A report recently released in Mexico City by Mental Disability Rights

International documents the appalling conditions in Mexico’s mental health

system and makes recommendations for bringing the system into conformity with

international human rights conventions.

The report, titled “Human Rights and Mental Health: Mexico,” is a result of

three visits to Mexican psychiatric hospitals in 1996, 1998, and 1999 by a team

of attorneys and psychiatrists, including Robert L. Okin, MD, UCSF chief of

psychiatry at San Francisco General Hospital Medical Center and professor of

clinical psychiatry at UCSF.

“The conditions in most of the Mexican psychiatric hospitals we visited were

absolutely shocking,” said Okin, who coauthored the report. “These conditions

can only be characterized as degrading and dehumanizing. Living in these grim

circumstances, patients are deprived of even their most basic human rights

under international law.”

Mental Disability Rights International (MDRI) is an advocacy organization

dedicated to the international recognition and enforcement of the rights of

people with mental disabilities and has published similar reports for Hungary,

Uruguay, and Russia.

In a statement that summarized the report, Okin described the conditions of the

psychiatric hospitals he visited.

Although there have been some improvements since the team first visited in

1996, most hospitals continue to confine patients in wards that are totally

barren, devoid of personal possessions and lack any opportunity for personal

privacy, said Okin. Either through a lack of adequate food or through

insufficient staff to help them eat, many patients seemed to be suffering from

malnutrition and had almost skeletal physiques, he said.

“There is almost no treatment or rehabilitation in the hospitals, restraint is

misused and abused, and day to day life is characterized by pervasive

inactivity,” said Okin. “People sit motionless on chairs or barren floors, are

tied into wheelchairs, or spend their days pacing back and forth.”

Self-abusive children were often restrained for hours at a time either with

their shirt sleeves, or with cords which were tied to bed frames, said Okin.

Many other children were unable to use their arms or legs because their

neurological deficits were aggravated by total physical inactivity and frequent

confinement. In certain cases, these children were not even able to swat the

flies that crawled over their mouths and eyes all day long, he said.

“The absence of physical therapy and other kinds of training will almost

certainly prevent these children from ever being able to walk or use their arms

and hands to take care of even the most basic aspects of their lives,” said

Okin.

The team visited hospitals where patients were penned all day in a small area

and routinely urinated and defecated on themselves and on the floor, said

Okin. They were forced to walk through their own urine and feces in bare

feet. At one hospital, the team saw children and adolescents lying for hours

in their own soiled clothes.

“In addition to the way in which these conditions violate patients’ human

rights, the most tragic part of this entire situation is that it doesn’t have

to be this way,” said Okin. “Most of the patients could live in the community

if Mexico had even the most rudimentary system of community services. In the

absence of these services, the families of many patients abandon them to the

psychiatric hospitals.”

Additional information about MDRI is available at www.mdri.org.