Mental disorders: a worrying situation, a pending law

In its 2021 annual report, the National Human Rights Council (CNDH) reports on a worrying situation in Moroccan mental health hospitals, whose capacity is just 2,136 beds for 150,000 people suffering from diseases.

A figure that has been rising since 2016, as Morocco has welcomed 50,000 new people with mental disorders in four years, according to the estimate communicated on this occasion. However, there are only a dozen specialized hospitals and 23 hospital centers, some of which were visited by the CNDH in 2021.

Morocco therefore has neither the infrastructure nor the adequate legal framework for mental health. The CNDH reports a worrying situation and calls for the passage of Bill 71.13, which has been pending since 2016.

State of play of the CNDH

Thanks to the visits made by the CNDH, it has been able to identify a “disturbing situation” that “does not meet the standards” that these institutions should respect. But also “the need to act urgently”, in particular to act against “the deterioration of infrastructure”, “the increased lack of human resources”, or even the lack of “new generation” medicines, which are “more effective”. and fewer side effects”.

In addition, the Council denounces the unequal geographical distribution of these establishments, as most of them are located in the major cities: Casablanca, Rabat and Marrakech. On the other hand, “more than half of the municipalities and provinces do not have mental health hospital structures”.

Therefore, the Council recommends: emergency construction two specialized hospitals with larger reception capacity. One in the region of Laayoune-Sakia El Hamra † the other in the region of Beni Mellal-Khenifra

The CNDH also dwells on the need toaccelerate adoption by account 71.13on combating mental disorders and protecting the rights of people with these disorders.

This text, prepared by the Ministry of Health, at the time headed by Houcine Louardi, was sent to parliament in 2016. The legislative process has since been suspended, leaving the 1959 Dahir as the only legal framework in this case.

An inappropriate legal framework

For the CNDH, this law “is no longer in line with developments in this area”. And this phase shift “affects the rights of this category” of citizens. This is also the same comment the Ministry of Health made when it presented this bill in 2015.

In its presentation note accompanying the text, the Ministry of Health states that the 1959 Dahir – although it is “an important achievement for our country for being one of the few countries to have specific mental health legislation in the 1960s” – contains provisions that: “are no longer suitable” on the evolution recorded in the protection of the rights and freedoms of these persons, whether in international treaties or in the laws of advanced countries”.

It is in this sense that the purpose of the introduction of the said bill was to “protect the fundamental rights and individual freedoms of people with mental disorders” and to “establish the general principles to which the care of these people must obey”.

With this text, the Ministry of Health also wanted “a National Commission and Regional Commissions for Mental Health Carecomposed of magistrates, medical and administrative staff, nurses and representatives of civil society organizations”.

The text gives the national committee the task of: participate in the development of national policies and strategies in this area, but also that ofdraw up an annual report about the situation and evolution of mental health, as well as about patient treatment conditions based on control reports from the regional commissions.

A strict text, with heavy penalties

In this context, the text instructs these committees to unexpected visits mental health institutions. And this, at least every six months† A sustained level of control that ensures respect for the fundamental rights of people with mental disorders, by specialized health institutions.

Both their leaders and their staff are at risk heavy punishments, provided for in this bill, in case of violation of its provisions. It is about prison sentences can go up to five yearsand Fines can reach the 100,000 MAD

For example, Article 85 of the bill punishes “anyone who opposes or hinders or attempts to oppose the exercise by a patient of any of his rights (…)” with a prison sentence of one to three years and a fine of 20,000 to 50,000 dirhams.

These severe sanctions reflect a firm commitment to the fight against mental disorders and the protection of the rights of people with these disorders. A commitment to which the mental health institutions that existed before the promulgation of the law must contribute, by meeting the standards of renovation and equipment that will be established by regulation. And this within two years after the publication of the relevant regulatory text.

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