For those who have chronic and severe mental health diagnoses — like schizophrenia, major depression, bipolar disorder and obsessive-compulsive disorder — access to doctors and medications are essential to staying alive.
Psychiatric wards in Venezuelan hospitals are in crisis mode. Amid general medicine shortages in Venezuela, it is nearly impossible for those who need psychiatric medications to receive them. According to Dr. Julio Castro, the health coordinator of the National Assembly, 80 percent of hospitals reported a total lack of oral benzodiazepine medications and 60 percent do not have oral antipsychotic drugs; 50 percent of hospitals did not have either intravenous benzodiazepine or antipsychotic drugs.
If a hospital does not have the medication a patient needs, the patient has two options: a relative who lives abroad can send it in the mail or the patient can buy a prescription out of pocket at the local pharmacy. The cost of a phenobarbital prescription — a mental health medication — averages around $70 per month; the minimum wage in Venezuela is $5 per month.
“In real terms, the psychiatric patients are getting worse every day,” said Castro. “They need to go to the acute wards, but 50 percent of those wards do not have medication. So at the end, the patient has nothing, and they die.”
Outside the country, Venezuelans are struggling to overcome these same mental health struggles while also grappling with the trauma of displacement. The United Nations estimates that over 4.8 million Venezuelan refugees have poured out of Venezuela, with 3.9 million into Latin America, the Caribbean and neighboring South American countries, most of them into Colombia.
Venezuelans “left their country — in many instances — with the clothes they had on their back and the money they had in their pocket,” explained Dr. Pierluigi Mancini, an expert on South and Central American immigrant mental health.
As a result, displaced persons often do not have their medical records with them, which means that starting over in a new country is an uphill battle.
In Colombia, Venezuelan refugees must register with the country’s health care system, but many have not. As of 2018, only 28,069 Venezuelans — out of roughly 1.6 million refugees — had refugee status, according to a Colombian government report. Those who are unregistered must pay hundreds or thousands of dollars out of pocket.
All of these barriers can appear insurmountable, especially for those who have severe disorders and require regular medication or treatment.
According to Mancini, when people see a displaced individual with a severe disorder openly struggling in public, “they either take them to an emergency room or to jail,” he said. “Sometimes, one right after the other.”