On a fresh and sunny morning, Elizabeth, Angela, Nilda and Ana drink mate in the dining room of the house they share in Remedios de Escalada, Lanús. Their stories, as hard as they are different, coincide on one point: after years of hospitalization at the Esteves Hospital (a neuropsychiatric hospital where more than 600 women live) and thanks to its Assisted Rehabilitation and Externalization Program (PREA), the four achieved reintegrate into the community
“I was in the hospital for many years and I was not encouraged to accept the program and leave. I had a situation of accustoming, I had lost that the human being lives in society,” says Elizabeth, who is 54 years old and spent almost nine interned in the Esteves. Since April 2016, it is part of the PREA. “When I left I remember that it was very difficult for me to cross the street, I was afraid. I had forgotten how to use a bus. It cost me a lot of freedom. But I always say that it has no price,” he adds.
They lived years in a neuropsychiatric and today they share a house in Lanús
María Rosa Riva Roure, psychiatrist and general coordinator of PREA (
Facebook: Freely PREA) ,, explains that it is a deinstitutionalization or demanicomalization program, based on the recovery of citizenship rights and destined to exterminate inmates in the Esteves, who once suffered a mental health crisis that motivated hospitalization , and that for various reasons (in general, because they have no family or did not have the necessary financial resources or support) they remained there for many years.
Today, PREA has 20 cohabitation houses where they live alone, contained by a team of professionals, 78 women between 36 and 87 years old. Together they sustain their treatment and reinsert themselves socially. They are constantly contained by the team of professionals (psychiatrists, psychologists, community escorts, nurses, occupational therapists and social workers). “It's a melee job,” says Riva Roure.
The program began in 1999, after a resolution of the Ministry of Health of the province of Buenos Aires that planned its implementation in the four monovalent Buenos Aires hospitals. Although in the rest the PREA had ups and downs, in the Esteves it remains uninterrupted since its creation. This year, they are two decades old.
“The hospital is a situation of mixed individualities, it is a deposit of people, there is an alienation of being. Eye, I was treated very well. But it is an institutional life. You have to stand in line for the medication, to bathe, for everything For a practical reason for the nurses, we had to go all naked to the bathroom and I was ashamed to see my body and see the 70 patients together. That was awful, it was not a home, “recalls Elizabeth. “The community nurses are different: they come, they visit us, they correct some situation. They accompany our life. And we are free, we are neighbors of the neighborhood, like any other person.”
Although the national mental health law (26,657, enacted in 2010), establishes the need to create alternative and community devices that should replace neuropsychiatric by 2020, and stresses that hospitalizations are a resource of a restrictive nature, which must be carried out For the shortest possible time, experts say there is still a long way to go.
In fact, there are people who have been living in neuropsychiatric for decades: patients with severe psychic conditions who, after suffering an outbreak, were admitted and after the episode failed to return to the community. The lack of financial resources and that of a containment network are some of the reasons; but, in all cases, what prevails is the shortage of community devices whereby once they are discharged they can continue with their treatments inserted in society.
Riva Roure argues that the development of intermediate community-based devices, such as half-way and cohabitation houses, hostels, day-care centers and hospitals, and the development of social enterprises are essential to achieve full compliance and implementation of the national law on mental health.
“These devices favor and facilitate the ambulatory care of people with serious mental illnesses in non-confinement contexts, allowing their broad social inclusion and the development of capacities in the various aspects of life,” Riva Roure affirms. “Despite being explicitly stated in the text of the law and its regulatory decree, the sufficient response has not been given from the State, which constitutes a debt to the affected population. “
Elizabeth says that when she returned to live in community, “I didn't know what a house was.” “You had to learn everything back. I had forgotten to cook, that you have to say good day when you get up, what it is like to have privacy to sleep. In the hospital there were forty beds in a space,” he says. “One day, when I was already in this house, I went to the Mariano Moreno square, I sat on the grass, cried and thanked the gift of freedom so much. It was magical to have a house again and be able to respond, when they asked me where he lived: 'In my house'. I used to have the hospital address in the document. “
Riva Roure points out that during long hospitalizations, these women have been losing social skills and daily habits: “The asylum is a total institution, such as the jail, which provides clothes, food, organizes the routine, etc. Therefore, the PREA it has two large sectors: in-hospital and out of the hospital. “
The first has two stages: admission (women are interviewed in conditions of being outsourced) and participation in the workshops where the recovery of daily habits is worked (from health care to how to manage money or cook), since many women spent years (and even decades) interned. “The idea is that they get to know and assemble groups by affinity, so that they live later in the houses of coexistence”, adds Riva Roure.
One of the greatest difficulties of PREA is to get houses to rent: “The rental of homes is made with funds from the Ministry of Health of the Province of Buenos Aires. At this time there is a delay in payment, which complicates the continuity of this healthcare modality, “says Riva Roure.
Today, Elizabeth enjoys writing, going for a walk, having her clothes always tidy, making, once a week, a meal to share with her housemates. “There were many times that I thought I was not going to leave the hospital anymore, because I saw people grow old and die there. When I saw the bodies go to the morgue I thought: 'when will I be'. I had a feeling of imminent death,” admits Elizabeth . “Today I dream of living with my son again, recovering the link, leaving the PREA and leaving the place to another woman who needs it, because I think it is a place of transition,” he concludes.
. (tagsToTranslate) Mental Health Day: they lived for years in a neuropsychiatric hospital and today they share a house in Lanús – LA NACION
Publicado en el diario La Nación