Ruined Lives

Yesterday I returned from Argentina, where we released the report we've been working on for three years, Ruined Lives: Segregation from Society in Argentina's Psychiatric Asylums. The report documents the conditions and treatment of the nearly 25,000 people detained in Argentina's psychiatric institutions. Abuses documented include people burning to death in isolation cells, physical and sexual violence, forced sterilization, arbitrary detention, long-term sensory deprivation in isolation cells, lack of appropriate medical care, among others.

The abuses are nothing new. In every institution I've monitored there are abuses. The striking thing about Argentina is the number of people detained in institutions for socio-economic reasons. According to authorities and mental health professionals interviewed, anywhere between 60 and 90% of those institutionalized are there because they have nowhere else to go. Indeed, authorities have coined the phrase, "the psychiatrization of poverty" to explain the phenomenon. Argentina has almost no community-based mental health services and supports, so people who are institutionalized tend to stay there: 80% of those committed to public institutions are detained for a year or longer; the average length of institutionalization is 9 years.

Despite this bleak outlook, there are mental health reform efforts under way. Two large institutions (more than 1,000 beds) are working to discharge people and provide them with community supports to aid in their social reintegration. The psychiatric forensic unit where we documented people detained naked in tiny, dark cells for months at a time have been dismantled. There are a number of movements lobbying the government to deinstitutionalize.

The transformation of mental health services in Argentina will doubtless take many years, but the reform movement is gaining momentum. Likely, the tide will not turn back. Ruined Lives is available in PDF at: www.mdri.org.