[Controversies between mental health and disability standards in Mexico].

Gabriel Eugenio Sotelo-Monroy, Clarisa Villaseñor-Robledo, Guillermo Peñaloza-Solano, Fabiola Tafoya-Ramos
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Abstract

There are controversies between the practice of psychiatry, current international standards and mental disorders or conditions with disabilities, framed in social care models. The objective of this work is to provide evidence and analyze the main gaps in mental health such as: the invisibility of some people with disabilities for the design of policies, legislation, or public programs; the predominance of the medical model, in which the substitution of decision-making in informed consent prevails, which violates the rights of legal personality, equality, freedom, security and respect for personal integrity, among others. This analysis highlights the importance of: a) integrating the legal provisions on health and disability to international standards, and complying with the Human Rights framework of the Political Constitution of the United States of Mexico, especially the pro personae principle and to the conforming interpretation clause; b) reform the General Health Law in matters of mental health and general health, in order to change the paradigm of asylum care to move towards that of community care with a focus on primary health care, adjacent to the services of the National System of Health; c) prohibit the institutionalization of people with mental disorders, as well as coercive measures as containment measures, and instead train and encourage verbal de-escalation techniques.

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[墨西哥精神健康与残疾标准之间的争议]。
在精神病学实践、现行国际标准和社会护理模式框架下的精神障碍或残疾状况之间存在争议。这项工作的目的是提供证据并分析精神卫生方面的主要差距,例如:一些残疾人在政策、立法或公共项目的设计中被忽视;以知情同意代替决策的医疗模式占主导地位,这侵犯了法律人格、平等、自由、安全和尊重人格完整等权利。这一分析强调了以下方面的重要性:a)将关于健康和残疾的法律规定纳入国际标准,并遵守《墨西哥合众国政治宪法》的人权框架,特别是对人原则和符合解释条款;(b)在精神健康和一般健康方面改革《一般卫生法》,以改变庇护护理模式,转向社区护理模式,重点是初级保健,与国家卫生系统的服务相结合;C)禁止将精神障碍患者送入精神病院,以及将强制措施作为遏制措施,取而代之的是培训和鼓励口头降级技术。
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