[Law and mental health (goals achieved and pending challenges in Spain). SESPAS report 2020]. / Derecho y salud mental: logros conseguidos y retos pendientes en España. Informe SESPAS 2020.

After the approval of the Constitution there have been major improvements on the juridical status of the patient in general and specifically of the mental kind. Nevertheless the regulation of the rights regarding the mental patients has been less thorough. Consequently there are significant deficiencies regarding this matter, being the existing regulations minimal, those which do not take on account the most relevant international reference tools. With the approval of the New York Convention major legal reforms have been introduced regarding the sensory and physically handicapped. However not the same has happened with the case of those with mental conditions. On this subject exists a sizable delay on the adaptation of our juridical application to this Convention. Furthermore major problems arise for its implementation. This changes the traditional assistance model (towards rehabilitation) for the social model and uses new concepts brought by the Convention (legal capacity) which do not coincide with other ones characteristic of the Spanish legislative tradition. The interpretation of the Convention done by the Committee on the Rights of Persons with Disabilities adds difficulties to validate our regulation to the Convention. With all this in mind it is clear to see that there are many challenges to take on the future, being necessary for this the implementation of a previous rational dialogue.

La internación psiquiátrica por razón penal en España: ejecución de la medida en el ámbito penitenciario / Psychiatric internment for criminal reasons in Spain: measure enforcement or implementation in the prison environment / O internamento psiquiátrico devido à razão penal na Espanha: execução da medida no âmbitopenitenciário

La inimputabilidad o semiimputabilidad del sujeto aquejado de un trastorno psíquico que comete una infracción penal, es asumida por la mayoría de las naciones desde antiguo, aunque las respuestas penales ante tal tipo de conductas difieren de manera considerable. El objetivo es analizar la ejecución de medidas de seguridad privativas de libertad (internación/internamiento) en España, para sujetos inimputables del delito por razón de trastorno psíquico y para aquellos con trastorno psíquico sobrevenido a la sentencia. El Método seguido ha consistido en estudiar la normativa aplicable a dichas medidas y la práctica de su ejecución, con especial mención a la implementación de determinados programas de tratamiento. Los resultados obtenidos ponen de relieve la existencia de un aceptable marco normativo, que incluye numerosas alternativas al internamiento, y el éxito del Programa de "Salidas Terapéuticas". Se concluye que: a) el marco legal es el adecuado, aunque demanda reformas en la esfera del control judicial; b) es plausible continuar con el programa de salidas de pacientes, y c) es preciso reforzar los mecanismos y recursos de rehabilitación social pospenitenciaria.

The unimputability or semi-unimputability of a patient with a psychic disorder having committed a criminal offense has been assumed by must nations for a long time, although the judicial responses in the face of such kind of conducts differ in a very significant way. The objective here is to analyze the enforcement of security measures involving deprivation of liberty (internment/detention) in Spain for unimputable individuals, i.e. not subject to criminal liability because of their psychic disorder and for those with some sudden mental illness subsequent to the sentence. The method followed here has consisted of studying the legislation or rules applicable to any such measures and their, with particular reference to the implementation of certain treatment programs. The results obtained highlight the existence of an acceptable normative framework including a good number of alternative measures to detention, as well as the success of the "salidas terapéuticas" (therapeutical leaves of absence or releases from the detention premises). It has been concluded that: a) the legal framework is the appropriate, although it calls for reforms within the judicial control sphere; b) the continuation of the patients' leaves of absence program is commendable and plausible, and c) it is necessary to reinforce post-rehabilitation mechanisms and resources.

A inimputabilidade ou o semiimputabilidade do sujeito afetado por uma doença mental que comete uma infração penal, é assumida pela maioria das naçõeshámuito tempo, embora as respostas penais perante tal tipo de condutas difiram de jeito considerável. O objetivo é analisar a execução de medidas de segurança privativas da liberdade (internamento) em Espanha, para sujeitos inimputáveis do crime por causa da doença mental e para aquelas com doença mental acontecida apos à sentença. O Método seguido consistiu estudar a norma aplicável a estas medidas e à prática de sua execução, com menção especial à implementação de determinados programas do tratamento. Os resultados obtidos evidenciam a existência de um quadro normativo aceitável, que inclui alternativas numerosas ao internamento, e o sucesso do programa de "saídasterapêuticas". Conclui-se que: a) o quadro legal é certo, embora precisam-se reformas na esfera do controle judicial; b) é razoável continuar com o programa das saídas dos pacientes, e c) é preciso reforçar os mecanismos e os recursos da reabilitação social pospenitenciaria.

El internamiento psiquiátrico en España: de Valencia a Zaragoza (1409-1808) / Psychiatric admission in Spain: from Valencia to Zaragoza (1409-1808)

En 1409 un fraile mercedario, el P. Jofré inaugura en Valencia el que para buena parte de la doctrina fue el primer manicomio, propiamente tal, de la historia. Con independencia de la discusión sobre su primacía, lo cierto es que este establecimiento es exponente de una tradición humanitaria que materializada en la creación de numerosos establecimientos psiquiátricos en España y en América, llega hasta los albores del s. XIX y que influye -en este caso a través de las descripciones del Manicomio de Zaragoza- en la obra del más conocido adalid de la reforma psiquiátrica, Philippe Pinel