Appalling Conditions in Mexico's Mental Health Institutions

• by Emilio Godoy (mexico city)
• Friday, January 14, 2011
• Inter Press Service

Brigido, whose last name and age are unknown, is one of the 365 patients in Atlampa, which means 'where the water divides' in the Náhuatl indigenous language. The centre, on the southeast side of the capital, was founded in the early 1970s and has a capacity to hold only 300 people.

The psychiatric patients in the CAIS centres, which are administered by Mexico City's left-wing government, all have one thing in common: they are victims of social, institutional and family neglect.

'The state of psychiatric centres is extremely serious in this country,' said Sofía Galván, Disability Rights International's (DRI) Mexico and Central America programmes director.

'Hygiene and health conditions are deplorable, and there are serious human rights violations,' she told IPS.

The Mexican Commission for the Defence and Promotion of Human Rights, an NGO, and the U.S.-based DRI presented the study 'Abandoned & Disappeared: Mexico’s Segregation and Abuse of Children and Adults with Disabilities' in late November.

'Children and adults are detained in institutions because of a lack of treatment…and rehabilitation programmes -- as well as other supports -- that would allow them to develop the skills they need to live in the community,' says the report, based on visits to 20 institutions in Mexico City and in five different states between August 2009 and September 2010.

In this country of 112 million people, there are at least 10 million people with mental, visual, hearing or motor disabilities, according to the Mexican Confederation of Organisations in Favour of Persons with Intellectual Disabilities, a non-governmental institution.

And the public health ministry reports that at least 15 million people suffer from some kind of mental illness or disorder, such as schizophrenia, depression or bipolar, obsessive-compulsive or borderline personality disorder.

Mexico's 31 state psychiatric hospitals hold 7,000 patients.

'To make timely diagnosis and treatment of a disorder possible, there has to be a capacity for prevention and for fighting stigma,' said Gabriela Cámara, president of Voz Pro Salud Mental (Voice for Mental Health), an NGO founded in 2001 that gives workshops on illness management for families and patients.

José González, another patient in Atlampa, gets around by wheelchair and says he is 'Saint Joseph', looking at you with a serious, firm gaze. He is one of the few that can move around by themselves; most of his fellow patients have to be carried.

In the back of the large centre there is a 'cemetery' of broken wheelchairs which no one has bothered to fix.

The patients in this CAIS centre, 10 of which operate in Mexico City with a budget of around 11 million dollars, have no past or future, no families or clinical diagnosis; they are merely warehoused here forever. Since December, three men have died in Atlampa, and were buried in lonely funerals.

The Mexican government of conservative President Felipe Calderón had a May 2010 deadline to present a report on its compliance with the United Nations Convention on the Rights of Persons with Disabilities, in effect since 2008. But it has not yet delivered the report.

A General Law on Persons with Disabilities has been in force since 2005, and last year the government unveiled the 2009-2012 National Programme for the Development of Persons with Disabilities.

The programme outlines nine objectives for coordinating public policies in education, health and sports, as well as harmonising the legal framework on disabilities, reducing discrimination and guaranteeing access to spaces, goods and services.

In December, the Mexico City legislature passed a mental health law, the first in this country to stipulate the creation of a mental health committee and a hotline for people with mental disorders. But it does not include closing psychiatric hospitals and replacing them with alternative centres that enable patients to return to social life.

In Latin America, only Colombia and Argentina have similar laws. But in countries like Argentina and Brazil, the authorities have started shutting down traditional mental hospitals and opening alternative facilities where patients receive rehabilitation and treatment with the aim of returning to a productive life.

The 'abandonados' (abandoned ones), as they are known in Mexico, 'remain in the institution for life,' says the DRI report.

'Many of Mexico’s institutions are filthy, leaving people to walk around in ragged clothing on barren floors covered with urine and feces,' it adds, reflecting the reality in Atlampa -- fully as shocking as any scene in the classic 1975 film One Flew Over the Cuckoo's Nest starring Jack Nicholson or the 1995 12 Monkeys with Bruce Willis.

'The model has to be changed,' Galván said. 'Effective rehabilitation services are necessary, so that people can return to their communities.'

'There is little rehabilitation and reintegration,' said Cámara, who has a brother with bipolar disorder. 'Mental health services should be incorporated in all hospitals.'

In Atlampa, many of the patients are dressed in dirty, ragged clothing, even though there are piles of clothes in the laundry. They don't even know what hot water is. The kitchen is the best-functioning part of the centre, equipped with huge pots and large stoves where decent food is prepared.

The gym and the workshop, set up for rehabilitation purposes, are deserted, as they have never received maintenance. There are just two psychologists and one doctor to treat the 365 patients.

The Mexican state violates 10 articles of the United Nations Convention on the Rights of Persons with Disabilities, according to the DRI and Voz Pro Salud Mental. After the Mexican government delivers its report, a group of NGOs and other institutions active in the area will draw up their own report in response.

© Inter Press Service (2011) — All Rights ReservedOriginal source: Inter Press Service

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