September 18, 2021

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Patients face long waits to leave psychiatric hospitals

TEMPERLEY, ARGENTINA – Carmen Rita Graneros spent the last 10 years of her life in a psychiatric hospital. For nearly half of that time, he didn’t need a diagnosis or treatment. She was simply waiting for the paperwork and government support that would allow her to leave.

In 2017, Graneros, 55, moved to a transitional ward at the Dr. José A. Esteves interzonal hospital, where patients have more privacy and autonomy and can relearn things like managing their money, shopping. and take care of yourself.

After a year, Graneros was ready to live independently. But it took the government and the courts another three years to determine if she could have independent access to the disability pension she needed to pay her rent and day-to-day expenses, or if her finances should be managed by a guardian. Finally, this year the authorization to manage her own pension arrived and in May Graneros moved into a house with three other women.

“I am ready to move today,” Graneros said shortly before leaving the hospital, wiping the tears from his eyes. “It’s so close.”

Argentina’s national mental health law requires that stays in psychiatric hospitals be as short as possible and not prolonged due to lack of accommodation or support from family, friends or other personal ties. But disability rights activists and users of Argentina’s mental health system say the lack of affordable housing, financial support and outpatient psychiatric services means patients are forced to stay hospitalized much longer than necessary. .

The problem is not isolated in Argentina. A 2018 report from the Pan American Health Organization found that low-income countries, where mental health is mainly treated in neuropsychiatric hospitals, tend to have poorer overall outcomes than higher-income countries, where mental health is more integrated into primary care and the resource community.

“Most people hospitalized but ready to be discharged are not discharged due to the lack of support structures for living in the community,” says Eduardo Quiroga, lawyer for the Rights Program for People with Disabilities, part of the Civil Association for Equality and Justice, a human rights organization.

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A government census released in 2019 found that around 12,000 people have been hospitalized for mental health reasons across the country. According to the census, about a third of hospitalizations occurred for less than a year, but 53% were for two years or more. Of these hospitalizations, 25% were for at least 11 years.

Patients and advocates of people with disabilities say the government has not allocated enough resources to help people live alone outside these institutions, trapping hundreds, perhaps thousands, in psychiatric care.

At Dr. Alejandro Korn Hospital, more than 300 patients could be discharged and live on their own if they had more government support, says Fabián Murua, a lawyer at the Center for Legal and Social Studies, a human rights organization, who works at the hospital as an advocate for people with disabilities. “They are still hospitalized due to social, housing and family problems,” says Murua. “Most of them are people who could leave, have a life outside, some with more support or assistance.”

“Most of the people hospitalized but ready to be discharged are not discharged due to the lack of support structures to live in the community.”human rights lawyer

Rolando Hanono, 58, says that after being hospitalized in a mental health center for six years, he was discharged because he has a house of his own. If this were not the case, he would not have been able to support himself on the disability pension and would have been forced to remain in hospital.

“If I didn’t have housing, I couldn’t live,” he says.

María Graciela Iglesias, executive secretary of the National Mental Health Review Body, an entity created by the mental health law to guarantee the rights of users of the mental health system, says the government needs to think comprehensively about how to address these challenges, which they span various sectors, from health to housing to employment.

“It really has to be an integrated policy that the other ministries are engaged in,” says Iglesias.

The Ministry of Health and the Ministry of Social Development declined to comment. The Ministry of Territorial Development and Habitat, the Ministry of Education and the Ministry of Labor, Employment and Social Security did not respond to requests for interviews.

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At the Dr. José A. Esteves Interzonal Hospital, the women’s psychiatric hospital where Graneros was treated, staff do their best to discharge patients despite the lack of more robust support systems.

Nadia Percovich, a psychologist, says staff members work with patients to find out if they own property or re-establish ties with their families. When it is not possible to return to work, they file documents for pensions, pensions or benefits so that patients can become financially independent.

“It’s a very uphill battle,” says Percovich.

He adds that not discharging patients as soon as they are ready can have serious health consequences. Patients lose the ability to take care of themselves and find it difficult to reintegrate into society due to being institutionalized for so long.

“Many times you realize that you are not rehabilitating them from a disease,” says Percovich, “but rather you are rehabilitating them from being locked up in an institution like this.”


[ https://globalpressjournal.com/americas/argentina/ready-discharge-patients-face-long-waits-leave-psychiatric-hospitals/ https://d26toa8f6ahusa.cloudfront.net/wp-content/uploads/2021/07/30214746/a-quiet-place-part-2-bigs-16.pdf
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