After 16 initiatives presented in recent years, the Senate took an important step on the issue of mental health, albeit with some nuances.
After 16 initiatives presented in recent years to legislate on mental health in a human rights tone, yesterday the Senate approved an initiative that emphasizes the importance of community services, strategies for community and manage crises, but also in the users' right to decide... except in crises.
By Katia D'Artigues
On Thursday, after voting was halted on Tuesday for technical reasons, a reform to the General Health Law on Mental Health and Addictions was unanimously voted in the Senate.
It is a better law that sees mental health from a human rights perspective: where it brings psychiatry closer to community services (just now, when it is most needed), with the axis of recovering the right to decide of the users of these services but that at the mere hour he passed two reservations (endorsed by all the senators and senators) that are in conflict.
One by Miguel Angel Mancera, from the PRD, which modifies the term "informed consent" (it went from a fraction in Article 27 to an Article 51 bis) in which, although it says that users have the right to decide freely on the application of procedures and diagnoses... allows that in cases of crisis, "of temporary or permanent disability" the authorization to proceed may be given by a "family member who accompanies him or legal representative". In the event that this is not possible, "the health service provider" may decide to intervene, leaving a record in the clinical file, especially if his life is in danger.
Elsewhere it says: "It will not be understood that the person cannot give their consent when it is considered that they are in error or are not aware of what they are doing."
On the other hand, another reservation by Emilio Álvarez Icaza, from the Plural Group, to Article 75 says:
"Hospitalization can only be carried out voluntarily and when it provides greater therapeutic benefits for the person than the rest of the possible interventions, it will be carried out for the time strictly necessary and in the general or pediatric hospital closest to the patient's home. user".
So, yes… but no.
A long road
It is a law that has not been passed by steam, which took into account 16 different initiatives presented since 2018. To discuss the issue last year, for example, both a open parliament in the Health Commission of the Chamber of Deputies (which had some technical failures) and also another one co-organized by the deputy Martha Tagle and part of civil society that has defended the right to decide of people with psychosocial disabilities for some time years, like Documenta and other organizations (including Yo También) gathered in a group called “Salud Mental Con Derechos”.
Commitment half fulfilled
It is a commitment half fulfilled after last October 4, the Mexican State offered a public apology to Arturo Medina Vela, a young man with psychosocial and intellectual disabilities who was imprisoned against his will, admitted to a psychiatric ward and his rights to defend himself were violated. In that apology that was made at the request of the UN, in the Ministry of the Interior, Alejandro Encinas promised to reform several laws, including the General Health Law regarding involuntary hospitalizations and restrictions on legal capacity (that is, the right to decide) of users of mental health services.
The law that was voted yesterday in the Senate does not fully guarantee that people with psychosocial disabilities are considered people who can make their own decisions and that their legal capacity is respected.
Why is it important?
He's going back to the Chamber of Deputies. What is the challenge for this new way of understanding mental health to work in terms of human rights and respecting the decision of the people? Among them invest money to dedicate even more budget to the urgent mental health issue and more after the pandemic. The opinion does not authorize new budget items and a model will have to be redone with what is available. Is this possible? According to this document from the Center for Economic and Budgetary Research drawn up after the Covid emergency, in 2018 15 million Mexicans and Mexican women presented some mental health condition. ((and this is growing).
Middle- and high-income countries allocate 2.4% and 5.1%, respectively, of their health budget to mental health (WHO; PAHO 2018). From 2013 to 2021, Mexico allocated, on average, 2.1% of the budget of the Ministry of Health.
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