The Brazilian State has until November 15 to present a detailed report on the measures adopted to prevent violence in psychiatric clinics and hospitals. The determination is made by Pablo Saavedra Alessandri, secretary of the Inter-American Court of Human Rights (Inter-American Court), and refers to compliance with the sentence in the Damião Ximenes Lopes case.
On October 4, 1999, young Damião, then 30 years old, died in the former Casa de Reposo Guararapes, then linked to the Unified Health System (SUS) in Sobral (CE). The body had typical torture injuries, which were omitted from the death certificate.
The case marked Brazil’s first conviction by the Inter-American Court in history, on July 6, 2006, unanimously.
In a hearing at the Inter-American Court four months ago, the Brazilian State acknowledged that it violates the human rights of people with mental disorders.
At the time, the Global Justice, the Brazilian Association of Mental Health (ABRASME) and the National Mechanism for the Prevention and Fight against Torture denounced human rights violations that continue to occur in these spaces of deprivation, such as torture, hunger and deaths caused by iron bars.
In the report, Brazil will also need to respond to these questions, in light of data presented by the National Council of Justice (CNJ) on the subject. In December 2018, inspections were carried out in 40 Brazilian psychiatric hospitals. In 33 of them, there were people hospitalized for over a year. In six of them, more than half of the patients had been in the institution for more than a year.
These violations are described in a study published in March 2020 by the Federal Council of Psychology, the National Mechanism for the Prevention and Combat of Torture, the National Council of the Public Ministry and the Public Ministry of Labor. The material demonstrates that cases of physical violence, rape, LGBTphobia, vexatious searches and religious intolerance in these environments are recurrent.
The Damião Ximenes Lopes case was referred by the Inter-American Commission on Human Rights (IACHR) to the Court on October 1, 2004. The application, against the Federative Republic of Brazil, pointed to a violation of the right to life, personal integrity, judicial guarantees and judicial protection .
The Brazilian State was accused of violating the rights provided for in Articles 4 (right to life), 6 (to personal integrity), 8 (judicial guarantees) and 25 (judicial protection) of the Pact of San José of Costa Rica.
As stated in the process, Damião “developed a depressive mental condition of organic origin, that is, acquired through functional changes in his brain.”
Between 1995 and 1999, the young man was hospitalized three times in the same clinic, as it was the only one with public service in Sobral.
The last time, Damião’s mother, Dona Albertina, took him for an appointment at the clinic, but was informed that there were no doctors available. Fearing that her son would have a new psychiatric crisis at home, she left her son in the hospital to await a medical examination.
On a visit on October 3, 1999, Dona Albertina saw her son tied with his hands behind his body, “bleeding from the nose, with his head all swollen and his eyes almost closed, coming to fall at my feet, all dirty. and smells like urine.”
Hours later, Damião received a medical prescription without even having been examined, and he died the next day.
The autopsy result was “natural death”, despite injuries to the eye, shoulder and wrist. The family suspected the report and managed to transfer the body to the capital Fortaleza (CE), where a new analysis was carried out. This time, the result was “indeterminate death”.
After pressure from the family, the Casa de Reposo de Guararapes was disaccredited by the Legislative Assembly of Ceará, but there was no progress on the accountability of those involved until the case reached the IACHR, in November 1999.
In the 2006 sentence, the Court established that the Brazilian State should ensure speed in investigating and punishing those responsible for the torture and death of Damião, in addition to compensating the young man’s family.
Another obligation was to ensure decent conditions in clinics and hospitals and to develop a training and training program for all people involved in mental health care, so that cases like that do not recur.
Except for the payment of compensation to the next of kin, the Inter-American Court considers that compliance with the judgment was partial. It is on these gaps that the State is once again being called upon to speak out.
Edition: Anelize Moreira