Mental trauma worsens due to deficit of psychologists in prison

Neptalí Ramírez spent six years in prison, after being convicted of unintentional homicide. He served his sentence from 2012 to 2018, during which time, he states, he did not receive psychological care: “I did not request it, nor did the State provide it to me.”

The only time a psychologist evaluated him, remember, was before he was released from prison. “There they determine if one is right or wrong mentally, but it is not ideal, because they do not have control over that person,” he says, adding that since he regained his freedom they have not valued his emotional state.

The Comprehensive Penal Code establishes in art. 700 that the prison system will provide “social and psychological assistance during and after serving the sentence”. But this is not true, agree Ramírez, relatives of people deprived of liberty and even health professionals.

“That is one of the main deficiencies that become attitudes of negligence”, considers Billy Navarrete, secretary of the Committee for the Defense of Human Rights (CDH).

One of the reasons limiting care is a lack of staff. 20 psychologists work in the Guayas prison complex, 5 from the Ministry of Health (MSP) and 15 from the Comprehensive Attention Service (SNAI), for a population of 14,696 inmates. In other words, there is one professional for every 734 prisoners.

In other provinces there are fewer or none personnel, as in Bolívar and Pastaza; while at the national level there are 95 psychologists for the 37,347 confined in 53 centers.

“It is not adequate, it is insufficient (the staff), but the authorities are working,” says Alexandra Mantilla, expert in criminal profiling, who affirms that the inmates do receive psychological care.

Although not all. In the Penitentiary, for example, the ‘bosses’ of the pavilions make a list of those who will receive appointments, according to prison staff. But all require these assessments because only with the fact of being deprived of liberty face, explains Mantilla, “an emotional and psychological impact that will fragment their life and way of thinking in various ways.”

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Added to this are traumatic situations that some suffer behind bars, such as sexual assaults. Carlos lived it in the Loja prison in 2019: “after struggling and attacking me, they raped me,” according to the complaint. This type of violence “humiliates them physically and emotionally” and is “difficult to overcome”, according to the Inter-American Court of Human Rights.

However, Gabriela Quinaluisa, director of the first level of care (e) of the MSP, considers that the 34 psychologists they have in prison “manage to attend to the people who require this care.”

The MSP reports that 38% of the 5,067 inmates who have been treated in the 31 mental health posts in prisons have mental and behavioral disorders due to drug use. They have symptoms of paranoia, delusions of persecution and become more aggressive, which, according to a specialist, could partly explain the violence that broke out in prisons this year and caused 335 deaths.

Another 30% of those seen have neurotic disorders, such as anxiety; 14%, mood disorders, such as depression; among others, that affect mental health, conceived by the World Health Organization as a state of physical, mental and social well-being.

The MSP also indicates that it has given 1,956 intensive care; while SNAI, with 61 psychologists in prisons and 20 in adolescent centers, reported that 38,916 inmates received group therapy; 8,547, individual citations; and 25,534, talks on drug use, in 2020.

“We try to give the greatest emotional protection that we can,” says a health professional who works in a prison in Guayaquil, where – according to his account – some inmates with depressive symptoms have attempted suicide. This year, until November 12, 18 made it.

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In many cases, he acknowledges, the inmates need the evaluation of a psychiatrist, but there are only five of the MSP in the prisons. In Guayaquil, he affirms, “they have not yet come” due to the violent acts of this year. Given this, they are consulted with the hospital specialist, but -he affirms- it takes two to three weeks. And it takes longer, he says, if SNAI vehicles are busy for transfers.

The tension and anxiety that the inmates accumulate, and that also impacts their families, could be attenuated in addition to psychological care with educational, work and cultural activities, according to specialists. But the programs are ‘insufficient’ and not everyone has access. For example, 30% of inmates participated in educational issues in 2020.

Family members also claim the lack of drugs for mental pathologies. “My son was not given his medications that he needed every day. Only once did I pass the medicines on to him, because they don’t let it pass, ”laments Jaime’s mother, who had a 70% psychological disability due to the chronic schizophrenia that she had suffered since adolescence.

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This year, Jaime was imprisoned in the Provisional Detention Center (CDP), where inmates with minor crimes and vulnerable groups are placed. But this was not fulfilled, they took him to the Penitentiary, ‘negligence’ that exposed his son to violent people who killed him. His case was reported to the Public Prosecutor’s Office and CDH.

Navarrete, from the CDH, also remembers another young man with an intellectual disability who had severe depression due to the mistreatment he received in prison. The family asked that he be changed to his pavilion, but they did not do so because – criticism – the MSP did not know about his condition: “That is, people enter jail without any registration, without any diagnosis, and the State forgets it to its fate”. (I)