Argentina: A mental health system caught in transition (original) (raw)

2020, International Journal of Mental Health

For the past 20 years, Argentina has been embroiled in a debate about its psychiatric asylums slated to be closed by 2020. These 19th century edifices have been the subject of serious criticism centered on human rights abuses of patients and appalling conditions of care. Legislation introduced in 2010 directed a 10-year timeline for the closure of psychiatric institutions, heralding a policy of deinstitutionalization to be completed by the imposed time limit. It looks now however, that the process is arguably at a tipping point between continued institutionalization and partial community reintegration. The law requires the reduction of patients in psychiatric institutions, the availability of psychiatry beds in general hospitals, a guarantee of patient rights, the establishment of interdisciplinary teams, day hospitals and community-based care. Although some changes have occurred in the delivery of mental health services, minimal progress has been made toward implementing a comprehensive vision for mental health. Community mental health programs are few and underdeveloped, with some notable exceptions, and the mental health system as a whole appears to be stuck in the early stages of transition. This paper reviews the historical and current mental health system in Argentina and uses interpretative phenomenological analysis (IPA) as a method for exploring the views of stakeholders, including practitioners, academics and researchers in Buenos Aires, in order to understand how they make sense of the difficulties in implementation of the 2010 law. Some key recommendations about community mental health programs emerge from the findings of the study. KEYWORDS Deinstitutionalization; community mental health; Argentina Background Currently in Argentina, there is an ongoing discussion about the process of deinstitutionalization of mental health patients given impetus by the Mental Health Law 26,657 (Congreso de la Naci on Argentina, 2010). In Buenos Aires, where a number of large psychiatric institutions are located, serious concerns have been raised over discharging long-term psychiatric patients into the community with no planning or resources in place to