Human rights violations documented in mexican psychiatric hospitals

By Kevin Boyd

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

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