The people and organizations who are members of the Salud Mental con Derechos coalition have the pleasure of writing you to express some concerns regarding the process for beginning the Open Parliament which will soon be convened to discuss the initiative of the General Law on Mental Health, presented in November 2019 by Senator Geovanna Bañuelos in the Senate of the Mexican Republic.
We applaud Senator Bañuelos’ decision to withdraw the initiative in question from the discussion of the agenda of the past extraordinary period of the Senate of the Republic. We believe it is now necessary to lay the foundations for a process that is truly participatory and inclusive of all people potentially affected by the mental health legislation that is being adopted. We agree with Senator Bañuelos about the need for profound reform of the mental health services that currently exist in Mexico in order to make the right to health effective for the entire population.
We also agree on the need for immediate action to address the problems arising from the current health emergency caused by the COVID-19 epidemic, notably the situation of hundreds of people with mental health conditions who are permanently institutionalized in psychiatric facilities, often in overcrowded conditions, according to data published by INEGI which reports an average of 161 people per psychiatric center in a census published in 2015 about social assistance accommodation. The adoption of profound reforms of the mental health services currently existing in Mexico requires initiating a progressive, safe and sustainable process to deinstitutionalize these people and provide them with quality support services in the community in such a way as to cease the abuses of and limitations on their personal freedom and their right to live independently. Institutionalization places these people at increased risk of contagion from COVID-19.
We believe the decision to reform the mental health legislation should be based on strong rationality, clarity, and transparency and strengthened by civic participation, especially by those who will be affected by these decisions since currently existing practices and approaches that violate human rights in the field of mental health services may be exacerbated by the adoption of legislation that is not aligned with international human rights law and the public policy changes recommended by the World Health Organization (WHO) in its QualityRights initiative.
We believe that the processes to discuss the initiative must comply with the minimum standards of a true Open Parliament, and, even more, with the principles and guidelines of the Mexican Government’s international obligation to carry out close consultations with people with disabilities through the organizations that represent them, provided for in articles 4.3 and 33.3 of the Convention on the Rights of Persons with Disabilities.
It is important that the call issued to carry out this exercise should clearly state which processes and methodology will be followed to address the discussion, whether there will be pressure to adopt a General Mental Health Law or whether reforms will be made to the General Health Law in the specific section that refers to this matter as well as the session’s agenda to follow the order of the discussions. It would be equally important to provide sufficient time and clarity to guarantee the diversity of multiple sectors of civil society relevant to the issue, among other necessary elements.
An adequate Open Parliament process should include, at minimum, the following elements:
- Transparency and access to information. A clear methodology and follow-up processes that are open to discussion until the initiative becomes law. The methodology and processes must be published in a timely manner on the websites of the commissions responsible for ruling on the initiative in the Senate. At minimum this should include the following: identify the legislators who integrate the work commissions; identify the external participants at each stage of the process; the judgments; the calendar of meetings with their dates, locations and agendas; stenographic versions and/or video recording of the meetings and supporting technical documents.
- Civic participation. Timely public notices, accessible to civil society experts, academia, service providers and other interested parties so they can comment and thoroughly discuss the initiative’s content.
- Accountability. Publication and simple and complete explanation of the initiative’s discussion process, the reasons for including or discarding the proposals, the final opinion with arguments that support it, the meaning of the votes, the documents referenced for discussion, with the name of the proposer and his/her affiliation, the meetings’ minutes and the attendance and voting record.
- Use of information technologies. It must be guaranteed that all work meetings are communicated by electronic means of dissemination, such as the Congress channel and its social media platforms, in addition to being published in accessible, open and timely formats.
In addition to the above conditions, it is imperative to closely consult with organizations of people with disabilities, for which it is necessary to meet the following minimum requirements:
- Wide consultation with organizations. Contact all organizations of persons with disabilities in Mexico through appropriate information channels and include access to all relevant information, including the websites of the ruling Commissions, through various accessible digital formats with reasonable adjustments when needed, such as interpretation in sign language, texts in easy reading and clear language, braille and tactile communication.
- Consultation with children and adolescents. Since the legislation will also include regulations on children and adolescents with mental health conditions, suitable consultations should also be carried out with this population, respecting the principles of progressive autonomy and the best interests of the child.
- Consultation with people under any form of guardianship or who are institutionalized. Consultations should also be carried out among those people with disabilities who are under any form of guardianship or institutionalized, including the elderly, through organizations that protect their rights. For such purposes, mechanisms should be provided to facilitate these people expressing their views, including the possibility of making mechanisms available for supported decision-making.
- Information on the results of the consultation. Update the organizations of persons with disabilities on the results of these processes, in particular by providing a clear explanation, in an understandable, easy-to-read format, of the conclusions, considerations and rationale for decisions on how their opinions were taken into account and why.
We would also like to point out that the absence of a consultation process could lead to a failure to recognize current fundamental rights within Mexico’s legal system, notably the right of people with disabilities to autonomy and to make their own decisions in mental health issues.
With all due respect, we urge that the convening and continuity of the Open Parliament sessions are carried out with these conditions in the process, and that diverse voices and opinions on the subject be included, in a timely and substantive manner, to guarantee plurality and representativeness in order to avoid the hasty adoption of reforms to mental health services in Mexico that will worsen the situation of the population in general, and for people with mental health conditions in particular.