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  • Writer's pictureThe San Juan Daily Star

ASSMCA: Fiona reopened the scar left by Maria

On the day before Hurricane Fiona struck the island, the number of calls to the Mental Health and Anti-Addiction Services Administration’s PAS Line doubled. On the day of the storm, “the same thing happened,” the head of the agency said.

By Alejandra M. Jover Tovar

Special to The Star

When Hurricane Maria battered Puerto Rico in 2017 as a Category 5 hurricane, the people weren’t ready for the devastation it caused in economic, mortal and emotional terms. Now, Tropical Storm Fiona, which became a Category 1 hurricane just as it was leaving the island, nearly five years to the day after Maria, has become catastrophic for those still struggling to heal from the 2017 calamity.

In an exclusive interview with the STAR, Dr. Carlos Rodríguez Mateo, who heads the Mental Health and Anti-Addiction Services Administration (ASSMCA by its Spanish initials) recognized that “we are in a period where we can say that a scar that had been sealed is coming back and opening up.”

It’s not just the hurricane. Since 2017, Puerto Rico has had to endure earthquakes in the southwestern part of the island and the pandemic caused by COVID-19.

“Before the arrival of Maria, there were warnings about the need to attend to the mental health of Puerto Ricans,” Rodríguez Mateo said. “We saw during Irma and Maria how anxiety, depression, phobia, and suicidal ideation increased. Then came new social stressors, and we have seen in these more than two and a half years of the pandemic how Puerto Ricans’ minds continue to deteriorate.”

Mental health hospitals, both public (there are three) and private, are full, the ASSCMA administrator said. Fortunately, the situation has been contained thanks to the ASSMCA’s PAS Line, where trained clinical psychologists, social workers and others treat people (over the phone or by chat) before it’s too late.

Before the pandemic started in 2020, the PAS Line received on average 170,000 calls annually. In 2021, those calls increased to 920,000, highlighting the critical need for people to receive mental health attention.

“This is an indicator that this pandemic has penetrated the psyche of Puerto Ricans, and we saw an increase in intra-family violence, in the use and abuse of alcohol and substances; we also saw in adolescents the use of alcohol, tobacco and marijuana, and no sooner had we recovered from the pandemic than this storm comes and turns into a hurricane,” Rodríguez Mateo recalled. “This generation has had to live through events that they had not lived through before. This generation had not experienced a public health emergency like this.”

With Fiona, the number of calls to the PAS Line doubled, he said.

“Normally, we receive between 250 and 300 calls daily; on the first days of preparation for the pandemic, on Saturday and Sunday before the storm, that Saturday, we received 600 calls, and 461 of them were related to Fiona,” Rodríguez Mateo said. “On Sunday, the same thing happened, with 334 related to the hurricane.”

ASSMCA conducted public campaigns to prepare people for the storm.

“When the shelters opened, our personnel arrived, and there are still personnel at the open ones,” Rodríguez Mateo said. “But once the shelters began to close, we visited house to house with our entire team.”

ASSMCA is armed with 450 mental health facilitators, identifying risk behaviors, doing early interventions, and making referrals to mental health programs. They’re also strongly advocating for the use of the PAS Line.

“It is much more convenient for people because an emergency does not choose a schedule, and we are there 24 hours a day,” the ASSMCA chief said.

People can access PAS Line services by calling 1-800-981-0023 or 1-888-672-7622 for the deaf, calling 9-8-8, or visiting There is also an app available on Google Play and the App Store.

“Puerto Ricans find it difficult to talk about mental health. We don’t dare, or it’s hard for us, to talk about depression or anxiety,” Rodríguez Mateo said. “Much less do we accept that someone in our family may suffer from it, and we want to break that stigma through the PAS Line.”

‘ASSMCA Visits Your Community’

ASSMCA’s services aren’t restricted to phone numbers or chat lines. Weekly, teams go to different communities and offer workshops to everyone, from preschoolers to senior citizens, on managing emotions and dealing with substance abuse. Then, they go house to house to make assessments. On this matter, the STAR asked if people were wary of their presence, and Rodríguez Mateo was quick to say that, on the contrary, people wanted to talk.

“My vision as ASSMCA’s administrator is that as a country, we must bring services closer to the citizens who need them,” he said. “If people do not know about them, it is the same as if we did not exist.”

“Five months ago, we started ‘Assmca Visits Your Community.’ Twice a week, we visit a different municipality; we arrive at 8 a.m. and present all the programs we have, recognizing that the municipal entity is the closest to the citizen,” Rodríguez Mateo said. “We start with the mayors, give the presentation, and then we have different activities in the municipality.”

“What we want is to bring the services closer to the people, to make them aware of them and not to be waiting for people to arrive,” Rodríguez Mateo reiterated, while asking people not to be afraid to reach out to the agency’s trained personnel through the PAS Line.

Workshops for municipal employees

Starting next week, a team of human behavior professionals attached to the agency will provide services to municipal employees, corporations, and government agencies to prevent work burnout syndrome.

Rodríguez Mateo noted that the initiative has been designed under ASSMCA’s Brigades of Hope educational program and is focused on providing tools through an experiential workshop to public servants in coordination with the Employee Assistance Programs (PAEs by the Spanish acronym). The primary purpose of the effort is to promote behavioral health, which includes preventing mental and emotional health problems by maximizing the strengths of each public servant for high productivity, a healthy work environment and positive interpersonal relationships.

In the recovery process of the 78 municipalities, public servants may experience conditions that require them to work long hours, excessive stress, an increased number of tasks, and physical and mental exhaustion, which, according to studies and evidence-based practice, could trigger burnout. This can lead to an immediate drop in employee production, demotivation at work, and even a marked pattern of absences due to chronic burnout and other associated illnesses.

Municipalities, corporations and public agencies interested in coordinating the resources of ASSMCA’s Brigades of Hope program for their employees can contact (787) 763-3133 for coordination.

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