Deinstitutionalization and the Rights of People with Disabilities to Live in the Community in Mexico and Beyond

By Megan Abbot

It is difficult to estimate the number of people worldwide who are detained in institutions against their will.  People with disabilities are especially vulnerable to being locked up under the guise of protection and rehabilitation. Such segregation violates international law and should outrage human rights supporters everywhere. 

The United Nations Convention on the Rights of Persons with Disabilities (CRDP) codifies the rights of people with disabilities and is part of a broad paradigm shift.  Historically, disability has been treated as a normative failing, a medical illness that should be corrected to help a person live a normal life.  Today the social model of disability seeks to build understanding of the many cultural, physical, or systemic obstacles that prevent people from participating equally in society on the basis of disability.  Disability, then, is a construction.  The onus of adaptation is not on the individual to overcome their disability.  The onus is on society to build a more inclusive environment for all.

A full 15% of the world has a disability.  Communities worldwide accommodate or perpetuate obstacles to disabilities differently.  The structural barriers to full participation based on physical, sensory, cognitive, developmental, or psychosocial disabilities are all unique and intersect with other systems of both empowerment and oppression.  And the challenges to equal participation are outsized in developing countries.

Let’s take Mexico as an example.  Mexico was a leader in adopting the CRPD, and yet the government has done little to implement the convention or develop community-based programs for people detained in institutions.  I have seen this firsthand. I worked for Disability Rights International (DRI) in Mexico City this past summer, where we conducted fact-finding on human rights abuses against people with disabilities in institutions. 

Institutions segregate people from society, deny them fundamental freedoms, and can subject them to egregious violence and abuse. Beatings, sexual assault, human trafficking, long-term physical restraints, rampant over-medication, and utter neglect are disturbingly common.  In Mexico, DRI documented a policy of forced sterilization of women with psychosocial disabilities.  I, myself, saw a man who had lived in a cage for most of the last 50 years.  (Learn more.)  Despite the data showing that institutions are not safe, UNICEF estimates that there are nearly 30,000 children living in institutions in Mexico alone. 

International law and disability theory pin the responsibility for preventing these abuses on society at large.  One fundamental tenant of the CRPD is the right to live in the community with choices equal to others.  This means the abolition of institutions and the creation of community-based services and support. 

Building sustainable community-based services will not be easy for Mexico, if the United States’ history is any indicator.  Disability rights advocates fear that the call to deinstitutionalization will allow governments to shutter institutions without providing the comprehensive services that these populations need to adjust to life in the community.  (Think: housing, education, employment, holistic medical and rehabilitative services, social workers, psychological and legal support, etc.)

The United States’ own deinstitutionalization process had some tragic unintended results.  We closed most of our institutions over the last half-century, but did little to develop community-based supports for people with psychosocial disabilities.  The result? Mass homelessness and the attendant criminalization of being mentally ill on the streets.  Today the largest concentrations of people with psychosocial disabilities in the U.S. are in America’s jails.  

Much needs to be done to assure the full participation and human rights of people with disabilities in Mexico and worldwide.  An effective de-institutionalization process will require that holistic support structures be in place before institutions’ doors are closed.  Disability rights advocates are right to push for governmental accountability on abuses occurring in institutions, and also to keep advocating for community-based services.