely the administration, the educational centers, the management teams, teachers and the rest of the center staff, families and students, 00:36:01

the concern for knowing the quantitative and qualitative dimensions of the preceding consequences 00:36:09

de planificar y desarrollar adecuadas líneas de respuesta y ajuste a las necesidades detectadas 00:36:15

representó y representa, sin atisbo de duda, un referente constante e inexcusable que requiere 00:36:22

de permanente estudio, interpretación, valoración, revisión y adecuación de las medidas y acciones 00:36:28

adoptadas y, por supuesto, por adoptar. Si bien, como hemos señalado lo ocurrido a partir 00:36:34

since March 14, 2020, was supposed to be a before and after in the perception of mental health 00:36:39

and in the consideration of the need to care for our children and adolescents, 00:36:46

the research on this matter has been saying for more than 15 years 00:36:53

about the pertinence of deepening in a world that we were configuring as a society 00:36:58

y los efectos que esta circunstancia sistémica parecía estar provocando en el crecimiento, maduración y desarrollo de la infancia y la adolescencia. 00:37:04

Cabe significar, pues, que si bien es cierto que lo acontecido hace ya más de cinco años 00:37:15

marcó un punto de inflexión de especial significación como catalizador de nuevos y esperables efectos, 00:37:20

What we could observe through numerous statistical indicators, 00:37:27

such as the number of hospital admissions related to psychological breakdown 00:37:35

and the incidence of emotional and adaptive disorders, 00:37:39

the reality, almost always hazy and pragmatic, 00:37:43

showed the radiography of a history already announced in the whole State, 00:37:46

in all of Europe, in the whole world, 00:37:51

in a notorious and explicit way by the research experts. 00:37:54

We were not doing something right in the attention of our children and adolescents. 00:37:59

We were configuring a world that probably left aside 00:38:06

needs of high importance, of high incidence, 00:38:11

especially related to growth, psychological and emotional well-being. 00:38:16

Over the past few years, the measures adopted to give an adequate response to the status quo, which is of reference, have been numerous and diversified, 00:38:22

all of which are the result of the involvement, commitment and responsibility of the Administrations and all their agents. 00:38:31

Some of them will have space to be traveled in the current Congress. 00:38:37

However, it is necessary to continue insisting, exploring, adjusting, modulating or rectifying, if necessary, the response plans. 00:38:42

As our Vice-Counselor has been able to mean, all this in a context of integrated, 00:38:49

transversal and systemic collaboration, and always with the participation of everyone, 00:38:57

administrations, institutions, professionals, educators, teachers and, of course, families and students. 00:39:02

The Congress that has today started with the words of our Vice-Counselor of Political and Educational Organization 00:39:09

pretende contribuir al proceso, siempre complejo pero ineludible, de la constante reflexión y 00:39:16

revisión de lo realizado, de los problemas detectados y abordados, y también de los 00:39:22

impactos sobrevenidos e inesperados, y por supuesto de la toma en consideración de nuevos retos 00:39:26

emergentes. Este es un Congreso que nace desde la ilusión y con esperanza, y el compromiso por 00:39:33

insist to improve. This is a Congress that has essential components and 00:39:42

content of absolute currentness and complicity with the objectives and 00:39:46

challenges that, without a solution of continuity, show us the reality that 00:39:50

every day opens the way in our environment. Educating to take care is the 00:39:54

motto of this Congress, a look at the essential consideration of the 00:39:58

world that we are configuring and the reflection on the necessary 00:40:02

pondering of the values, the foundations and the principles that abound in the 00:40:05

the heart and soul of the human being and, of course, always of our children, teenagers and also young people. 00:40:10

These two days we are going to count, I insist, I am finishing now, with reference professionals 00:40:17

and consequently absolutely concerned in the exploration of appropriate analyses and efficient answers 00:40:23

in the matter that we are going to deal with today and tomorrow. 00:40:30

Contamos con figuras implicadas en los contenidos esenciales del Congreso, 00:40:35

como los especialistas en psiquiatría, Mercedes Navío, Francisco Ferre, Abigail Huertas, 00:40:39

que serán adecuadamente presentados con posterioridad hoy, expertos imprescindibles y buenos amigos. 00:40:46

Contamos asimismo mañana con el Catedrático de Psicología de la Personalidad 00:40:54

y miembro de número de la Academia de Psicología de España, don Marino Pérez. 00:40:58

Estamos con nuestra presidenta del Consejo Escolar de la Comunidad de Madrid, 00:41:06

con Lucía Jalti, la directora de la Cátedra de Innovación y Salud Mental Digital de la Universidad Potificia de Comillas, 00:41:11

y, por supuesto, con las coordinadoras de tres equipos de especial relevancia en la estructura de la Consejería de Educación. 00:41:18

Estamos hablando de Astrid Rodríguez, la coordinadora del equipo contra el acoso escolar de Sandra Rodríguez, la coordinadora del equipo socioemocional, y también con Silvia Martín, coordinadora del equipo de salud mental para centros de educación especial, en una de las configuraciones del programa enlace al que se ha referido nuestro viceconsejero. 00:41:25

Anyway, because of this, the number of applicants for assistance has exceeded the capacity announced. 00:41:44

There have been almost 300 people interested in attending. 00:41:50

Unfortunately, we only had 150 possibilities of attendance. 00:41:54

Thank you all for your interest in being here today. 00:41:59

And greetings also to those of you who are following us through the streaming. 00:42:03

Thank you once again to the authorities present for their support of this initiative. 00:42:08

Thank you from the bottom of my heart. 00:42:14

Very well, we are going to give you approximately 10 minutes of time. 00:42:17

I sincerely apologize. 00:42:39

We are going to start with the inaugural speech of this congress. 00:42:42

No tengo papeles aquí encima de este atril para hablar de la persona a la que vamos a escuchar durante 45 minutos en este congreso que hoy se inaugura, Mercedes Navío. 00:42:48

Mercedes Navío, she is the director, manager of the hospitals of our community of Madrid, 00:43:07

of the Health Council of the community of Madrid. 00:43:17

She is also, for a long time, coordinator of the Regional Office of Mental Health and Addictions 00:43:20

of our region as well. 00:43:26

Es una psiquiatra de alto y gran y largo recorrido en la atención al sufrimiento, al sufrimiento psicológico de las personas. 00:43:28

Hemos quedado con los ponentes en que no íbamos a extendernos demasiado en aspectos curriculares que podemos ver perfectamente buscando, accediendo a través de buscadores. 00:43:41

Y queremos sobre todo significar los aspectos más humanos de su vida. 00:43:52

Mercedes Navío is also responsible for the prevention plan of suicidal behavior in the community of Madrid. 00:43:58

And she is a person with whom I have always been able to collaborate humbly in all those actions, 00:44:07

all those initiatives, interventions that she has always put on top of me to manage that collaboration in some way. 00:44:15

He is an endearing person, intellectually I have to say that he is a person, I would say, more than outstanding. 00:44:28

We normally see people who manage positions, positions, responsibilities in the administration, 00:44:40

always, well, as people who are very much in the area of management and others, 00:44:49

y nos olvidamos un poco de quiénes son, la vais a escuchar, 00:44:54

y vais a poder escuchar el corazón que late detrás de una persona 00:45:00

que ha sufrido mucho en el abordaje también de su profesión diaria 00:45:06

con el sufrimiento de las personas a las que ha tratado. 00:45:13

Espero, Mercedes, que este señalamiento de aspectos puramente humanos 00:45:17

y personales y no tanto del currículum hayan sido no hayan sido exagerados 00:45:23

gracias por estar hoy aquí de todo corazón y este estudio 00:45:31

pues pues buenas tardes buenas tardes gracias por por la invitación 00:45:51

jose antonio es buen amigo de forma que sus palabras 00:45:59

me han, en fin, aparte de conmovido, han superado ahora a ver quién está a la altura de las 00:46:04

expectativas generadas. Bueno, que detrás de mí y de mi responsabilidad en gestión 00:46:14

hay un corazón que late, eso es rigurosamente cierto. Y bueno, pues insisto, para mí es 00:46:20

It is a pleasure and a privilege to be here today, and to be accompanied by people with the commitment that the fact that you are in this Congress and this weekend translates to. 00:46:30

I would like to thank you for the invitation to be present. 00:46:41

I would also like to mention Raquel, of course, the sub-director and the group of people who have made it possible for us to be here today, 00:46:45

here, also from the School Board, in short, to the civil society articulated in the field 00:46:55

of education and with our hand held from the field of health. 00:47:00

Well, first I will start with the most prosaic aspects. They are ineligible and I will try 00:47:05

to be as brief as possible, but they asked me to talk about prevention, among other things, 00:47:16

And before we get to the most systematic interventions in which we have worked together with you, 00:47:24

with the entire Consejería de Educación, and ultimately with each of those of you who are teaching 00:47:32

and being what I don't know if then Dr. Abigail Huertas or Dr. Ferrer will mention, 00:47:41

always in health we talk about the professional being the therapeutic instrument. 00:47:49

Regardless of the organisational approaches that have also been proposed in education, 00:47:53

and which I will allude to after my intervention, 00:48:00

teachers, each one of you, are subject to emotional modeling and containment 00:48:05

of the people, of the children, teenagers and young people with whom you work and are formed. 00:48:13

This modeling has to do with the fact that, not only in education, but in any human group, 00:48:22

there has to be someone who resists to behave like an adult, as Gregorio Luri said. 00:48:30

and adults in the field of education, modeling subjects, the people on whom children, adolescents and young people look at each other, 00:48:37

you are each one of you, and in that sense you make the difference, as I hope to be able to translate and be, I insist, at the height, 00:48:50

from a more prosaic and less important field. 00:48:59

The most important thing we do in management is to facilitate 00:49:06

that both from the health and clinical field and from the educational field 00:49:11

you are in the best conditions to be able to do what you have to do. 00:49:15

That is our responsibility. 00:49:19

That can be our success and that can also be our failure. 00:49:21

In any case, of course, undoubtedly, and I can affirm that, it is our commitment. 00:49:26

The types of prevention in general health and mental health in particular have to do with primary, secondary and tertiary prevention. 00:49:33

I am going to talk today, fundamentally, about aspects that have to do with primary prevention, which is the intervention when a situation has not occurred that we could already call a risk or, in your case, a pathology, and secondary prevention when it has already manifested and we have to try to prevent it from repeating itself. 00:49:42

In terms of prevention, there are also different approaches, primary, secondary and tertiary prevention, universal, selective and indicated. 00:50:02

Depending on whether we are talking about prevention in an absolutely broad sense in the community, whether we are talking about when there are risk populations or whether we are talking about situations in which we have already identified a pathology. 00:50:16

In terms of mental health, we always talk about the bio-psycho-social model, and the factors of these three natures are combined in such a way that it is not easy to differentiate them from each other. 00:50:32

What I can tell you is that, although there are significant advances from a scientific point of view in terms of what we can modify in genetics, this is still very limited. 00:50:48

In psychological interventions we have a greater development, and in what has to do with the so-called social determinants of health, we have a particularly important capacity to operate. 00:51:00

I say transdiagnostics because each one of these factors, sexual abuse, physical abuse, 00:51:13

adversity in childhood, understood as abuse, as emotional negligence, 00:51:23

to talk about those that are more directly related to mental health, 00:51:27

are subjacent to very different pathologies and also have very important risks. 00:51:33

And all of these are potentially detectable and avoidable. 00:51:41

I have not included here, although I will mention later, 00:51:46

something that has already been mentioned in the interventions that have preceded me, 00:51:49

and that is the harassment among equals. 00:51:52

Any form of violence has a potential impact on people's mental health, 00:51:54

and specifically in what has to do with coexistence 00:52:00

and the situations of, I insist, of harassment in any of the forms, also, of course, in cyber harassment. 00:52:06

And this is what I am coming to tell you about publications that are very well-known and prestigious, like Lancet. 00:52:16

We know that access to substances, we know that prevention of harassment, 00:52:25

We know that this type of intervention works and that it is in the hands of all, of the community as a whole and, of course, of the forms of organization. 00:52:31

I was particularly interested in highlighting this because one of the things that I want to share with you is a hopeful vision of what we can do. 00:52:43

to do. Not omnipotent, not guilty of where we can get, because the illusion of control is an illusion, 00:52:56

we cannot control everything, no one can control everything. We are not guilty, we are, in any case, 00:53:07

co-responsible of the joint task that we have ahead. But I want to transfer that hope. 00:53:15

Many times what ends up transcending in the public debate, especially after the pandemic, is a vision that is sometimes a bit catastrophic or pessimistic. 00:53:24

And without abandoning the realism that responsibility requires, I also want to say that there are objective data that allow us to be hopeful. 00:53:37

There are also preventive interventions, as I said, all those that point to social determinants of health, 00:53:51

to inequality, to inequity, to all types of violence, they are in our hands when it comes to proposing this prevention. 00:54:00

The domains of mental health, here you can see them, from those that have to do with knowledge or attitude, 00:54:10

to those others that have to do with meaning. 00:54:18

Adolescents, and the author Huertas will surely talk about this later, 00:54:21

are in the process of maturation, of incorporation, of the ability to face stress, 00:54:27

in the process of construction or discovery of their identity. 00:54:37

They are, in short, being very dependent on the eyes of others and, above all, and particularly, on the eyes of the equals and they are rehearsing the projection of themselves towards the future. 00:54:42

Towards a future that they have to be able to visualize and project, as I say, in a hopeful way and that makes sense. 00:54:58

The greatest adversities leave a mark. 00:55:07

Boris Zirulnik said that all adversity is a wound that is written in our history, but it is not a destiny. 00:55:11

And it is not because the destiny is not written. 00:55:18

And the ability to contribute so that the teenager finds meaning in his own purpose and project 00:55:21

is something that the whole community, the tribe, would say we have to contribute. 00:55:28

No podemos hacer el camino por ellos, pero sí tenemos que hacer posible el que ellos puedan recorrer ese camino. 00:55:36

Las intervenciones, y dentro de ellas las que más evidencia plantean, son las de la psicoeducación. 00:55:46

Es la más efectiva para promover conocimientos sobre salud mental y sobre habilidades cognitivas. 00:55:53

And psychoeducation is in the hands of the actors, of course, of the health workers, but also, in a joint way, of the professionals of education. 00:55:58

Look, look, psychotherapy has evidence, the combined therapies, of course, have evidence, and other types of therapies have evidence. 00:56:12

Psychoeducation has a very important role, we do not consider it a minor action when it comes to prevention. 00:56:20

There are strategies at the European and international level that influence what I am communicating to you in a summarized manner. 00:56:30

There are also instances at the national and international level, as I said. 00:56:41

These are examples of prevention of mental health disorders in primary care, 00:56:50

or in the case of the superior publication, a publication from Canada, this last one is Spanish, 00:56:55

but there is a broad consensus in relation to the fact that this is possible. 00:57:03

As I said, at the level of the Ministry's strategy, we have general health improvements in these strategies, and emotional well-being is, as it cannot be otherwise, one of the fundamentals. 00:57:08

Another potentially modifiable element is access to drugs. The national plan has a broad development. 00:57:25

We in the Community of Madrid have a specific plan against drugs. 00:57:34

We know that, in the young population, cannabis is the most consumed drug, 00:57:39

and we know this both from studies or publications called surveys, 00:57:45

as well as from the studies of studies or ages, 00:57:52

as well as from the data of health care activities that we have in the set of our health care services. 00:57:57

We have a network of addiction centers, and one of them is specifically intended for the adolescent population. 00:58:03

More than 85% of the problems of addictions, if we subtract the behavioral addictions, which I don't know if Dr. Ferrer will later comment on, 00:58:14

the substance that is most consumed and that is generating mental health problems is cannabis. 00:58:25

Well, there are guidelines on prevention, as you well know, we have a portfolio of services in primary care, which is our most permeable, most capitalized level of care, which affect the importance and the possibility of that prevention. 00:58:33

we have actions from the General Directorate of Public Health, in the field of the Ministry of Health, 00:58:50

which also talk about this promotion and prevention by hand and in the group of the educational community. 00:58:56

In short, at the macro level, there is reasonable evidence and there are actions from the operational field around the possibility of this prevention. 00:59:08

José Antonio has alluded to what the pandemic meant, and he has already mentioned something that we were beginning to tinker with. 00:59:18

The pandemic has undoubtedly had a catalytic effect. This curve, take it as a proposal that can be illustrative. 00:59:27

In terms of scientific evidence, if we are very purist, it could be critical, but I think it serves us for illustrative purposes. 00:59:37

There was a disruptive increase in behavioral emergencies not in March 2020. 00:59:47

We began to see it in what has to do with the need for hospital admission in October 2020, 00:59:58

at the beginning of the academic year after March 2020. 01:00:05

A wave that was, at that time, the third, we were in the first two epidemics, and the third, in October 2020. 01:00:12

Before, we already knew that there had been a tendency to increase, especially in terms of self-harm, in this adolescent population, and in food disorders. 01:00:25

These two trends, with this catalyzing effect, had a disruptive increase that forced us to duplicate both the hospitalization units and the beds available for hospitalization in children and adolescents. 01:00:38

Before the pandemic, we had 52 beds in Madrid. 01:00:55

After October 2020, we have more than doubled that need. 01:01:01

And now we are in a situation that we could call new normality, 01:01:11

in which that disruptive increase was stabilized, 01:01:15

but it was not stabilized at the same basal level, but at a different basal. 01:01:19

We have a network of mental health and addiction that is very stupid and that also has a history of decades of work with the Family Council, 01:01:24

with the social attention network to mental disorder in the Family Council. 01:01:38

It is true that in this case it is very linked to the adult population, the Social Policy Council, 01:01:44

...although it also has an impact on adolescents, as we will see later. 01:01:52

As I said, here you can see in the graph how the suicide attempts in adolescents increased in that period... 01:01:58

...and how they maintained the curve that I have mentioned, and how we also had other behavioral emergencies... 01:02:05

...such as eating disorders. 01:02:10

It is true that many of them resigned because they were the exponent of a form of self-regulation in the face of a situation of acute stress that was also overcoming the anguish of adults at that time. 01:02:13

And in the family groups and in any group, the emerging ones have to do with the people who have the most difficulties when it comes to having this elaboration that I was talking about. 01:02:37

Adolescents were an important part of the population, but we also find it in other processes of adult life or of the elderly. 01:02:51

We have been monitoring and we continue to monitor the whole phenomenon of suicidal behavior through our early warning called ARSUIC, which is a kind of early and intensive risk of attention to people who have had this problem of suicide attempts. 01:03:04

In addition, we first launched a specific plan called COVID and then the 2022-2024 Mental Health Plan. 01:03:26

As I said, in Plan 18-20 we had a specific line of attention for children and adolescents because we were warning that it was a line that had to be prioritized. 01:03:35

We have maintained this priority in 2022-2024 and, as I will tell you now, we continue to keep it absolutely prioritized in the attention to serious mental health. 01:03:49

How has this been translated? In addition to duplicating hospital resources, we have increased all the equipment for attention to serious mental health in mental health centers. 01:04:01

We have also launched suicide prevention equipment and a number of other special programs, 01:04:16

in addition to a considerable reinforcement of what we call intermediate resources, 01:04:22

such as day care hospitals for adolescents, in which we have also had a particularly important growth. 01:04:26

Four more day care hospitals were opened in this plan, and we have continued this path 01:04:33

We have continued this path because we have a commitment that all general hospitals, and there are more than 20 of them in the Ministry of Health, 01:04:39

all general hospitals have a day hospital for mental health adolescents. 01:04:50

In addition, we had a reinforcement of home care, which had its pilot experience, 01:04:56

of which we have made a balance very recently, in the Hospital of Niño Jesús, 01:05:05

and which has then been extended as a reinforcement to all day-care hospitals that already exist, 01:05:10

to pivot home care from there. 01:05:15

Let's see, here are the ones we launched, La Paz, Getafe, Clínico San Carlos and then the home care from the same. 01:05:19

And in terms of addictions, as I say, we are working on specific programs, in addition to having units like the one I mentioned in the case of Los Mesejos. 01:05:31

This is the map of day care hospitals. 01:05:43

Before the end of the year, there will be a day care hospital, 01:05:46

the Hospital of Arganda and the Hospital of Infanta Cristina de Parla, 01:05:50

and in the following year, on the 26th, 01:05:54

Elenares in the north and Infanta Sofía in San Sebastián de los Reyes, 01:05:58

in what we have called an intensive program. 01:06:10

In addition, we are strengthening psychological attention in these populations, increasing the provision of clinical psychologists, which is one of the professional categories in which we still have a greater need for treatment. 01:06:12

Well, this is not to talk about my book, this is to tell you that the plurality of which José Antonio previously talked about and that we share, the commitment that we share, is translated and encourages the strategies that are often prosaic, 01:06:26

that are books, that are papers, that look like bureaucracy, 01:06:48

but that behind them there are people who want, 01:06:52

that we want to work together so that the attention is getting better and better. 01:06:57

In parallel with these plans that I mentioned, 01:07:04

we also started working on the Autonomous Suicide Prevention Plan. 01:07:09

In the previous plan we had a specific suicide prevention line 01:07:13

and we chose to give it the role that suicide prevention required. 01:07:17

In the Community of Madrid, we have been working systematically on suicide prevention since 2011. 01:07:25

That work has been going on for almost 15 years. 01:07:32

This plan has just been evaluated in Ecuador. 01:07:35

This plan has the participation of all the councils and, of course, and as it could not be otherwise, the Education Council, which palpitates in many of the actions that are being put in place, some of which have already been alluded to. 01:07:43

This type of actions are followed by multi-level programs, which are recommended by the World Health Organization, 01:07:58

in which information is put as an accent to the citizen through different campaigns, 01:08:06

also training professionals, in this case mainly health professionals, cooperation with social facilitators, 01:08:12

social and in this the teachers are absolutely key to reach the 01:08:22

adolescent and young population and also in what we call reorganization 01:08:28

our internal in the identification of people of risk within the system 01:08:33

health care for access to immediate and intensive treatment in 01:08:38

suicide prevention risk situations 01:08:43

when we were working on the prevention plan in this confluence of 01:08:47

What we found is that many, in education we already knew it, but many, I would say that the total practice, were working on suicide prevention and they were doing it to achieve… 01:08:51

This is the evaluation of one of the pilot programs that we did on 12 October and the Jiménez Díaz Foundation, which has shown to be effective, to reduce risk and, in addition, to be cost-effective. 01:09:06

This is the publication that I bring to you, as well as the evaluation of the ARSUIC, which we also launched. 01:09:21

But, ultimately, what is it about? 01:09:27

It is about the fact that the group of social facilitators, who are people who, due to their professional or social role, can be potential detectors or vehicle of the arrival to the health sector, the person at risk can end up receiving the attention he or she needs. 01:09:29

I would like to point out this guide, which we work together with you, as well as with other social facilitators, but being here with you today, it seemed to me that it was especially relevant to thank you and remind you of the implementation of this guide and its dissemination. 01:09:48

Los 21 equipos de prevención, casi 400 profesionales se han incorporado. 01:10:10

Estamos trabajando, por ejemplo, con Metro, con Cercanías, con El Suma, 01:10:19

con todo lo que tiene que ver con la limitación de acceso a métodos potencialmente letales. 01:10:25

Estamos trabajando con vosotros, codo con codo, 01:10:30

y os agradecemos especialmente todo lo que estáis llevando a cabo. 01:10:33

Campaigns like No siempre le levantan la mano, En sus zapatos, 01:10:37

all the work that is done from the unit of coexistence, the SICE protocol, 01:10:43

the programs in which we are working together and that have been mentioned, 01:10:49

the Interconsultor program, all this is being woven, that is our intention, 01:10:54

We have to create a more and more stupid network so that none of our teenagers can escape it, 01:11:03

so that they feel contented and listened to. 01:11:14

In short, they feel that they matter, that we care, that we see them, 01:11:18

that we are able to attend to them in the way they require, 01:11:25

with the right distance. 01:11:30

I suppose that Dr. Abigail Huerta will also agree on this. 01:11:32

We are also working with the Consejería de Asuntos Sociales, 01:11:35

Juventud y Asuntos Sociales. 01:11:40

They have specific devices in the adolescent population. 01:11:41

We are also working on plans with the administration of proximity, 01:11:44

with the municipalities of the Community of Madrid. 01:11:49

And there are more and more municipalities with their own prevention plans, articulating the set of actors in each of those areas. 01:11:51

I gave you the example of Alcobendas, which I don't see here now, with specific campaigns, 01:12:03

but in each one of them what is being done is to weave this network that I was talking about previously. 01:12:12

and that ultimately pursues this, that each and every one of us can make a difference as anti-suicide agents. 01:12:18

This is sometimes very scary and I am very aware of the urgent task that each one of you has in matters strictly of education. 01:12:30

And here I come back to the first thing I said when I intervened. 01:12:47

You are model agents, you are the mirror in which teenagers look at themselves, 01:12:52

and we educate with what we are much more and infinitely more than what we can say. 01:12:59

It is true that we also submit to that look at the contradictions and inconsistencies that all human beings have, 01:13:06

But with authenticity, that can also be useful to those who are conforming at this moment. 01:13:13

And I finish with something that I usually underline. 01:13:24

Mental health and suicide prevention, in particular, have come out of the dark. 01:13:30

and they are very present today in the public and political debate. 01:13:38

That is, in general, good news. 01:13:43

But I think it is especially important to note that silence killed, 01:13:46

silence killed, and it can continue to be very harmful, 01:13:53

especially for people who are in a situation of vulnerability, 01:13:59

vulnerability, suffering violence of any kind, but noise can also do harm. 01:14:02

When we make approaches that do not contemplate the possibility that, even with the best intention, 01:14:09

an uncontrolled emotional ventilation can somehow favor contagion phenomena 01:14:17

...and the imitative behaviours that we know can be given, that we know exist, that we have to take into account. 01:14:26

With this, I do not want to give you more responsibility than you already have, which is not little. 01:14:35

I want to emphasise the hand held that we will always have and will continue to have in the strategic areas... 01:14:42

and also in the operations, through the direct connection with the link teams that we are going to work with to extend. 01:14:51

And, ultimately, we are co-participants and co-responsible that our adolescents, 01:14:58

and I emphasize adolescence, although there may also be situations of risk in youth, 01:15:07

who, in fact, there are, feel that they can project themselves towards the future 01:15:15

and can do so with a sense of agency recovered in which they can be who they are 01:15:23

and in which the anguishes that emerge, particularly in adolescence, in the management of their ambivalences, 01:15:31

find adult emotional contentment in each and every one of us who have that obligation. 01:15:37

And this is an obligation that, I insist, corresponds to all of us. 01:15:46

I hope I have not limited myself in time. José Antonio, I think I cannot pass this slide, but I was finishing. 01:15:51

I will finish with Gregorio Luri, reminding you and reminding me of the importance that in every human group someone behaves like an adult and also thanking you all and each one of you as anti-suicide agents and, above all, as providers of meaning for this generation that is opening its way and that requires that the inheritance that we receive, 01:16:01

find it, at least if not improved, at the same level as we receive it and that they can transmit, 01:16:29

they can make this delegated transfer and develop their own existential project with meaning. 01:16:38

Thank you very much everyone. Thank you. 01:16:45

Thank you very much, Mercedes, for your presentation, for your involvement, for your love, always, and above all for the quality that you print for each one of the actions that you develop in all your responsibilities. 01:16:48

Here there are people from your team that I have been able to greet from afar. 01:17:28

I am delighted that you are here. 01:17:33

In this life you have to be grateful. 01:17:40

It is said that the saying is that you have to be grateful for being born well. 01:17:43

Thank you very much. 01:17:52

Here, the one who has the most responsibility, without a doubt, 01:17:54

in ensuring that this goes well, that it is carefully treated and so on, 01:17:59

is our CEO, Raquel Yepen, my colleague, who has done an absolutely splendid job. 01:18:04

I would like to thank all the colleagues of ISMIE who have generously contributed to this work. 01:18:13

The support of the Directorate, the General Directorate, of the entire General Directorate, of course. 01:18:26

Well, and now we are going to give the floor to the next speaker, Francisco Ferri. 01:18:33

He is a specialist in psychiatry, as we have mentioned before, 01:18:46

a doctor in psychiatry, an associate professor of psychiatry 01:18:52

and a diploma in health management in hospital institutions. 01:18:56

I had the opportunity to meet Francisco when I had the responsibility of the General Secretary with Pedro Núñez Morgádez as defender of the minor. 01:19:01

At that time, Francisco Ferre was the coordinator of the Regional Office of Mental Health and Addictions, the position of responsibility that Mercedes Bernabéu has now. 01:19:13

y era siempre tan agradable estar con él, escucharle. 01:19:25

Vais a ver, por encima de todo, su sonrisa. 01:19:32

Él es un hombre que sonríe, que es amable, que es generoso. 01:19:35

Bueno, a veces se enfada un poco, pero yo no le suelo ver en esas circunstancias. 01:19:38

Podría decir de él muchas cosas, pero le quiero quedar, como antes he hecho con Mercedes, 01:19:45

con alguna singularidad que no vemos normalmente en Wikipedia o en estos repositorios de Curriculum Vitae que están en nuestros buscadores. 01:19:51

Él dirigió su interés siempre a aspectos psíquicos del enfermo físico, 01:20:05

y su tesis doctoral versó sobre la adaptación psicosocial en la espera de un trasplante hepático. 01:20:12

Well, this seems to be something, a milestone in his life, but he already pointed out the importance of marrying different aspects, the physical and the psychological. 01:20:19

This thesis was awarded with the Extraordinary Prize of the Complutense University. 01:20:36

Currently, his interest is directed to models of humanization of psychiatry with the implementation and analysis of an open hospitalization unit project. 01:20:42

Well, he is now, it must be said, he is the head of the adult psychiatry service and director of the Institute of Psychiatry and Mental Health of the Gregorio Marañón Hospital in Madrid. 01:20:54

But I'm going with the singularities, they matter to him, they interest him, they give him the professional life, 01:21:08

they give him the professional life, the reflection, the permanent research in the world of behavioral addictions. 01:21:18

What we are going to hear today, we have heard it from very few people, 01:21:25

who is the director of one of the pioneering centers in our country, 01:21:30

which is ADCOM, Center for Addictions, 01:21:35

for the approach and treatment of behavioral addictions. 01:21:38

It is an aspect or dimension that sometimes we read, 01:21:41

sometimes we find some kind of article in El País and other press headlines, 01:21:49

but we have to say that the one who knows the most about all these aspects of the new wedge, 01:21:55

so to speak, in the concern of this society, where we are heading, is him. 01:22:02

And he is especially interested, logically, in the processes of digitization 01:22:11

and the application of artificial intelligence in the assistance process 01:22:16

de la Atención de Psiquiatría y Salud Mental. 01:22:21

Bueno, él ha sido, termino ya con esto, medalla del Ministerio de Sanidad 01:22:25

por la Organización de la Atención en Salud Mental, 01:22:30

algo que nunca se nos olvidará, a las víctimas del atentado de los 11M. 01:22:34

Francisco, aquí tienes este espacio para deleitarnos. 01:22:40

Thank you very much, Antonio. We have known each other for a long time. 01:22:46

By the way, do you remember the time I have? Are you ready? 01:23:11

Well, I say that we have known each other for a long time. 01:23:18

Jorge Antonio is a person that I personally admire and appreciate very much. 01:23:22

And every time he calls me for these things, the truth is that I am delighted. 01:23:28

But today I am especially interested in being here today for several reasons. 01:23:32

I come to talk about my book, as he has already announced. 01:23:37

As Dr. Navío has been much more elegant, I am going to talk about my book and only about my book. 01:23:41

my book and then I'm sure you're going to learn a lot with Dr. Abigail Huertas, but I'm going to go to 01:23:46

the concrete. Why? Because I would like to take advantage of this space so that the teachers have 01:23:53

knowledge, if you don't already have it, which surely you do, of a service, as Antonio has said, 01:24:00

absolutely pioneering and that you can use it and that you should use it if you can help your 01:24:06

You will see that it is very simple, it is very easy, it is for everyone, you do not have to ask anyone to plug in so that they can see the students. 01:24:12

So, I insist that you please take us into account. 01:24:20

And I also want to take advantage of this space to lend a hand or throw a glove to the director of research training. 01:24:24

because I think there could be some area, in particular in primary prevention, 01:24:33

in the subject of behavioral diseases, in which we could collaborate. 01:24:39

And with that idea I am going to tell you first, as I say, the… 01:24:44

Well, this slide, this slide that you see here is the one you would find 01:24:54

if you search for Adcom Madrid on Google. 01:25:01

What is the Adcom Center? 01:25:05

Let's see, it is a public center, this is very important, 01:25:07

and I want to underline it because until we started in 2022, 01:25:11

the attention to behavioral addictions in our country in general 01:25:15

and in our community in particular, 01:25:19

was distributed in private devices with, sometimes, professionals who knew what they did 01:25:22

and others, many times with dubious competition in those fields. 01:25:30

No one looked at this, at addictions, at sex, at video games, it was not collected. 01:25:35

So we considered, and I think it was an achievement of the Government of the Community of Madrid, 01:25:40

to realize that this bull had to be caught by the horns. 01:25:44

And that is why a center dedicated to behavioral addictions was created from the Public Service, 01:25:48

to detection, prevention, treatment and research. 01:25:53

What are behavioral addictions? Well, there are different definitions, but I would like to remember one. 01:25:57

They are psychological disorders that have nothing else to do with the loss of control over a behavior, 01:26:06

a behavior that we repeat compulsively and that we cannot escape. 01:26:12

And we cannot escape in the same way that a person addicted to alcohol cannot escape. 01:26:16

How does alcohol work? Well, we start drinking more, a boy with a video game starts to spend more time on the convenient, that's called abuse. 01:26:26

One day we realize that to get the point with alcohol we need more and more, we need to drink more and more, 01:26:36

the kid to stay, to leave the mobile or the screen, every day realizes that he has had to use more time, 01:26:43

that is invading hours that should be assigned to other issues. 01:26:51

It is the phenomenon of tolerance. 01:26:55

Then comes the phenomenon of abstinence, 01:26:57

which is the day when I do not have alcohol in hand and then I have a bad time. 01:26:59

I have a bad time from a physical and psychological point of view. 01:27:02

This is called abstinence. 01:27:06

How many times have you seen, known, heard, 01:27:08

those kids who, when they take their cell phone out, 01:27:11

because they have to study today, 01:27:13

have sometimes choleric reactions 01:27:14

or really, at least, discomfort and protest. 01:27:16

And there comes a time, which is the last phase of addiction with substance, for example, alcohol, 01:27:20

which is when, knowing that it is destroying his life, he cannot stop drinking because he has lost his freedom from substance. 01:27:26

And in video games, which I have taken as an example, but I can apply it to more behavioral addictions, 01:27:33

that boy knows, and I say it because we see them in the most serious phases, 01:27:38

that he is trapped and that he cannot live without being next to the screen. 01:27:43

Well, obviously we have to say that life, and denying this is absurd, 01:27:49

currently there is an offline life and an online life. 01:27:59

When I was younger, I couldn't even imagine that I was going to live my life here. 01:28:03

Here I have my family relationships, my emotional relationships, my health, here I have health insurance. 01:28:14

I also have, if I want to do some money operation, I have it all here, in this little drawer. 01:28:22

I could never imagine, and it really seems to me that it was yesterday, when I was studying medicine, that this could ever happen. 01:28:27

It is obvious that life has changed, it is obvious that there is an online world, and denying that is absurd. 01:28:35

and demonize the screens and the Internet, I think it is completely absurd. 01:28:40

What happens is that we have to regulate it and we have to make a therapeutic use of it. 01:28:44

In this context, we have to understand that, of course, there are excesses. 01:28:48

These figures are tremendous. 01:28:52

One in every five young people consumes the risk of tiktok. 01:28:54

This is from the University of Oberta in Catalonia. 01:28:58

Infocop has found that the availability of mobiles is, each time, even earlier. 01:29:01

23.3% of young people under 10 years old already have a mobile phone. 01:29:07

93% of children in Spain are users of a network. 01:29:11

Well, this is what there is and we cannot avoid it. 01:29:15

Then, there are two behavioral diseases that are genuinely online. 01:29:17

I am making this reflection so that we understand that, obviously, 01:29:23

the online world has brought us a new form of presentation of psychiatric pathology, 01:29:27

and in this case what we are talking about today. 01:29:31

Social networks and video games are obviously online. 01:29:33

From video games, we can distinguish between multi-online and video console. 01:29:36

And then there are three behavioral additions that have their offline version, 01:29:41

which are shopping, sex and gambling, which is the most important, and that have that other online version. 01:29:47

And it is that today I have to say that in these three genuinely offline, 01:29:54

The online version is causing more problems. 01:30:01

It is obvious that the world of screens and the world of the Internet has brought this and we cannot ignore it. 01:30:08

It is very frequent. There are very different figures. 01:30:16

There are many studies that are very unequal. 01:30:20

But I would have to tell you something, despite the figures that some may seem large or small. 01:30:24

Our experience, and we will have data as we will see later, is that really enslaved people, 01:30:30

people addicted to new technologies, well, and to behavioral health services in general, 01:30:37

fortunately, they are few, serious, but they are few. 01:30:42

I also want this to be clear. 01:30:47

This alarm, which obviously exists, and I think it is very useful and very interesting to do the prevention, 01:30:48

but I assure you, if this is a reality, that really what is the serious addict, 01:30:56

the case, for example, the video game of that child who is already locked up, who does not go to school, 01:31:01

who almost does not eat, this is really very infrequent. 01:31:07

What are our objectives? Well, on the one hand we have to do prevention, 01:31:11

Preventing is not only detecting over time, it is also telling someone that they don't have something. 01:31:16

Because a lot of people have tried to instrumentalize diagnostics of behavioral addictions for other purposes. 01:31:22

I am an addict. This is a caricature, it is grotesque, but it is real. 01:31:29

A prisoner of a prison wrote to us saying that he wanted to come to Azcón to have his sex addiction taken care of 01:31:35

He was convicted of rape and he was not a rapist, he was a sex addict. 01:31:42

This is an example of people who sometimes pretend… 01:31:46

And of course, to tell people, no, you are not a mobile addict, 01:31:49

you are an uneducated person who uses it out of place, 01:31:52

or your parents have been educated in an inadequate way that we have to recycle. 01:31:56

So, it is also important that these diagnoses are not abused. 01:32:00

We are a network project, and in those little balls I would like to find someone from education, 01:32:05

We exchange patients and we coordinate according to what moments with the mental health networks, logically, of the mental health centers, with the social services, the service of attention, technological additions, with the units of Juego Patológico Madrid, Ramón y Cajal and 12 de Octubre, and also very intensely with the entire Institute of Additions Madrid Salud, which has some drug centers. 01:32:09

I don't know, because I don't know if there would be any device in education with which we could exchange patients because we could give them some kind of attention. 01:32:36

We want to work in a network. There are many times that we need the support of elements, of entities that are not necessarily sanitary. 01:32:46

How are they treated? This is a general vision, to give a brushstroke, because basically psychotherapy is the most effective instrument, 01:32:57

cognitive-conductual in particular, as well as occupational therapies, as you will see later that I will tell you. 01:33:07

Pharmacotherapy has its usefulness because, as we will see later, when there is a mental illness below 01:33:13

and that illness has a response to a drug, it is very important to use the drug 01:33:19

and not to waste this opportunity to correct, incidentally, the behavioural addition of psychosocial interventions. 01:33:23

And digital technologies are already arriving, but we are not using them yet. 01:33:29

Who is it aimed at? Who can access it? 01:33:33

Ladies and gentlemen, any Madrilenian older than 12 years, we do not see less than 12 years, 01:33:36

and we recommend that they have the virtual health card activated. 01:33:42

No sé cuántos la tienen aquí, pero si alguno la tiene y la abre, verá que hay un apartado que pone adicciones comportamentales. 01:33:47

Estamos metidos hasta en vuestro teléfono móvil. 01:33:54

¿Dónde estamos? Pues este es el hospital, decían hace tiempo que era uno de los más grandes de Europa, yo no sé si lo es, 01:33:58

pero aquí en aquella esquinilla, ahí estamos en la esquina de la calle Ibiza con Maikez, en la primera planta del edificio de psiquiatría, 01:34:05

I was going to say, you have your own house, it's not too far away, there you can get closer. 01:34:12

It is understood that I want to sell my book, but everything has a limit. 01:34:21

Who do we make up this team? 01:34:26

Well, you should know that there is a psychiatrist for children and adolescents, 01:34:31

there is a psychiatrist for adults, a clinical psychologist, a nurse specialist in mental health, 01:34:34

There is a psychologist-researcher from CSIC who helps us design research projects. 01:34:39

A social worker who is doing a great job and we have many rotations to the point that we have already had to close the opening to foreign residents 01:34:45

because we are completely saturated until the year almost 2028. 01:34:55

Why? Because it is a topic that interests young people. 01:34:58

What do we do here? Well, here I want to remember this topic. 01:35:02

What is that about dual pathology? Well, the usual thing is that a person who has an addiction to the game, shopping, sex, video games, social networks, 01:35:08

has a mental disorder below. It is true that a mental disorder considered not serious, such as anxiety, 01:35:24

It is true that it is rare for a psychosis to appear under this, but there are pathologies that are very prevalent and very important, 01:35:31

such as attention deficit disorder, obsessive-compulsive disorder, 01:35:38

and we must know that if this is not treated, we will not solve the problem of behavioral addiction. 01:35:42

Well, affective disorders are very common, especially in almost all cases. 01:35:48

I would say that depression is especially prevalent in gambling and sex addictions. 01:35:58

Impulsivity is also a shared trait in all of them. 01:36:05

There are also personality disorder alterations, and in the case of shopping, 01:36:10

it is very characteristic, although it is not the most frequent, 01:36:15

of eating disorders, especially bulimia. 01:36:17

And then there are also many people who have abuse of other addictions with substances. 01:36:21

Well, what do we do? Well, then we have four phases. Access, which for us is our jewel, that is, how to access, I will explain it now. 01:36:27

The private, which is where we decide who has a disorder, who is at risk and who has nothing. 01:36:35

The evaluation, which is what we already do with them, and then the treatment and treatment and the high. 01:36:43

Let's see. Access, and here it is what interests me the most, so that everyone knows how easy it is to access. 01:36:47

It is accessed by self-cite. The self-cite of the adult is obvious, and of the minor, as it is. 01:36:55

Since the minors do not yet have an individual health card, it has to be with the father's health card, 01:37:01

the delegated health card, but you will see how simple it is. 01:37:06

You go to Google, you type Adcom Madrid, you can also do it directly from the virtual health card, 01:37:12

because there are many people who do not have it, and I do not only recommend having it, because it is very interesting. 01:37:20

So, as I say there, it is as easy as booking a table in a restaurant, and look that we do not do it. 01:37:26

Or a hotel. Ah, yes, well, even easier. 01:37:32

We go there, you see there on the page, you put your little guitar, we click, I click and a screen appears, 01:37:35

in which we have to go to our data, and then they ask us for a date, we ask for a date, 01:37:46

and here we are going to choose the day, imagine what a luxury, the day is chosen. 01:37:52

I can tell you that today, except for holidays, if today you ask for a date for the private, 01:37:58

next week we are going to receive you. 01:38:04

You choose the day, I repeat, this is important, but you do not choose the day, but also the time. 01:38:08

We have two different shifts for minors and adults, but you can choose. 01:38:15

And on top of that, you already have your appointment, here it tells you where you have to go, at what time, and when we wait for you. 01:38:22

But if it doesn't suit you and you want to cancel it, you can cancel it. 01:38:32

Ladies and gentlemen, it can't be easier. 01:38:35

You don't have to ask any friend of the hospital for a recommendation. 01:38:39

Nothing. You take your student's father, you sit him down, you put him in Action Madrid and you get him yourself, 01:38:43

because sometimes you say, I don't know if I'll know, and you get the appointment yourself. 01:38:51

That simple. And that's one of the things I wanted to take advantage of today. 01:38:55

Please, know that it exists, know that it's very easy, and know that we're there for this. 01:38:58

Well, and then comes the screening, which is a critical moment as well. 01:39:04

The screening of adults and minors, we do two phases, I will comment on them, 01:39:09

the one of the minors first and then the parents separately, but we have to do it. 01:39:15

Then I will make a reflection on the issue of minors. 01:39:21

So, we quote eight people at once in a specially prepared room. 01:39:23

If they do not have the virtual health card activated, they are given a tablet 01:39:29

And then we start, there is a social worker or a nurse who directs the session, in case anyone has a doubt. 01:39:33

Then, directly, as soon as we capture the appointment, that is, you have arrived, in your virtual health card, 01:39:39

all your questionnaires appear. 01:39:47

Here, you see? The screen has been modernized. 01:39:53

And here they give their questionnaire, these are the ones they have to fill out, 01:39:58

you see there, they fill it out and when they finish they click and this appears in the corrected clinical history. 01:40:03

You can't imagine the hours of work that it takes for a psychologist to have to correct those scales, 01:40:10

it could be hours, hours, and this in a second, and this is thanks to digitalization, 01:40:17

I have to say that it has cost a lot of money, it has cost a lot of money, the investment in being able to achieve this, it seems an obvious, simple thing that happens, 01:40:22

but no, the fact that it comes out corrected, even pre-diagnosed by the patient, is really a wonder for us, because we have it, as I say, right away. 01:40:33

You see, this is one of the tests that you fill in and, as I say, it ends. 01:40:42

So, that result comes to the clinical history, and we, every Thursday, 01:40:47

I always say about Thursdays, because sometimes there are people who want to come and visit us, 01:40:52

and I say, come on Thursday, because that way you can see how the issue works. 01:40:55

Every Thursday, almost until 12 in the morning, almost in the morning, the whole team gathers, 01:40:58

and then we see, one by one, the cases that have occurred that week. 01:41:03

What do we do? 01:41:07

We not only see the results that have come out, but we also go through ORUS, 01:41:09

I don't know if you know it, but it's a system that allows us to know the person's sanitary life in Madrid. 01:41:13

And then you can discover things there. 01:41:19

Look, they've been looking at mental health for a long time. 01:41:21

Or look, this is a schizophrenia that what he wanted, these are real things, I tell you, 01:41:23

that he doesn't like the diagnosis that they have put on him and he wants to come here for mental health 01:41:28

and the behavioral action has nothing because it hasn't come out in the tests. 01:41:31

Or the other one, this one has wanted to skip the waiting list of his mental health 01:41:35

and it is believed that by saying that they have to make some purchases, we catch them all and there is no problem. 01:41:38

So, in that meeting, in which we are very satisfied, we really make a very personalized prioritization. 01:41:46

So, Group 1 is in those who have nothing, they are the ones who have less. 01:41:54

In reality, the people who come, as you will see, are usually serious people, but there are people who say, 01:42:00

Hey, you don't have any problem. I don't know, be careful, maybe you use too much of this, you buy a lot, but you don't have any problem. 01:42:04

But there is another group, the one that we need all the time to have places where to derive people who are people at risk. 01:42:11

People who have not yet passed the red line, but who are having an abuse of behavior, a risk consumption. 01:42:18

And then there are the group 3, which are the ones who are bad and stay with us, who are the majority. 01:42:25

Here you see what happens, only two are discarded, there are some that we send to the drug care centers and others are left in their mental health centers where they were already because they do not proceed to break that therapeutic relationship. 01:42:28

Well, the ones with the greatest success are the ones that stay with us. 01:42:42

Next, after the screening, what else is going to happen? Well, we now move on to evaluation, which we are going to see more closely. 01:42:48

Yes. So, the patient, when we have decided that he is our patient, so that you can see the multidisciplinary attention that is given to him, 01:42:55

he is admitted at 8.30 with the nurse, he is given an analytical diagnostic battery, because there are a number of variables that we need to control, 01:43:03

apart from the fact that it is a good opportunity to evaluate the physical condition of the patient, both minor and adult, 01:43:12

and then he is given an appointment with a psychiatrist and a psychologist, usually, 01:43:18

to then, multidisciplinary, decide which plan is going to be followed by that patient. 01:43:22

Because sometimes they are plans that are only individual, but most of the time we use group therapies. 01:43:28

So, in the evaluation we use some instruments that evaluate two aspects, 01:43:34

what is behavioral addiction itself and, on the other hand, what is the pathology, that is, the mental disorders. 01:43:41

Well, for behavioral addictions, we have these, I put it simply so that you know that they are scales, logically, scientifically validated, demonstrated, that they exist. 01:43:47

With these we evaluate behavioral addictions and with these we evaluate depression, anxiety, adult TDAH, you do not know how frequent it is, 01:43:59

emotional regulation, motivation to change and personality disorder. 01:44:08

This is very important because this is what I said before about dual pathology as a norm, 01:44:14

not as an exception in these people. 01:44:19

Well, and then what happens in the future? 01:44:21

Well, usually, we already do a dual follow-up, but very often we include them in group therapies. 01:44:24

We now have group therapy for both sex and compulsive buying. 01:44:32

I have to tell you, because we are evaluating not only results, but also satisfaction, that patients in general are very satisfied with this approach. 01:44:37

I say this because, a priori, there are many people who say, well, talking about all the shopping I spend in groups or talking about my sexual problems in groups, well, no. 01:44:46

We have to say that it is probably the most accepted intervention by patients and that, of course, we are quite satisfied with this structure. 01:44:56

with this structure, it is a model that is based on the control of impulses, 01:45:06

what happens is that it is the same structure, but it is modulated according to whether it is a game, sex or purchase, 01:45:10

or then we see in minors also the topic of video games. 01:45:15

Then, if we give them the high, they can go to the Mental Health Center, 01:45:19

or to the Cat of Madrid Salud, or well, this is already according to each case. 01:45:22

Well, the issue of minors, we do that multidisciplinary development to see what we are going to do with them. 01:45:26

I have to say that we don't have minors because of sex, games, pathology or shopping. 01:45:33

We basically see boys with social media and video games problems and they usually associate with it. 01:45:40

This is what we do in the shelter, the scales that we go through, simply to share it. 01:45:47

As you can see, the yellow box is the largest part of the people who are cases and we have to stay. 01:45:53

very few have come with a problem absence because because the young people the teenagers this 01:45:59

that the father tells him hey you are all day with the mobile you have a problem of which they look at him 01:46:08

from top to bottom but you what are you going to do is as if you tell me that you that I told you I started one 01:46:13

that you are addicted to sports shoes that is, what are you talking about you do not understand anything you do not know 01:46:18

how life is we enter this dynamic of adolescence is really I have to say that we have not 01:46:23

But we haven't managed to reach the adolescents as we would like. 01:46:28

What we see are extreme cases, very serious cases. 01:46:31

These are cases where we are already in a limited situation, of course at the school level, at the family level, even at the physical level. 01:46:35

Because the others do not have that awareness, we have not been able to reach them. 01:46:44

I am willing to listen to advice, we have thought about going to schools to see if we could get there. 01:46:49

We would continue, we have thought of going on social media, but it is not so easy to do it from the public administration, 01:46:55

because society is alarmed by teenagers, but really teenagers are not alarmed at all. 01:47:01

I remember a scene that I have told you more often, maybe on the escalator that went up, 01:47:08

a mother facing the teenager and the teenager saying, 01:47:16

you have deceived me, you told me that we were going to the dermatologist and you brought me this scene. 01:47:19

This is the problem. When we do the evaluations, of course, it is complex. 01:47:23

So, in the end, of course, what we have left, what is coming to see us as young people, 01:47:28

I have to say that it is much less than adults and that they are already quite serious people. 01:47:33

Well, these are the scales that we passed them. We have to say that we always work with families. 01:47:38

In fact, we now have a school of parents, which is very good. 01:47:44

We are already working on a primary prevention project to work with parents of children from 5 to 12 years old, 01:47:48

they have not yet asked for the mobile to teach them to see if we are going to try to see if with a model that we have of intervention 01:48:04

really those parents are able to teach a rational use of the screens to those kids when they think about it. 01:48:11

The group of teenagers, well, it is of a psychoeducational character, it also has cognitive-conductual interventions 01:48:18

and basically we address impulsivity. 01:48:24

In the case of minors, many of them go to the Center for the Attention of Technological Addictions. 01:48:27

In some cases, there is a comorbidity with the abuse of cannabis, and we have to support ourselves in the CAID. 01:48:35

And many of them end up in the mental health center, if they need it. 01:48:42

Well, I'm going to tell you a little bit about the data. 01:48:47

Do you remember? Group 1, Group 2, Group 3. I have already told you this figure, I have already taught it before. 01:48:51

Just to tell you that more and more people are coming, logically, according to what we have opened. 01:48:56

And note that this does have more curiosity. 01:49:01

Adults, the average age, 38 years. It fits, right? Of what we see. 01:49:04

You do not know the number of young adults that we have, well, they are not the most, with video game problems, which is not despicable. 01:49:10

Men. Men win in everything. In everything. 01:49:18

In bowling, except for one thing that we will mention later. 01:49:25

65% of those who come stay with us, they are very serious. 01:49:28

And it is also interesting to say that 20% have several types of problems. 01:49:35

Let's see. The game of betting is the most frequent and the most serious too. 01:49:40

But look, online is equal to offline, but the problem in other studies in Spain is that online, to be clear, is the sports bet. 01:49:46

That's the one that destroys everything, and that's basically the boys who play this. 01:50:04

Sex is only 24%. What happened to us with sex is that in Madrid there were no places to attend to it. 01:50:11

So, when we opened, we had an avalanche of people who were really tortured by this, 01:50:20

because I would like to make it clear, although it is not the day to explain it, that there are real sex addicts and that they are people who suffer a lot. 01:50:25

They are neither perverse nor hypersexual. 01:50:32

I assure you that when you know a case of these, the suffering and torture of life that they have is tremendous. 01:50:35

Well, these people, which fortunately are not very frequent, we have them, I think, almost all of them, 01:50:42

because they come and it is a place ... 01:50:47

Keep in mind that the self-cite prevents you from having to tell the family doctor and the mental health psychiatrist these kinds of things. 01:50:49

That if I play, that if I don't play, that if I'm all day, I don't know, using prostitution or porn. 01:50:57

So, this issue of self-quoting in this type of pathologies is one of the things that we are most grateful for in the satisfaction surveys, 01:51:03

which is confidentiality or intimacy, so to speak. 01:51:10

Purchases. Here, women do win, I have to say. 01:51:14

In video games, men also win. 01:51:17

Girls are more social media, although there are some video games that they also use, 01:51:22

but this is the reality and it corresponds to the reality that… 01:51:27

Although these are adults, now we are going with these. 01:51:32

What things would we highlight that we have seen in adults that may be interesting? 01:51:35

Well, the frequent thing that is in the bets, the association with depression, with tobacco and alcohol. 01:51:39

I suppose that those who are closer to my age, when they could smoke in bars, 01:51:47

I'm sure you remember people clinging to a machine, a slug, with a tube cup and a cigar. 01:51:52

Tobacco, alcohol and slugs. 01:52:05

This is how it is, this is what is most associated. 01:52:07

In addition to sex, it is interesting to know that the compulsive disorder is very frequent. 01:52:10

It is also interesting to see the relationship that I have seen in the editions of the purchases with the disorders of food taste. 01:52:15

In the edition of video games, who was going to say it, it is quite frequent, not only the TDAH, but also the autism spectrum disorder. 01:52:23

Here we have the doctor, plus the doctor Abigail Huertas, who is my TA, we are in the same corridor, that is, we work, we pass the patients with a certain lightness. 01:52:32

In fact, the pediatric psychiatrist who works with us is also a person who works with autism, 01:52:42

but this she will be able to tell why it is so frequent in these boys, but it is quite frequent, yes. 01:52:46

Well, and the levels of adult ADHD are also very important, that is why we evaluate them from the beginning. 01:52:52

In young people, in minors, the average age, what do we see? 14 years. 01:52:57

Men win, they remain at 57% and 15% have polyaddiction. 01:53:02

Well, here, as you can see, the champions are video games, obviously, 92% are boys, and the social networks are more girls. 01:53:09

I have told you before that the cases that are coming are the most serious. 01:53:17

They are cases, really, maybe I should tell you this one day, my partner Nacho Civeira, 01:53:20

they are cases that sometimes impact, that is, we are talking about very important deteriorations in family life and in boys. 01:53:25

That is why I say that in the end, of course, those who come to settle are left alone, because those who really come are already worrisome cases. 01:53:34

About sex, well, it is totally anecdotal the 3% and, well, about porn and such, but there is not, I think it is a polyaddiction, 01:53:43

there is not a boy in young people who says, I am only watching porn, with the damage it does. 01:53:52

What is not the actual thing is that it is associated with social networks or video games. 01:53:57

And the purchases, well, some start already, those who can get money, to do it. 01:54:02

Well, about teenagers, what tips can we remember? 01:54:07

Well, that of video game addicts, 45% suffer from attention disorders. 01:54:14

That of teenagers, 20% have been diagnosed with something that has to do with depressive or anxious symptomatology. 01:54:19

The 10%, as we have said before, meets the diagnostic criteria of spectro-optical disorder. 01:54:27

The 70% of the patients who have intervened in social networks are women, 01:54:34

that is, the women, the girls, are more involved in everything that has to do with messaging, 01:54:42

communication and the boys more in what is competition. 01:54:48

Well, and I'm closing the experience by summarizing that most of what we see today is adults, 01:54:51

because of what I have explained, because it is very difficult, and I accept ideas of how to reach young people, 01:55:01

and what message to give them so that they can say, hey, well, I still have to go to this place, right? 01:55:07

That is the difficult part. 01:55:15

As I just said, girls have more problems with social networks and boys with online games. 01:55:17

Adults, especially, have an addition to the game and sex. Sex is the second, it is important. 01:55:22

We have also seen tremendous cases there. 01:55:27

One thing I wanted to say about sex is that we have a clause, that is, when there is someone who comes, 01:55:30

we warn them that if any type of criminal conduct is detected, especially in pediatrics, it will be denounced. 01:55:36

And this is clear from the beginning that they come and in fact we have already had to denounce a case. 01:55:43

Well, in the elderly, 78% are men and 24% are... 01:55:48

And well, I wanted to tell you that of all this about Adcon, it seems to me that accessibility is one of the great successes, 01:55:54

which is not only valid for Adcon, it would be valid for certain pathologies. 01:56:01

Logically, the self-cite cannot be universal, it cannot be, it is impossible. 01:56:06

but I think there are certain pathologies in which autocyta can be, and in fact it is what I have said before, what they are most grateful for. 01:56:10

The screening is important because beyond what we detect and do not detect, there are many serious cases, especially in adults, 01:56:21

that we detect earlier than what would have been at another time, at another time, in other years that the adcom center did not exist. 01:56:30

The multidisciplinary approach enriches us a lot. 01:56:39

On Thursdays, we all see… 01:56:42

Well, they do, because I'm the head of the medical department, 01:56:45

and I'm not going there, but they get there, 01:56:48

and they analyze and it's very enriching. 01:56:51

And above all, the approach to dual pathology is very important. 01:56:57

And if I'm not mistaken, that's all. Thank you very much. 01:57:04

We have a few minutes in case any of you have any questions. 01:57:09

Nobody's going to give me any idea how to get to the young people? 01:57:34

Oh, oh, oh, oh, oh, oh, oh, oh, oh. 01:57:36

Let's see, you were the fastest. 01:57:39

I can't hear you, sorry. 01:57:41

Hello? Yes? I am the director of a preferred center for deaf students and I have many cases of deaf students with accessibility problems to mental health. 01:57:45

For deaf students? 01:58:00

Yes, because I have contact, but the psychologists who are competent in sign language are very limited and not only is it an interpreter, 01:58:02

that is, the interpreter helps, but it is an important barrier. Are you prepared for that? 01:58:15

Let's see, maybe you don't know it, we have the mental and deaf health unit since 2005, a pioneer in Spain, 01:58:20

in Spain, where the Basque Country has been formed, which is the next unit. 01:58:27

So, we have signatory professionals. 01:58:31

Indeed, as you say very well, attending a deaf person, I'm going to get out of hearing disability, 01:58:34

it is an invisible disability that generates a lot of suffering simply by being adapted to a hearing world. 01:58:39

So, what we know is that it is not only the language, but also knowing the deaf culture, the deaf community. 01:58:47

The deaf community is a different world. We cannot evaluate what happens to the deaf with our own criteria. 01:58:55

They have a different way of seeing life. 01:59:02

There are situations, for example, with the cochlear implant, which has faced the deaf community, 01:59:04

with respect to those who consider that they have to continue being deaf to maintain that identity, 01:59:09

and those who believe that the cochlear implant is an advance. 01:59:15

Of course, we know them, we have them, we have professionals who sign. 01:59:18

What happens is that psychiatrists, I see, I see, I take care of patients, but always with the psychologist, and really we have been doing this for many years and it is not for nothing, but the patients are quite, yes, of course, but also, I mean, we are not going to make you wait a long time. 01:59:24

However, this has nothing to do with behavioral issues. 01:59:45

If it has to do with behavioral issues, we will also address it. 01:59:48

But the deaf unit is specific for that. 01:59:51

It is in Leroy Marañón. 01:59:55

And, well, it is simply to contact us. 01:59:57

In special education centers, we have a profile of students 02:00:00

who can manifest some of these types of addictions. 02:00:15

and we do not know if the fact of having intellectual disability would be an exclusionary factor to be served. 02:00:20

Well, we would have to see it, we would have to see what degree of disability and also what you are talking about, 02:00:28

if it is a compulsive behavior that even generates a certain calm at a given moment. 02:00:32

The question is, is it a problem, is it dysfunctional? I do not know what case you are thinking about. 02:00:39

Tell me about video games, social networks. 02:00:46

I have several cases. Yes, it would be like a higher profile of students in special education centers that are up to 22 years old, 02:00:49

with oral language, with a certain type of social relations, with more or less preserved cognitive capacity within the entire profile of students that we have in special education. 02:00:56

And maybe it has more to do with the subject of video games. 02:01:08

Screens. 02:01:13

Screens, yes. 02:01:14

We are not talking about money, bets or purchases, I think we should see that, in some cases it is not so dysfunctional, 02:01:15

or do you think that what they do with the screens is causing problems to those cases that you are thinking about? 02:01:24

Of course, I could not tell you exactly because I do not only have one case in mind, I would just like to know if they have the possibility. 02:01:30

Yes, if they have the possibility, but we can also tell you, hey, maybe in this case not so bad, you know? 02:01:38

mal sabes ya entiendo lo que quieres decir que dentro de la vida hay que saber no podemos ser 02:01:43

muy radicales en a veces los diagnósticos bueno según qué persona igual es mejor dejar las cosas 02:01:53

como están gracias allí hay dos a ver si alguna me da una idea y no me preguntan bueno menos mal 02:01:59

Well, two questions and an idea, and we close. 02:02:14

Good afternoon. I wanted to ask about… 02:02:18

I was thinking about the case of minors with families, 02:02:23

the parents in situations of separation, divorce, 02:02:30

There are even situations where the judges come to a very extreme situation. 02:02:35

As for the point, the moment of treatment, there has to be consent from both progenitors. How is this managed? 02:02:44

To begin with, both parents do the screening of the adult part. 02:02:56

We take into account the opinion of both parents. 02:03:01

And then the protocol is applied, and Abigail knows this better, 02:03:06

the protocol that we have in the hospital of attention to separated parents. 02:03:09

And then, well, there it is protocolized how to do it, how to notify, 02:03:14

and that does not have a major problem in our hospital. 02:03:18

In other words, things are done protocolically, they know it, 02:03:21

When it comes to behavioural issues, the peculiarity is to tell you that, whether they are in conflict or not, 02:03:24

both of them are asked to come, so that both of them fill in, because what they want are some questionnaires 02:03:31

about how they see the behavior of the child. 02:03:39

We also take the opportunity, I have to say it, to give them TDAH questionnaires, 02:03:42

because, as you know, the definition of attention is highly charitable, 02:03:46

and then we also take the opportunity to situate ourselves as is the thing in the family. 02:03:50

Minor or minor, it seems a addiction and one of the parts of the progenitors does not authorize that intervention plan or that treatment. 02:03:55

I don't know, but I suppose that there was... What is the protocol for, Micael? 02:04:22

When you don't want to... 02:04:28

That's more or less... 02:04:30

Yes, in the protocol of parents in conflict, you can't deny... 02:04:32

That, the evaluation. 02:04:36

A diagnosis, if there is a diagnosis and no recommendations, 02:04:39

and there is no agreement, they can take it to a judicial process. 02:04:42

And it is the judge who decides. 02:04:45

But that's not only in this, it's in everything, right? 02:04:48

In all of them. 02:04:50

That does not only affect them. 02:04:51

Once there is a diagnosis and an indication of treatment, 02:04:53

as in all illnesses, unless it is due on an urgent basis, 02:04:56

if there is suicide, suicide risk, perhaps... 02:05:04

Exactly, I'm telling you, it doesn't matter if they are behavioral issues or... 02:05:11

You just have to know everything. 02:05:14

Exactly. 02:05:15

Very well, one more question and we'll close with... 02:05:16

Hello, hello. 02:05:19

Look, I wanted to ask, when it comes to directing students, 02:05:20

or also with families, depending on age, 02:05:26

to some resource related to the issue of addictions, right? 02:05:29

The ADCOM, there is also the CAD, the CAI, the SAT, 02:05:35

Madrid Salud, Salud Mental, right? 02:05:40

That you also coordinate with them from the ADCOM center. 02:05:42

My question is, to which specific one do I assign the student? 02:05:46

No, no, no. 02:05:51

How do I decide to assign one to the other? 02:05:52

You don't assign it to us. 02:05:54

If it is a behavioral addiction, you sit down, if you want to help them, 02:05:55

If you want to help them, you say, come on, let's do it together. 02:05:58

You open the mobile phone, pam, pam, pam, with the ID card and it is already quoted. 02:06:01

You tell them, hey, but if you don't have anything, they will tell you. 02:06:05

I mean, you don't, I mean, try to make them see that what we are going to do for them there is not at the moment any treatment, 02:06:08

it is simply an evaluation and that it is an opportunity to know if there is a problem. 02:06:15

So, you don't have anything, forget it. 02:06:19

I mean, the fact is that we, depending on what they have, we derive them there or not. 02:06:21

but we are the front door, for behavioural reasons. 02:06:26

But we can also send it directly to the CAF, for example. 02:06:29

If you want to send it, of course, but because it has a substance problem. 02:06:32

Thank you. 02:06:36

Well, the idea that is going to start, in reality, is not an idea, 02:06:38

it is something that we are already doing and almost more to tell them. 02:06:49

I am Pilar Ponce, President of the School Council of the Community of Madrid, 02:06:53

en alguna ocasión hemos hablado estamos dando llevamos treinta y tantos municipios de la 02:06:57

comunidad de madrid con una charla sobre navegación segura para adolescentes en esta charla incluimos 02:07:03

el enlace al centro atco hemos tenido alguna ocasión en el que al finalizar la charla 02:07:10

habido alguna familia es son charlas para familias al finalizar alguna familia bueno 02:07:15

casi siempre hay alguna familia que viene y nos pregunta por el centro y lo dirigimos 02:07:20

And sometimes they have called us to the school council and said that what they told us is true and works well. 02:07:23

So, I have more than one idea, it is something that we already do and to tell them. 02:07:31

The documents that the school council has published, behavioral addictions, mental health, healthy habits, etc. 02:07:36

We always put your link. 02:07:44

I would like that all the teachers in the community of Madrid who receive the e-mails from the school council, 02:07:46

I'm going to put them on the screen if you allow me, 02:07:54

open them and see the resources that are facilitated, 02:07:56

where among other things it is linked to the Center for Behavioral Editions and how easy it is to use it. 02:07:59

So, a request please, because you have received all this in your e-mails five or six times at least. 02:08:05

And then the offer that you use us, because we are an extraordinary tool to reach families through the main federations of the FAPA, 02:08:13

make it arrive, also work with teachers and be able to take advantage of it. 02:08:23

Because indeed, Ateo, when a family, we see the situation that there is, the talk ends, 02:08:29

I told her, hey, my son has this problem. I took his cell phone off and he became violent, and it wasn't like that, and it happened, and he tells you the evolution, and you say, well, look, I don't know, but come here. 02:08:35

And when, on one occasion, it happened to us to call her afterwards and say, hey, this is really, it works phenomenal, how good, thank you for telling us, it's wonderful. 02:08:45

The resource is extraordinary and it's super important that it is known. And take advantage, it seems super important to me, the contact and the relationship with the main federations that we have in the Community of Madrid, 02:08:53

because because they arrive and because they have the trust of the families to know that if they 02:09:04

recommend it, it is something that is worth it and that is important then at your full 02:09:10

disposal as a school council to continue giving to know the resource that as I tell you we already 02:09:16

do it enough so but even so and even so I return to mine that the parents I already know that we 02:09:21

captamos a los jóvenes hay algo que pueda haber un joven que diga joven a ver si va a ser 02:09:31

porque las familias las familias ya sé que están preocupadas pero lo que lo que lo que es duro es 02:09:41

que hay chavales que cuando ya reconocen que es que ya sean dando un corte en su vida 02:09:48

Demonstrarle a los padres que no tienen un problema. Y así se lo demuestras a tus padres y se tienen que pagar. 02:09:54

Pero escucha, Abigail, que tenías que ver que no son tontos, que van a hacer el cribado y saben lo que tienen que contestar. 02:10:03

Que no mientan, pero no mientan. 02:10:09

Andrea, perdona, pero... 02:10:13

Muchas gracias. 02:10:14

Sí. 02:10:33

Yes, yes. We just rescued the wise man from the video games, a 16-year-old boy who you can't even imagine. 02:10:33

He's gone to the dark side and he's going to help us. He's a boy with a lot of contact difficulties. 02:10:55

These ambassadors are essential. 02:11:03

It's not easy to find them, but we already have one. 02:11:10

Very interesting. 02:11:12

Well, thank you very much. Thank you, Francisco. 02:11:20

We have been dragging time to time and we are doing quite well, 02:11:25

surely five minutes. 02:11:30

The next speaker is Dr. Abigail Huertas. 02:11:32

But before, well, we got in touch when we were thinking 02:11:36

about designing this congress with the one who is now the head 02:11:41

del Servicio de Psiquiatría del Hospital La Paz, 02:11:48

que ha sido responsable en el Hospital Gregorio Marañón, 02:11:55

Celso Arango, también una persona con la que mantenemos 02:11:59

una relación fantástica, y nos quiso dejar tres minutos 02:12:03

de observación en un vídeo. 02:12:07

Inmediatamente pasará la CEO Raquel Llevenes 02:12:10

a presentar a Abigail Huertas. 02:12:14

So let's put the video on if you don't mind. 02:12:17

Hello, I'm Celso Arango, Head of Child Psychiatry Services at the Hospital of the Ministry of Peace, 02:12:21

until recently Head of Child Psychiatry Services at the Marañón University. 02:12:28

And for me it is a great pleasure to be able to tell you these words in the inauguration of the course Educate to Take Care. 02:12:33

What a nice name, Educate to Take Care, to take care in a topic that includes, naturally, mental health. 02:12:40

A very short time ago, a few years ago, the World Health Organization reminded us, 02:12:47

coinciding with the visualization, the knowledge from the general population 02:12:52

that there is a problem and that problem is called mental health, 02:12:59

especially from the general population, children and adolescents, 02:13:04

and that we have to take a step forward to intervene, 02:13:07

fundamentally with measures of health promotion, primary prevention. 02:13:10

As the World Health Organization told us, 02:13:14

that we have to get out of our comfort zone, 02:13:16

that mental health professionals have to be where people are, 02:13:18

in their workplaces and, of course, in the school. 02:13:22

But, and from my own experience, I know that the grey areas, 02:13:27

and here by grey areas I mean those that are between disciplines, 02:13:31

or between administrations, or between councils, 02:13:34

for example, education and mental health, 02:13:36

have always been more complicated and have been a bit of nobody's territory. 02:13:40

Looking at the panel of speakers of these days, of the course, looking at the titles of the talks and knowing what is happening today in the community of Madrid, 02:13:44

I can say and affirm that that gray area has almost disappeared, that the daily work between people who have common objectives, 02:13:55

such as education professionals and mental health professionals, is a shared work space in this community. 02:14:04

The fact that courses are being given, partly thanks to the Maritza Koplovich Foundation for the training of educational professionals, both in ordinary and special education. 02:14:11

The fact that there are professionals working in schools directly with the directors, with the teachers, with the entire team of school centers, I think it is fundamental and it is a before and after. 02:14:23

and the one that can promote mental health, the one that can prevent eating disorders, 02:14:38

behavior disorders, substance abuse problems, substance abuse problems, etc. 02:14:43

From the first stages, primary, secondary, in the places where the minors are, 02:14:51

it is something that we have to carry marked on fire in our head and in our heart. 02:14:57

So the only thing I have to say is that I would have loved to be in this course, 02:15:03

which I cannot do because I had a commitment prior to thousands of kilometers away, 02:15:07

and that I am convinced that it will be a course that will have new editions, 02:15:12

and there you can surely count on me. Thank you very much. 02:15:16

Well, after listening to this affectionate message from Dr. Arango, we continue with Abigail Huertas. 02:15:19

She is a specialist in children's psychiatry and adolescence at the Gregorio Marañón University Hospital in Madrid. 02:15:33

She is the author of the book, I only need you to accept me, mental health in adolescence and how to detect problems in development. 02:15:40

And she is going to talk about something that worries us a lot in the educational community, which is the influence of screens on the development and well-being of our childhood and adolescence. 02:15:47

We are looking forward to listening to you, Abigail. 02:15:56

Bueno, muchas gracias. Además de agradecer a los cargos públicos que han venido a este 02:15:58

Congreso, a José Antonio por invitarme, a todos los que hay aquí presentes. Qué gusto 02:16:09

ver la cara de la gente, qué maravilla. Sé que hay gente en streaming y también agradezco 02:16:14

que un viernes estén aquí comprometidos. Estoy a la vez emocionada y orgullosa y a 02:16:19

la vez un poco abrumada porque estas dos personas que me han precedido, yo he podido presenciar 02:16:23

while I was working with them, how they have led the management and the organization of the implementation of mental health and juvenile child health programs 02:16:29

and prevention programs over many years and in two key, unfortunately, historical moments, such as the 11M and the COVID pandemic. 02:16:39

So, my colleagues have made me, my bosses have made me a constant reference and I feel a little depressed, 02:16:50

but since it's a Friday, it's late, and a lot of people have already received a lot of information and a lot of science, 02:16:57

I would say a little jokingly, I have come here to talk about my book. 02:17:03

Well, actually not, the subject that I have been invited to talk about I have not chosen, but indeed I have a book. 02:17:06

So, this is my conflict of interest, some of my conflicts of interest. 02:17:14

I have a teenage son, I use, here there are people who believe that I use social networks and screens 02:17:19

screens as a personal use and as a professional use sometimes in a way 02:17:24

a little intense and I have also had some specific collaborations with some 02:17:29

pharmaceutical laboratory because I declare my conflict of interest because 02:17:34

because we doctors always usually when we give scientific talks declare 02:17:40

our conflicts so that people know that what we are telling is true and 02:17:45

and they have not paid us to say it, but on the other hand, when an educational center acquires a tool for the management of learning resources, 02:17:50

or someone, a politician, bets on digitizing or not digitizing, no one asks him about his conflicts of interest. 02:17:59

And sometimes there are interests that, without being obscure, condition us. 02:18:07

So, I am here because I have been invited, I am very grateful, but you have to know that I use the screens. 02:18:12

So, what I'm going to say is mediated by that. 02:18:18

This next slide has... 02:18:21

Yes, it's over there. 02:18:23

Let's see. 02:18:25

There. 02:18:29

But what's the button? 02:18:31

It has worked before. 02:18:33

Ah, yes, it has been blocked. 02:18:35

This slide is almost 20 years old and, as you can see, it's not mine. 02:18:37

No, it's more than 20 years old, it's not mine. 02:18:41

We are here to improve society for all. 02:18:44

I feel a bit like those present here, because it is true that when bosses are awarded, they 02:18:47

thank them and say, this award is for everyone, but I am so naive and naive that I believe it 02:18:52

and that makes sense to my work. We are all responsible for our project to succeed, 02:18:58

for people to be healthy, for healthy adults to arrive. So, this slide is old. 02:19:04

The school is a reflection of society. All members of society necessarily go 02:19:10

by the school and the health system is also a place where the whole society passes. 02:19:15

I dream of a well-to-do marriage between health and education. And this slide means 02:19:22

that. Why are we here today? We are here today because we are worried. The doctor has already 02:19:31

put some figures that I also put here, because not in any slide. For all mental health 02:19:36

is a priority, but juvenile child mental health is a priority for adults, politicians, teachers and the whole world. 02:19:44

These figures are overwhelming. This image is from this year's American Psychiatry Congress, 02:19:52

where there was a person illustrating every day of the Congress what had been treated. 02:19:56

It is evident that in a adult psychiatry Congress, where everything is cooked and where the major scientific advances are, 02:20:01

There is concern about suicide, self-harm, everything that my colleagues have reviewed, which is of great relevance. 02:20:10

So, try to attend to the people who have come out here in the questions. 02:20:18

What do I do for a teenager to go to mental health? 02:20:23

How can a teenager from a special education center get to AZCOM? 02:20:26

All citizens are citizens of full right and we have the right to health care, 02:20:30

and health care also includes attention from mental health. 02:20:35

So, it wouldn't have to be a question, we would all have to know how to make the most vulnerable people have the right to health care, like all people. 02:20:39

And this is possible and we have to fight for it, because the delay of the consultation, once the symptoms appear, is a sign of poor prognosis. 02:20:51

and it has been estimated between 11 and 12 years, since one gets sick until it is diagnosed and given adequate treatment, and that is shocking. 02:21:01

Let's see if I can do it, because it's too late and this is a bit trolling. 02:21:09

Let's see, here, I've already got it. 02:21:15

Well, the slides are a bit shaky, the format has changed when downloading them, it must be, 02:21:18

but we are all concerned about the impact of screens on a developing brain. 02:21:22

We have to have well-being, we have to be able to develop our brain properly, we have to have healthy habits and intuitively we suspect that the screens sometimes boycott all these processes that the human being has to do. 02:21:27

These are the stages of life, that is, what we have to achieve at each age. 02:21:46

Children have to acquire skills and basic competencies. 02:21:51

Basic competencies is a very educational term. 02:21:55

Adults who live with them, we have to help them to guarantee those care without them having stress. 02:21:58

Approve, study more. No, you have to try to get it in an easy and natural way. 02:22:05

Adolescents have a moment of hormonal changes, of vital changes, of identity doubts. 02:22:10

They have to decide what kind of adult they want to be. 02:22:16

have to acquire autonomy and detach themselves from their parents and also from their teachers, 02:22:19

make their own decisions and lead their lives. 02:22:23

And sometimes I see in the consultation, I start to see teenagers who are opinion leaders 02:22:26

and they say, no, no, I don't drink anymore, I've tried what the drink is and it doesn't feel good. 02:22:33

And that's like when you throw a pebble in the center of a pond that becomes like waves 02:22:38

and other teenagers are imitating those behaviors. 02:22:44

When I have exams, I take my phone out of my room, because my concentration is disturbed and I get distracted to study, or I put it in airplane mode. 02:22:47

Adolescents who are starting to be models are starting to see themselves, because they take care of their problems, talk about mental health, 02:22:55

they are not ashamed of their vulnerabilities, and then they proudly tell how they have overcome adversity. 02:23:02

That starts to be seen and it is moving. I don't know if the teachers present here have a teenager like that in mind, 02:23:08

who have overcome very serious crises, have been hospitalized for a long time and have been able to recompose themselves and find mental stability, 02:23:13

and they begin to be as opinion leaders of their colleagues. 02:23:21

This is wonderful, but we have to not be afraid, not be afraid when someone says, 02:23:25

well, I was self-injured, or you have to know how to handle that information responsibly, 02:23:31

but you don't have to be afraid to address those issues in class, for example, if a topic arises. 02:23:37

Dr. Ferre talked about taking advantage when we detect a problem and they see that they can be quoted with the virtual health card. 02:23:42

Very few adolescents have the health card on their mobile phones, they usually have their mothers. 02:23:51

We are not going to deceive ourselves, but this also requires the collaboration of the parents, 02:23:55

who surely have expressed concern in the tutorials, and it is possible that joint tutorials with parents and children 02:24:00

parents and children are perhaps the most useful to solve these problems and avoid 02:24:08

triangulations of information between them and then when we reach adults that we have to 02:24:13

achieve serenity serenity that many times we do not have and the screens take away responsibilities 02:24:18

we have to assume I liked it a lot that the doctor had spoken that we must not be 02:24:24

guilty but we do have to assume our own part of responsibility in the things that 02:24:29

We have to have healthy habits, do physical exercise, eat healthy, sleep enough hours and find a sense for our existence, which is what teenagers are looking for. 02:24:34

That's why I often say I want to feel part of the prizes and achievements and merits, even of the administration. 02:24:46

We are all the administration, let's not forget that. 02:24:53

And I want to feel that I am part of, as a human resource, of achieving that society is better. 02:24:56

And I encourage everyone who is here and those who are streaming to reflect on this. 02:25:05

It is not about giving me a promotion, inviting me to a talk or recognizing a merit. 02:25:10

It is about what I can do to make the world a better place for the people who relate to me. 02:25:16

In this case, they are vulnerable because they are boys and girls, so it is much more relevant and valuable. 02:25:22

I want to highlight all the people here, because they already know all the resources we have, but it is very valuable that they are here to be better people. 02:25:30

And of course, that means that we ourselves have to make responsible use of the screens, of our leisure, and be present in the upbringing of our children. 02:25:38

Today there has been a convocation of doctors and one of the things that we claim as health professionals is that we don't have time to be with our children. 02:25:48

But it's that teachers can't go to the theater functions of their children, they can't go to the tutors sometimes because they are working at that time. 02:25:56

I get in a taxi and the taxi driver asks me what I do and I tell him that I am a psychiatrist and he says to me, 02:26:05

and how do you do to take care of your mental health? 02:26:10

The same thing the hairdresser asks me when she gives me the wigs. 02:26:14

How can you stand it? 02:26:17

But teachers are never asked that. 02:26:19

No one thinks about asking a teacher, 02:26:21

my God, if I only have one child and I'm up to here, 02:26:24

how can you with 20 or 25? 02:26:27

No one ever asks that. 02:26:29

So, I also want to take advantage 02:26:31

that these talks that preceded me 02:26:33

have had a lot of density of information 02:26:35

to invite the professionals who are listening to me 02:26:37

to have spaces for rest, 02:26:41

for mental health care, for digital disconnection, 02:26:43

to laugh with friends and schedule leisure because we need healthy people 02:26:45

so that the children give us less work and we can also rest and have coffee. 02:26:50

I'm sorry, we all have our own style and I empathize with all of you on a Friday afternoon 02:27:00

and so I need you to smile a little. 02:27:08

This is the mental health work that you have described very well 02:27:10

And we work with all those who are related to... 02:27:13

You're laughing, aren't you? 02:27:18

I didn't put the copyright here, but I could. 02:27:21

So, an important part of our work is with the teachers. 02:27:24

I've been working for many years, and when I worked in the Corredor de Lenares, 02:27:30

I went to the territorial area management, or to the teacher training center, 02:27:34

or to the Pablo Picasso School of Special Education, 02:27:39

I didn't have time to do the coordination with the counselors. 02:27:42

I had a child who had suddenly stopped eating and we didn't know why. 02:27:45

I said, hey, I have to know why this child has stopped eating all of a sudden. 02:27:48

And then you can only know sometimes in their environment. 02:27:51

So, when you discover that a little chubby child from a special education school 02:27:54

who doesn't have a language suddenly doesn't eat for three days, 02:27:59

and you're going to talk to the tutor, with the caretaker of the dining room, 02:28:02

and you talk to the person who puts the tray on it and says, 02:28:06

no, they have put a diet menu on it and they have removed the bread. 02:28:08

Of course, this child has his routines associated with the piece of bread with the food, 02:28:11

put a small piece of bread on it, let's see if he eats. 02:28:16

That can only be done going to school, 02:28:18

because from the consultation it is impossible to know what is happening. 02:28:22

You ask the parents, has there been any stress? 02:28:24

They ask in school if something has happened, to see if they are being bullied, 02:28:27

but you can never know if you are not present. 02:28:30

So I feel like mine, without being mine, of course, 02:28:32

the link between mental health and education, 02:28:37

Because I have a link between mental health and education that some people know and because I have always thought that it was the most valuable thing to move to the schools to see what was happening. 02:28:40

This girl has TDAH, she is very nervous. I go to the classroom, I meet her new teacher and I say, my God, if this lady is a flan. 02:28:50

I mean, now I understand why this girl is so nervous. So, nothing happens, each one is like her, I am also nervous, as you can see. 02:28:59

But sometimes, if you understand the behavior of children in the context, 02:29:06

you avoid psychotropic drugs, you avoid family anguish, 02:29:12

you avoid tensions with the school. 02:29:15

So, I think that the future is that we are siblings, or that we get married. 02:29:17

Whatever you see is better. 02:29:22

These clinical vignettes, I put them sometimes in talks, often, 02:29:24

but I have had to adapt them to the times. 02:29:30

Why? Because every time the children consult earlier 02:29:32

and they are worse. 02:29:35

Before, I was a teenager with behavior problems 02:29:37

of recent beginnings, 02:29:39

school absenteeism and insomnia, 02:29:41

and now I have had to add 02:29:43

the use of video games and harassment 02:29:45

through social networks, unfortunately. 02:29:47

I am no longer a teenager, I am a child. 02:29:49

And this is what is happening. 02:29:51

I have kept the same images 02:29:53

and I have changed the texts 02:29:55

because the problems are the same, 02:29:57

only they start before and are more relevant. 02:29:59

A teenager with an eating disorder, 02:30:01

social isolation, the use of networks, websites and forums of Ana and Mía. 02:30:03

These things complicate our lives, and even more since the pandemic. 02:30:08

A six-year-old child, Asian with hypoacusia, which has come up here, 02:30:11

the issue of deafness, a family that does not speak the language, 02:30:15

and the child spends long hours in the family business with a screen, 02:30:19

also watching content from their country of origin. 02:30:24

All these things complicate our lives. 02:30:28

Before they were in the family business, dispatching, so they had no choice but to socialize with other people. 02:30:30

Now they are watching programs from their country, so they don't even learn the language. 02:30:38

And on top of that, they are deaf, even worse. 02:30:43

A baby with a global age gap, with an autistic brother. 02:30:45

But of course, you have an autistic son, and what do you do when you take him to the doctors? 02:30:48

Well, you put the screen on the little one so that he doesn't protest in order to be able to stand in the waiting room. 02:30:52

If you don't put it on both of them, of course, it's a way to survive, I understand, but this is a problem that we didn't have in 2012, for example. 02:30:58

Well, depression, anxiety, lack of concentration, ideas of death, crying, exchange of images of self-harm. 02:31:07

This is something that has gone away from our hands, which doesn't mean that the screens are bad, good or regular. 02:31:15

It means that we have to know that the screens are in the lives of our children and our students, and this is very important not to forget it. 02:31:20

forget it the slide is the same but we have changed the context I wanted to bring 02:31:27

some science because it can't be all fun and chascarrillos then 02:31:32

this study eye being an observational longitudinal study is one of the best 02:31:37

studies that I have seen more interesting because it gives you like a 02:31:42

trajectory they have been included 18,000 and more children when they were 89 years 02:31:46

between 2016 and 2018 in different parts of the United States. 02:31:53

Of course, they have their risks because they participate voluntarily, 02:31:57

but in different regions with different cultural contexts, 02:32:01

and they have been followed up to adulthood. 02:32:05

Now publications are starting to come out of a study called HBCD, 02:32:07

which, as this study included children with nine years or so, 02:32:11

even if you ask them, I have studied this study well, 02:32:15

and they are done every year and sometimes some things every year after every two years functional image studies 02:32:18

genetic studies are done to them anxiety questionnaires depression is done to them intelligence tests 02:32:26

serials and the main caregivers are surveyed all the main caregivers who spend a long time with children 02:32:33

they have to answer if they consume toxins for example they are asked if people who spend more than X hours a day with this child 02:32:40

are toxic consumers things like that so it gives a lot of information that does not mean that the 02:32:47

results point to the fact that it is the cause, that is, that there is no cause but there are some 02:32:53

results that make us reflect there is a relationship then it is a very interesting study 02:33:00

because it has made a very long-term and meticulous follow-up and because the results 02:33:06

are open then any researcher can exploit those results and draw their own 02:33:10

conclusions and say of course this study was designed for the issue of 02:33:15

consumption of toxins but suddenly someone said well I'm going to see consumption of 02:33:18

screens and someone said well I'm going to see adverse family situation of 02:33:21

adversity and poverty and then of course as a single 02:33:27

researcher does not have to do it because they are publishing many articles about this as 02:33:30

they criticized it because of course you say if you take a nine-year-old child and 02:33:34

ask his mother if he smoked cannabis in the pregnancy and he can lie to you because 02:33:37

So now the HBCD is from pregnancy, so it has already been taken by mothers, results are already being published because they have been following pregnant women for a few years, and then the children, as they grow up, and this is very interesting. 02:33:41

So, here you can clearly see that there is already a thinning of the cerebral cortex when the children are more than seven hours with screens, which does not mean that it is the cause, but there it is. 02:33:56

So, of course, worse mental health and a worse cognitive profile the more time they spend in front of the screens. 02:34:06

This, combined, I'm not going to stop specifically because it's too late, but it has been seen that in the youngest children there is a delay in the language 02:34:15

and children whose mothers even use screens have more problems to advance in the language and problems of attention and concentration, 02:34:23

that we could call TDAH-like, because maybe it was not a thing of its own, of neurodevelopment, 02:34:32

but since we cannot go back in time and the brain is in development, 02:34:37

if you expose a brain in development to screens and it generates problems of attention, 02:34:40

even if it is a TDAH-like, the symptoms are there and we do not know what would have happened 02:34:44

if you had not exposed it to screens. 02:34:49

The elderly in school age, the period of latency that we call, 02:34:52

also affects social functioning, the family relationship with parents 02:34:56

and in adolescence I don't even want to talk about it. 02:35:01

It doesn't mean that the screens are the cause, 02:35:04

it means that in this study they have analyzed the exposure to screens 02:35:06

and they have found these results. 02:35:09

It's like to think about it a little bit. 02:35:11

So, of course, here, as my colleagues were saying, 02:35:14

girls have more impact on social networks than boys, 02:35:20

also on self-esteem, on body perception, 02:35:24

they get hooked more easily, 02:35:27

The kids get hooked more on video games, but we have also seen benefits from social media and we have all seen it in the pandemic. 02:35:29

In the pandemic you have been able to feel connected and accompanied, you have been able to have video calls with relatives who were in agony and you have been able to say goodbye. 02:35:38

And it is moving to remember it, but it is like that. 02:35:46

And there are people who have developed their creativity and who have contacted people with interests, especially the population with neurodevelopment disorders, 02:35:49

the autism spectrum disorder that sometimes have very peculiar interests apart from very 02:35:57

particular intense and I could not think when I met a boy who loved to listen and record the noise 02:36:01

of the trains when they arrive and the dino in dini of the metro stops that opened a youtube channel and 02:36:07

that he was going to find seven people with the same tastes as him to stay of different ages and adults 02:36:13

also to stay and go to the renfe to see the trains arrive I would never have thought that it was going to 02:36:19

serve to make social networks but I have seen this with my eyes in my 02:36:24

Alcalá de Henares consultation at the time 02:36:27

this is a brief summary of the most outstanding that has been found and that 02:36:31

professionals see but the important thing is this little picture that has come out 02:36:35

later it is not just about time what the evidence says is that it is not 02:36:38

just a matter of time of exposure to screens it is also at what 02:36:43

moment that exposure occurs of course if you expose a baby to screens it will be 02:36:46

much more harmful than a late teenager or a young adult and also the content and how 02:36:50

it is not the same to see porn than to see than to play with your parents an educational game or 02:36:57

play chess with another person through a screen then the educational games accompanied 02:37:03

by an adult a controlled time may not be as bad as they put you on the screen as a 02:37:10

child or that you are there they are entering videos on youtube randomly and then the design 02:37:14

of the applications, these applications with addictive patterns that I do not know if someone 02:37:20

can tell me when I have five minutes or ten to put the turbo on, because I want to talk 02:37:24

slowly because I tend to speak very fast and this is relevant, but there is a lot to say. 02:37:30

So, well, there are people more vulnerable than others, people with neurodevelopment 02:37:35

disorders, with intellectual development disorders, with autism, with ADHD, which my colleagues 02:37:39

have quoted, because it worries us a lot, because it is also a bit invisible. 02:37:43

There are professionals of education and health who believe that the TDAH is a religion and do not believe in it, 02:37:47

as if that were something possible when it is a neurodevelopment disorder. 02:37:52

So, we are concerned that these populations are the ones who suffer the most harassment by networks, for example. 02:37:56

There are more and more bad social understandings and they have problems with justice, 02:38:02

because they write in a chat and do not measure who is listening to them or what consequences they have. 02:38:07

because of the heat of the conversations on Telegram or the Alvise channel or whatever, 02:38:12

and they end up being arrested by the police because they have made some inappropriate comment. 02:38:18

They are vulnerable people who are not people with a profile of committing crimes and who have no intention of harming. 02:38:22

So, girls are also more vulnerable than boys because of this issue of the image, 02:38:28

that they are also exposed to sexual violence with images that they send them or when they steal images or ask for them, 02:38:33

and then the little ones. 02:38:40

So, well, we have to keep this in mind. 02:38:42

I had titled this slide Neurobiology of the hook, I don't know if here are the heads now to process things of neuroanatomy and neurophysiology, 02:38:45

but I also see myself obliged to explain that the profile of use of some video games and social networks is the same as addictive behaviors. 02:38:54

That is why there is a specific consultation on behavioral addictions that deals with the harmful consumption of video games, among other things. 02:39:05

It is true that few children arrive, because they are forced by their parents when they have already done a defalco, 02:39:13

or they are already there hacking the school tables and sending pornographic images to the girls, and it is already a very serious thing. 02:39:18

They arrive. I, in the Neurodevelopment consultation, sometimes I negotiate with them within a treatment plan, 02:39:26

but it is not worth telling them that this is here, we have to accompany them, and it is this, look, you say that you do not have a problem, I am a doctor, I think so, your parents are worried, let's check it, let's see what the experts say, let's see, if you can do the screening, if you want I will help you, because as I know how you consume screens, I will help you to answer with honesty, and maybe you do not remember, and I have once done the screening with them, on their side, to help them face that situation, but everyone lies, this has been told to me by Dr. Civeira, 02:39:31

who will not have told Dr. Ferrer, but the young people all lie, but that is why the questionnaire is also done to their parents and that is why their previous clinical history is looked at. 02:39:58

Most of them have ADHD or have autistic traits or have some vulnerability or have suffered bullying and have emotional discomfort and end up integrating intervention into mental health. 02:40:07

That is what happens. Very few adolescents stay at AzCom because they have only that problem. 02:40:19

That's why it's a very complex issue that we shouldn't focus on whether screens are good or bad. 02:40:24

If screens are good or bad, we can have them, just like cars. 02:40:30

Are you going to give a 14-year-old a Mercedes to drive? No, it's a great car. 02:40:36

I have a friend who bought a great car, a Mercedes, and her 14-year-old son with ADHD and a problem of behavioral addictions 02:40:42

He went down to the garage, hit the button, turned it on, and stamped it against the door of the garage. 02:40:51

You laugh because you know who it is. And I'm not going to say, that friend of mine is me, because I don't. 02:40:59

Who would think of giving the key of a Mercedes to a 14-year-old boy? Nobody, right? 02:41:07

Well, to the one who gives it to him or leaves it at hand, because she wouldn't want to give him the key, 02:41:14

I would like him not to touch it, but these things happen to him because with screens more or less the same thing can happen. 02:41:18

It is the same dynamics of addictions. 02:41:24

You do a behavior that produces a pulse of dopamine that is very softened by our companion Marian, 02:41:27

who is a wonderful broadcaster, but today a taxist has told me that he was reading this about dopamine and the balance with serotonin, 02:41:32

and I said, come on, just like the slide that I read to these people, but easily told. 02:41:39

But it's true, it's like that, you have to tell it because it's like that. 02:41:45

because it is so then the immediate gratification gives you that dopamine discharge that gives you a 02:41:47

pleasure that leads you to repeat the behavior to get that dopamine pulse again that 02:41:52

generates you a pleasure that marian says you have to find the balance between everything can be pleasure 02:41:57

no you also have to have serenity good mood because this is the same then what happens with the 02:42:02

screens sometimes is this and of course those who have problems of attention or behavior are more 02:42:08

vulnerables esto es escalofriante yo si le coges el móvil que es lo que hace mi compañero que pasa 02:42:13

lo de las horas de consumo 5 horas es poco esto está equilibrado con los que no tienen móvil o 02:42:19

sea la mayoría están entre 8 y 10 horas la mayoría de los que de los adolescentes que les cogemos el 02:42:23

móvil y les miramos que está esto se equilibra con el que no tiene el teléfono claro o que lo 02:42:29

tiene con restricción parental estricta pero comparado con el resto de personas dos horas 02:42:33

I have much more than two and a half hours, I confess, much more. 02:42:38

I try to control myself, I try not to exceed six, but also when you use it, 02:42:42

it is not the same to be organizing the photos of your gallery or with, 02:42:46

even if it is unhealthy too, because there are many hours of screens, 02:42:50

or replying to emails from work that are making the infinite scroll 02:42:53

that makes you kind of stupid and it alters your sleep. 02:42:56

Of course, it is not the same, but still you have to try that the screens do not move 02:42:59

physical exercise, face-to-face socialization, and this is what adults sometimes realize. 02:43:04

They say, I'm very tired, I'm going to go drink something with my neighbors, but I sit on the sofa, 02:43:11

I go to see social networks and time has passed and it's time to have dinner. 02:43:16

And I can't go out for a walk or go down to the pool. 02:43:20

Look, there are people who put their face like saying, it happened to me. 02:43:23

Well, imagine a developing brain. 02:43:26

So, I have put this cube with holes because sometimes we have that feeling that there is no way to stop it from being full of drops, but I think it can be repaired. 02:43:28

So, it is true that we must take into account this, that the likes, which we all look for, I also, the approval, reinforces our attitudes as more addictive. 02:43:40

Well, let's see what happens here. Well, I'm going to go over this quickly because what I wanted to highlight from here, 02:43:48

which is a draft report that you all have read, just like the studies and all these that are the ones you read, the teachers, 02:43:53

this is answered by the adolescents themselves, and 50% are aware that they have an excessive consumption of screens. 02:44:00

They are also aware that this affects their mood. 02:44:06

Some see that they have bad mental health, and they themselves realize it. 02:44:09

So, here what surprised me was that many identified themselves with some psychiatric diagnosis, 02:44:13

and that's why I wanted to put these slides, or with anxiety or depression, 02:44:20

some of them were labeled with a psychiatric diagnosis, 02:44:24

many had gotten the diagnosis on the Internet, 02:44:29

the poor were not even diagnosed. 02:44:31

So, this impacted me a lot, and they are worried about their well-being. 02:44:33

So, we can try to get hold of that healthy part that adolescents have, 02:44:39

which are the ones who make the change in life. 02:44:45

If you think about it, historical changes have been made by young people because they are unreflective, impulsive, they are ruled by their values, they do not think about the consequences in the medium term. 02:44:47

So, the fall of the Berlin Wall, if you go to Berlin and see the photos of all those who died trying to jump the wall, they were all very young. 02:44:57

So, the big social changes are made by young people who are aware that they are worried about the future, 02:45:05

about the well-being of society, about their own well-being. 02:45:16

You have to take hold of that part, which is a healthy part. 02:45:19

Well, I wanted to put some slides that I'm going to go through quickly about the TDAH, 02:45:21

because it's a very important issue, but we're going to be very late. 02:45:26

This is a plus. I mean, if you have ADHD, you have twice the risk of having a harmful screen consumption. 02:45:29

There are times that I say in the consultation, it is not known if it is caused by consequence, 02:45:36

I have put here the egg and the hen, not to put this meme because science says so, 02:45:40

but many times it is not known, but it is the same, it is there, they are a more vulnerable population. 02:45:45

Just as I say to families who have children with a high risk state of mind, with a serious mental disorder, 02:45:49

If you have three children and you only have money to send one to Ireland, or now to the United States, do not send this one, I say it like this. 02:45:54

This is not the one you have to send. Well, if you have to choose which of your children you leave screens to, this one does not. 02:46:01

So sometimes you have to do it like this, you say, look, it is the same for me that the oldest has a mobile phone. 02:46:07

It is that this one, because of his disorder, has a lot of risk and sometimes you have to use authority to say, 02:46:11

to say, no, it has been done by a very unique psychiatrist who has come to an education congress, 02:46:17

and well, sometimes yes, you have to quote me, quote me, and it has been done by Dr. Huertas. 02:46:21

Nothing happens, they are not going to criticize you because science says so, okay? So, doing sports, 02:46:26

science says so, doing sports with regularity, physical exercise, I have not done sports 02:46:31

as a child, not at all, because my parents did sports as children, I have already done it as a 02:46:38

but it is a protective factor in all children, whether they have a diagnosis or not. 02:46:42

And that their parents are present and supervise them is also a protective factor. 02:46:49

So, I know a lady who made a fake Instagram account with her puppy 02:46:53

to be able to see what her son and her friends were doing. 02:46:59

So, everyone supervises as much as they can. 02:47:03

Don't judge me, don't judge me. 02:47:07

I mean, 10-year-old children can't have an Instagram account, and if they have it and they accept a little dog that says wow, wow, thinking that it's a little dog that manages the account, the problem is with their parents. 02:47:12

But there I was as a police officer of the networks. I could have been a perverse psychopath, but no, it just so happens that not. 02:47:24

So, everyone supervises as they can, but you have to be present. 02:47:32

Well, as I have very little left, social networks also have benefits. 02:47:35

Dr. Ferre, I am very proud to be in Marañón, where tools are being developed to accompany patients with depression so that they do not abandon medication, 02:47:39

so that women with eating disorders can have better health control, so that women who suffer from violence and have to face judicial processes do not have so much stress. 02:47:48

We have a program with virtual reality glasses to minimize suffering in analytics in children with autism, in AMITEA. 02:47:58

In other words, we have incorporated technology into health, but in a mature, responsible and reasonable way and in the context of research. 02:48:06

And when we have the results of the research, that's when we can say, this works. 02:48:14

Before, it didn't. 02:48:18

In private hospitals, they tend to digitize a lot because a lot of money moves, but sometimes it hasn't been proven to work yet. 02:48:20

It's just that it's very beautiful and very attractive, which has also happened to us in education. 02:48:26

Why are we going to deceive ourselves? 02:48:29

Well, then, all this is the bad that can happen to us. 02:48:31

I have already told you the good things, but we see it in ourselves. FOMO is the fear of losing something. 02:48:34

What happens to adults? You are not replying to work emails and you don't know if something very serious is happening, right? 02:48:39

And you are left with that anguish. Well, that also happens to children, tiredness. 02:48:44

And, well, this was because if you look for ADHD, which is the English hashtag for ADHD, there are 500 million views. 02:48:48

All of these people spread TDAH on social media. 02:48:59

None of them are professionals. 02:49:02

They have a lot of visits. 02:49:04

I had linked a video, but in a version that I didn't send you. 02:49:06

Videos of broadcasters saying nonsense about TDAH. 02:49:09

But most people are fed up with this information and are confused. 02:49:14

Because, of course, if you have a little bit of TDAH, 02:49:19

and the other day I posted a meme on Instagram, 02:49:22

when they tell me, we all have a little bit of TDAH, 02:49:24

I get up and I leave, right? 02:49:27

Of course, because you say, 02:49:29

the effect you have a little bit of TDAH 02:49:31

is that someone gets up and leaves, 02:49:33

because that can't be said. 02:49:34

Well, and I'm going to finish 02:49:36

because I'm very worried about self-diagnosis, 02:49:38

which is what is making me work more lately. 02:49:40

People who suddenly without having had 02:49:43

any emotional discomfort 02:49:44

and no contact with mental health say, 02:49:45

I think I'm TEA, I think I'm TDAH, 02:49:47

I think I'm neurodivergent or PAS. 02:49:50

And then they demand that public health 02:49:52

validates their diagnosis or tests them. 02:49:54

And this also happens in education, with the over-equipment, with the high-capacity, right? 02:49:57

Of course. I'm sorry to open this melon so... 02:50:02

I think my son is of high-capacity. Is he of high-capacity or does he have high-capacity? 02:50:06

Let's see, because that's not an identity. 02:50:12

So, this is a problem that, in part, is also the fault of social networks, because they validate this. 02:50:14

I mean, if he has never given you a problem, then what else does he give you? 02:50:21

If you have problems, you will have to know how to manage this and where it comes from. 02:50:24

But if you have never consulted, now what? 02:50:29

If you have never had any discomfort. 02:50:31

So, to reflect on this and take advantage of the prevention opportunities. 02:50:33

We have to set limits, but we have to be there and we have to know where our children are. 02:50:38

It can't be that a mother says, no, I don't have a TikTok account because it scares me a lot. 02:50:42

But my daughter is a crack, she has a lot of followers. 02:50:46

But how are you going to leave your daughter in a place that scares you? 02:50:48

Are we crazy or what? 02:50:50

Of course, I encourage you, I started using social networks when I started working with teenagers, when I worked with adults in the Salamanca neighborhood, I knew the temporary exhibitions of the Thyssen Museum, the Planet Award, of course, because to relate to your patients and to be respected, you have to have more or less some knowledge of where they move, because if not, you don't know anything, as my colleagues have said. 02:50:52

I wanted to give you some strategies. You will already know this because it is very American. 02:51:14

Think before publishing, if I would say this in my class in front of my classmates, 02:51:20

if right now I feel good when I am publishing this, if tomorrow I will regret what I have published, 02:51:24

if this can be a mistake and it is not well referenced or well informed. But this is mine. 02:51:31

The network, the intervention network, checks sleep, mood and hours. 02:51:38

Do you sleep enough? Do you spend many hours with the screens? 02:51:43

Are you in a bad mood to enter X? 02:51:46

Establish limits. I have a limit of social networks of one hour a day, 02:51:49

I can skip it, but the mobile warns me and I am aware that I have exceeded the time. 02:51:55

And you set schedules and dialogue, family, school and patients. 02:52:00

So, all these little things, as well as mnemonic rules, we like very much the psychiatrists who work in neurodevelopment because the families memorize it and the kids too. 02:52:05

Make up these things! If I don't take long to make up this, social network, right? 02:52:15

So, and that's it. I'm not going to give you more stuff because the limits, that is, the recommendations of the pediatricians, you can look at them on the website of the pediatricians. 02:52:20

My recipe for today, five prescriptions. 02:52:29

Put screens out of the extreme hours of the day, neither when getting up nor when lying down. 02:52:33

Pre-check to give them a phone, what applications they are going to use and how long. 02:52:38

It's not worth everything, wide sleeve. 02:52:44

That the same rules apply to adults. 02:52:47

We had a little basket at home to leave the mobile when we got home. 02:52:49

We've had it. We've had a series of things. 02:52:53

That was Sicily in 1920, and if you have taken this reference, you are from my fifth grade. 02:52:56

And then you have to offer the kids very attractive plans B, sports, art, social things that they like a lot. 02:53:02

Not that they like the teachers or that they like their parents, but that they like them. 02:53:10

You have to make a sacrifice. And then, every now and then, I have put here quincenal because I talk about people who come to my consultation. 02:53:14

But if they don't have a problem, maybe it can be quarterly. 02:53:20

I know how to keep these rules and adjust them to the development, to the responsibility and to how things are coming out. 02:53:23

And with this I leave you. It is not about eliminating the screens, but about coexisting with them intelligently. 02:53:29

I stick with that. The screens are not prohibited, they are taught. 02:53:35

I am very pro-laws, because once they tell me this is out of the law, I already know what I have to do. 02:53:38

Fulfill the law. I like to fulfill the law. 02:53:44

So, if they legislate, great, but we are not the ones who legislate. 02:53:46

So, what we have to do is teach. That's why you are teachers. 02:53:50

Remove the environmental noise, improve sleep and reach agreements. 02:53:55

And that's it. 02:53:59

This was all I had to tell you today. 02:54:04

So much hype, so much hype that my colleagues have put me. It wasn't for much. 02:54:08

We have stolen five minutes of your presentation. 02:54:18

I have realized, I have realized that I was short of time for what I had calculated. 02:54:20

We would like all the teachers here to ask you something. 02:54:24

There are five minutes left, we will respect the time of departure, 02:54:29

but I'm sure they have some questions to ask you. 02:54:32

While they think about it and raise their hands and take the microphone, 02:54:36

I know very well from my dear companion and generous companion, José Antonio, 02:54:41

that you are part of the Control Z platform, 02:54:45

that you are now moving. Tell us a little bit about what you are defending. 02:54:50

It is true that I met José Antonio in person and more intimately, as well as with more confidence, 02:54:56

thanks to Amar España, who was the director of the Spanish Data Protection Agency. 02:55:01

So, he is a person who has done a very valuable job to protect children, 02:55:06

because he has set the priority channel of complaints, he has developed a tool, 02:55:11

a tool all within her work as a public position and with money from all 02:55:16

Spaniards but it is good that politicians use our money to do 02:55:21

the good is not a wonder then she then set up a work group in the 02:55:24

agency in which I joined as a health professional representative of a 02:55:28

scientific society and then invited us to a congress to a summer course and 02:55:32

that is where we could share true then of the most retired and then now 02:55:36

lidera esta plataforma control z y claro los que la conocemos y sabemos cómo ella lucha por mejorar 02:55:43

la sociedad y sobre todo de la infancia pues no le hemos podido decir que no entonces somos un 02:55:51

grupo de organismos a sociedades científicas plataformas ciudadanas en unicef está en la 02:55:55

sombra y como de apoyo la fundación edición no se posicionan claramente pero están ahí pero el 02:56:03

the Official Council of Psychologists, well, a large group that we are trying to see how we can raise awareness in society that we have to be responsible for this. 02:56:09

And that's all I have to tell you. We make healthy breakfasts once a month, with different topics, and we spread it in the media. 02:56:19

And at the moment we are only doing that, but we will do more things, because we are committed people and we want to improve society, so we will do more things. 02:56:25

Thank you. Any questions? Who's got the mic? 02:56:33

No one wants to ask me anything? I'll keep going, I've got a cart. 02:56:40

Maybe at home someone has a question, or a comment, or a complaint. 02:56:45

I mean, insults only on the first day. 02:56:50

So, since there are many people here who already know me, no. 02:56:53

Thank you. In one of the slides, you said you didn't have time and you went so fast. 02:56:56

Any recommended time? 30 minutes a day? 02:57:00

What slide are you referring to? I think it would be the one that was for age. 02:57:03

Talking about screens. 02:57:08

Of course. No, I cannot recommend a minimum time. 02:57:09

What I have copied in a slide were the recommendations of the Spanish Association of Pediatrics, 02:57:13

which have been recently reviewed, and they are for ages. 02:57:20

So, there are very early ages in which zero screens are recommended. 02:57:23

Then, in other ages, a very short time can be allowed, for example, 02:57:26

for video calls with grandparents, things like that that favor a little the connection. 02:57:31

And this is being reviewed, and we are reviewing it in the clinics every now and then, because 02:57:37

scientific publications are slow, that is, the research is slow, and we are reviewing 02:57:41

it and we are updating it. 02:57:47

I don't know exactly what slide you are referring to, but I imagine it would be ... 02:57:48

Oh, the TDAH, it could be. 02:57:52

Well, of course, you have to balance with the screens you have in the school, it is difficult to put recommendations, I don't remember, but it can be. 02:57:55

I don't put a specific time for my patients with ADHD, I try to use the screens as little as possible. 02:58:05

Then their parents suffer from it every day, and when they come with a mobile better than mine and an Apple Watch better than mine, I know it's going to be a difficult consultation. 02:58:15

Hello, I'm a little embarrassed to do it because I don't know if it makes much sense, but when you were talking about self-diagnosis, what came to me and that I have a serious problem and it happens to me a lot and I don't know if it happens to more people, and especially with girls, is this self-diagnosis of anxiety. 02:58:23

if you have seen it or not or indeed what I used to think it was an attack 02:58:42

of I do not know how to tell you about nerves is anxiety or not to me that is what anguish generates me the most 02:58:49

especially because also I tell you already with a daughter who is 19 years old she sees me as a person 02:58:54

like I am not empathetic at all and that I do not understand that all that is anxiety 02:59:00

Very good question, thank you very much. 02:59:05

I have really taken out the issue of self-diagnosis because sometimes it gives us work to adjust the expectations that people bring that demand things from us. 02:59:09

There are people who have information and know how to inform themselves and things resonate with them and they have dragged a discomfort, they have suffered bullying and they understand each other from a label and they ask for help and they are accurate diagnostics. 02:59:17

The issue of young people, because at 19 I still have to tell you, I'm sorry, that she is a teenager and you still have a few years of suffering left, is the search for identity and label. 02:59:29

And if the word anxiety suits her to justify what she feels and is a discomfort, maybe she has used that word for that. 02:59:39

La cuestión es si está utilizando esa etiqueta para refugiarse en su habitación y evitar enfrentarse a lo que se deben enfrentar las personas de 18 años para lograr los hitos que se esperan en esa etapa de la vida, 02:59:47

tiene que recibir ayuda y un profesional le tiene que ayudar a comprender qué siente ella cuando dice que tiene ansiedad, a qué se refiere con eso, con qué lo relaciona y cuándo fue la primera vez que sintió eso para intentar buscar un sentido a ese síntoma. 03:00:01

Yes, well, of course, because, well, I think it is true that now this of self-injuries and anxiety is a search for identity, 03:00:17

and that the scars of self-injuries already look proud because they have overcome a vital crisis, 03:00:39

and it is like before it was to wear Nike shoes or Levi's pants, which made you belong to a group, and that is a danger. 03:00:44

but we must never banalize that they call it whatever they call it, but they are suffering 03:00:52

and they are not being able to express an unpleasant emotion. 03:00:57

They are not being able to tolerate it or we are not giving them a space to manage it. 03:01:00

That before we did not have it and we have done well does not mean that they do not have to have a space now, 03:01:04

because we have gone through a pandemic, we have gone through the 11M, 03:01:11

but we have gone through a lot of historical things. 03:01:14

Okay, our parents went through the civil war, whatever you want, but they were not very well. 03:01:17

If you look back a little, the families, I mean, do we look at our parents and our grandparents, 03:01:22

we understand because we are as we are, right? 03:01:29

So, I would never take away, I mean, I would give them space to talk about it. 03:01:32

I would take away importance if we see that it is not important, that it is not a matter of life or death, 03:01:36

but that it would give validity to their suffering, because it is their way of expressing it. 03:01:39

And expressing suffering is much better than expressing it through behaviors. 03:01:43

Well, I think you could not have explained it better. 03:01:51

Well, forgive me the mess. 03:01:54

Thank you very much, Abigail. 03:01:56

Thank you very much to all the speakers who have made today's session possible. 03:01:59

We have reached the end of today. See you tomorrow at 10. 03:02:11

But thank you all for educating to take care. Thank you very much. 03:02:16

Thank you. 03:02:21

Congreso_Educar_para_Cuidar:UT_Salud_Mental_03_10_25

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