What will be the area for people discharged from a psychiatric hospital?

President Alberto Fernandez, along with Minister of Health Carla Vizzotti, announced the start of construction of the first inclusive area for people released from the Montes de Oca National Colony, in the Buenos Aires area of ​​Luján. The President stressed that the project is part of the application of the National Mental Health Act and aims to break with the logic of the mentality. “We are rebuilding the mental health system, which has always been a taboo subject,” he said.

Mariana Moreno, head of the Department of Health’s National Directorate for Comprehensive Mental Health and Consumption Problems, stressed that the announcement was “a big step forward in the process of wiping out” those in the colony. “This is part of an agreement with the Ministry of Territorial Development and Housing, which is also working in other provinces to build shelters for people in the process of extermination,” the official explained. cry of the south-. As part of the federal strategy, we are in the process of subsidizing projects in various provinces to create bridge devices that provide continuity of care for people who have been discharged, and operations or repairs in general hospitals so that people with mental health problems are treated there and are not dependent on having a monovalent hospital.”

The Colonia, which will be renamed Hospital Nacional y Comunidad Ramón Carrillo, will consist of 50 transit houses for 260 people, located on the territory owned by the institution, which already has services to start working, such as the opening of the streets connecting it with Torres, the city in which it is located, in the Luján district.

The project to transform the former colony, Moreno explained, “has been in place for several years,” but only last year, with an increase in the budget for mental health and the resumption of the work of the National Interministerial Commission on Mental Health and Addiction Policy (Conisma), “President and Minister Visotti are giving impetus to the transformation generated by the agreement with the Ministry of Territorial Development.”

In addition to building houses, the transformation at Ramón Carrillo includes a new health center that, while dedicated to mental health, is open to the entire Torres community, as well as reform of wards for seniors who need special care.

“Other houses for people who need high support are also being completed, because some of the people who were in the Colony are mentally retarded, so they cannot be completely alone and require more support from the collectives. But this does not mean that they have nowhere to live. There are even departments for people who are in a couple, this situation was considered so as not to destroy ties, ”said Moreno.

In 2010, Argentina passed a new mental health law, praised by the World Health Organization (WHO) as “the first mental health law to incorporate core mental health standards as well as regional and international human rights norms.” One of the issues raised by the law is the (gradual) closure of psychiatric hospitals, neuropsychiatric hospitals or monovalent hospitalization facilities, public or private.

“In 2020, shelters must be closed by law. They are not all closed yet, although there are very significant developments in some jurisdictions,” Carmen Cáceres, a psychologist and coordinator of the Educational Assisted Rehabilitation and Externation Program (PREA) training group at the Estevez Neuropsychiatric Hospital, told this publication.

The Mental Health Act establishes that mental health professionals must justify their actions and obtain the consent – in a state of clarity and understanding of the situation – of the person who will receive treatment.

Involuntary hospitalization is only considered if the medical team finds that the person is in a “definite and imminent situation of risk to themselves or third parties.” Similarly, hospitalization should be as short as possible and accompanied by a crisis that the user of the mental health service is experiencing at the time.

Esteves PREA, according to Caceres, was created in 1999, long before the law was passed. “Already at that time, the need was raised to create conditions for people who lived in lockdown, who turned into a chronic form, so that they would have the opportunity to recover. But it is necessary to develop a policy that guarantees care in a broad sense. These are people who are not only sick, but also suffer from being in a shelter. And they must have a habitat to develop their life and income, whether it is a pension or a job,” he said.

And he added: “How much support these people need is defined in the Law on Mental Health and in the Civil Code, which was reformed in 2015. It cannot be that someone is completely and forever incapacitated. The lives of these people have been affected by their pathology, but much more so by the social stigmatization, by a society that does not expect these people to be able to overcome the episode, and pushed them away.”

There is a lot of experience of deinstitutionalization all over the country. In the case of Esteves PREA, there are care homes with varying levels of support and coexistence groups where “there is a high degree of self-assertion and autonomy, making one’s own decisions and managing money.” “We have recently managed to form a team that accompanies people who do not live in the program home, but can choose to live with their host family. And this team is giving her support to avoid the so-called “revolving door syndrome,” Cáceres said.

“In the province of Buenos Aires and in PREA, we are pushing for the externadas house to be in an urban area so that it is not marked or separated from the externadas. We think it’s important that this inclusion condition be met so that they live in the neighborhood like everyone else.”

Currently, the psychologist added, a 24-hour intensive care home is being installed in Estevez for people who temporarily need a larger multidisciplinary team presence but are not returning to the hospital. Similarly, there are teams that accompany the externation and go to houses that are far from the hospital.

Moreno, for his part, highlighted progress across the country in federal strategy actions, especially “increasing the number of specialists in multidisciplinary mental health hospitals” to “support the transformation process with professionals trained under the Mental Health Act.”

Ahead of the election, the head of the National Office for Comprehensive Approach to Mental Health and Problematic Consumption stressed that the law is far from being fully implemented and that “the challenge is not to stop.” “It will take some time. There are provinces that are moving slower, others faster, but it happens in everyone,” he said. Implementation is a process and there should be a commitment because mental health is an issue for everyone.”


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