Elimination of Psychiatric Hospitals Draws Mixed Reception

After the recent reforms to the General Health Law regarding mental health, which impact family and community care where hospitalization is the last option, different organizations have vocalized their opinions on whether these changes could affect or benefit patients. 

The General Health Law reform was published in the Nation’s Official Gazette in early May 2022. It indicates that the 442 existing mental health and addiction establishments of the Federal and state Ministry of Health must disappear or be transformed into spaces for ambulatory care. Of the 442 hospitals, 77.1 percent are primary addiction care centers, 14.9 percent comprehensive mental health centers and 7.9 percent psychiatric hospitals.

The National Human Rights Commission (CNDH) and other human right organizations have spoken out in favor of the reform: “it is formulated from a progressive perspective in respect of the human rights of people with intellectual and psychosocial disabilities,” according to the CNDH.

The commission also stressed that the current asylum model has asymmetries of power that "disempower users and undermine their right to make decisions about their health, thereby creating an environment in which violations of human rights can and do occur… This misuse of power asymmetries prevails, in part, because legal provisions often oblige professionals and the state to adopt coercive measures,” according to the report.

Psychiatric facilities have 68 reported complaints, 26 related to the received medical treatment, 20 point to acts of violence and 12 refer to actions that threaten people's lives such as deaths, suicide attempts, suicides and escapes from hospitals, found an study by Documenta. The study also found 44 complaints to state human rights commissions related to beatings, humiliation and mistreatment. By type of center, 18 of the complaints correspond to psychiatric hospitals, 13 to prisons, nine to shelters in Mexico City and four to addiction treatment clinics.

Organizations such as REINSERTA, REINTEGRA and OCUPA asked the CNDH to sue the Supreme Court of Justice of the Nation (SCJN) to invalidate this decree, arguing that the disappearance of psychiatric hospitals will generate an “overload” in the tasks of caring for families, particularly for women, and will put at risk patients who do not have support networks. The organizations also encourage the government to implement other approaches to treat mental health, as it requires an integral approach that, in many occasions, is not available to many families. They urge for the creation of safe spaces for diagnosis and treatment and the opportunity to care for people with psychosocial disabilities.

Mexico has 3.68 psychiatrists for every 100,000 inhabitants, a low standard compared to the five recommended by the World Health Organization (WHO). From these, 60 percent work in Mexico City, Jalisco and New Leon.