New model of mental health will close mental hospitals

The Chamber of Deputies approved reforms for Public health law in terms of mental health and addiction, with which he seeks to provide community care and eliminate mental hospitals, among other actions. However, for the transition to this new treatment model, overwhelming resources will not be allowed not explained what will happen to the patients currently being treated in the state mental hospital.

“This idea of ​​deinstitutionalization is taking to the streets? It seems naive to me to believe that this is possible. If there is no way to send people somewhere, we assume they have somewhere to go”, critiques Cecilia Guillén, founder of En Primera Persona, AC.

Guillen points out that it is first necessary to know what support network the users of these centers have, because the fact that many of them were abandoned by their relatives was eliminated.

For human rights defenders, it is important to know how the agreed reforms will materialize in a gradual and progressive manner, due to the paradigm shift in mental health care, which for years has prioritized patient isolation, “more than closing hospitals.”

In accordance with the approved reforms, at least 33 mental hospitals responsible for the federal Ministry of Health —which has the capacity to serve more than 4,000 people— should be converted into a public hospital or outpatient center and no more monospecialist mental hospitals to be built.

The Community Mental Health Center will be a space that will provide all services, from the main ones, such as promotion, prevention and treatment, to those of high complexity.

Read more: Mental health with rights, a broad discussion forum topic

Separately, and during ongoing discussions to discuss the approved changes to the Public Health Act, Víctor Lizama, member of Orgullo Loco México, stressed the need to inform the actions to be taken to serve those currently hospitalized. mental hospitals, as well as the routes to be taken for their reintegration into society. Otherwise, he said, the authorities’ commitment to a real transformation of the mental health care model would only be on paper.

“Before the Olympics were held in Mexico, in the 1960s, it was decided to close La Castaneda (a mental hospital), and what happened to the residents who were hospitalized there? He went to another institution,” recalls the human rights activist.

Guillén, from En Primera Persona, pointed out that the closure of the La Castaneda hospital was not based on public policy decisions on mental health. It’s not that Mexico “has anticipated desanicomialization, it’s a process that favors urban interests and land-use speculation,” he said.

People who were there, he added, were transferred to smaller, less visible hospitals, which were not necessarily close to where their support network resided, if any.

“I’ve seen the film, it didn’t happen,” he said. “Closing asylum is not de-institutionalization, it’s part of the process, it’s part of the administration and that’s it. Part of the process of reintegration into society is something else.”

Read more: We need to talk: let’s prioritize mental health

Even countries that have legislated on this issue, such as Argentina, which did so in 2010 and set a 2020 goal of making changes to its treatment model, have not made progress toward that goal.

In accordance with the fourth transitional article of the approved decree, all expenditures generated by the enactment of the reforms must be paid with the budget approved by the dependencies, as “no extension of their budget will be authorized for the current fiscal year or subsequent”.

The reform of the Public Health Act in the area of ​​mental health and addiction is the first step towards the establishment of the National Council on Mental Health and Addiction (Conasama)—a decentralized body that will act as the regulatory, normative and implementing agency of national mental health and addiction policies—, implying the merger of the Technical Secretariat of the National Mental Health Council (Consame), the National Anti-Addiction Commission (Conadic) and the Psychiatric Treatment Service (SAP).

According to the Special Treatment Program for Mental Health and Addiction 2020-2024, in Mexico almost 2% of the health budget is spent on mental health. Of that percentage, 80% is only for the operational costs of mental hospitals.

Once the decree amending the Public Health Act is published in the Official Gazette of the Federation (DOF), the Federal Executive Branch will not have more than 180 calendar days to issue regulatory provisions to determine in the field of administration the appropriate provisions or, where appropriate, update current regulations. .

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Stuart Martin

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