Human Rights Brief
A Legal Resource for the International Human Rights CommunityFall 1994
MDRI Fosters Dialogue on Human Rights in Psychiatric Institutions at Montevideo Conference
by Eric Rosenthal
Some fifty people from Uruguay, Argentina, and the United States packed a small conference room at the old Hotel Parque in Montevideo August 17, 1994 to discuss human rights. The topic at hand was not the incarceration or torture of political dissidents during the dictatorship, but the arbitrary detention and mistreatment of people with mental disabilities in Uruguay's psychiatric facilities.
At the conference, Mental Disability Rights International (MDRI) experts discussed the findings of MDRI's forthcoming report, Human Rights and Mental Health: Uruguay. Presented by Dr. Humberto Martinez, Director of the South Bronx Community Mental Health Council and a member of the MDRI fact-finding team, the report documents that, "[f]or individuals committed to [Uruguay's] psychiatric institutions, the experience can be destructive rather than helpful .... Treatment is often inappropriate and unnecessarily dangerous." More than half of the people in Uruguay's institutions are officially referred to as "social patients," kept in institutions because they have no place else to go. The MDRI finds that the practice of institutionalizing "social patients" at the discretion of psychiatrists constitutes "arbitrary detention" in violation of the International Covenant on Civil and Political Rights.
The Montevideo conference was sponsored by the WCL Center for Human Rights and organized by the Instituto de Estudios Legales y Sociales del Uruguay (IELSUR), a human rights organization based in Montevideo, Uruguay. IELSUR organized the conference to foster discussion about human rights reforms among mental health system administrators, service providers, and advocates in Uruguay, including psychiatric system users and their families.
In his welcoming address, Francisco Ottonelli, the Director of IELSUR, said that the conference was the "first of its kind in Uruguay" to open up a discussion "in the language of human rights" about conditions in Uruguay's psychiatric facilities. "Given our history of struggle against dictatorship," Ottonelli later explained, "people in Uruguay are sensitive to human rights discourse. On the one hand, we must make clear that people who run the institutions are not like human rights abusers under the military - they do not intentionally inflict suffering on people. On the other hand, it is important for them to know that mental health policies and treatment practices raise fundamental human rights concerns."
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The conference provided the opportunity for human rights advocates and service providers from Uruguay, Argentina, and the United States to share experiences with successful advocacy and reform strategies. Dr. Hugo Cohen, Public Health Advisor in the Argentinean state of Rio Negro, described successful human rights reforms in Rio Negro over the past ten years. According to Cohen, nearly all of the individuals once held in Rio Negro's psychiatric institution have been transferred to the community where they have access to support and treatment and have experienced great improvements in quality of life.
Leonard Rubenstein, Director of the Bazelon Center for Mental Health Law in Washington, D.C., conducted a workshop on mental disability advocacy at the conference. The workshop was attended by attorneys and service providers from IELSUR and the Centro de Estudios Legales y Sociales (CELS), a human rights organization based in Buenos Aires, Argentina. Advocates from Argentina expressed interest in creating a mental disability rights project in Buenos Aires similar to the one established by IELSUR.
