CARACAS, Venezuela – Blanca Livia Arcineiga once managed her severe schizophrenia. Not so long ago, she was stable enough to work part time as a maid. She helped her elderly mother. They slept in the same bed.
Now she lies alone and naked on a soiled mattress. Her family has barred the door — to keep her from attacking them.
As Venezuela reels from one of the worst economic implosions in modern history, Blanca, 49, is an example of one of its most dehumanizing side effects: an escalating mental health crisis. Her condition has deteriorated because her family is unable to find or afford the medicines she needs. The family, with a household income of $16 a month, lives on yuca and plantains. Aurora García Sánchez, 81, looked at her daughter’s distant eyes. “I don’t know who she is.”
Years of failed socialist policies, economic mismanagement and corruption have exacted a heavy toll. For much of the population, hyperinflation, joblessness, blackouts and shortages of food and water have reduced life to a daily struggle to survive.
The impact on health has been acute. The scarcity of medicines — aspirin, antibiotics, cancer drugs and antiretrovirals for HIV patients — have turned state hospitals into squalid centers for hopeless, dying patients.
For the mentally ill, the sword cuts twice: The stress is exacerbating mental health symptoms and conditions to which the health care system is no longer able to respond. Doctors say the lack of drugs and deteriorating conditions at state facilities are causing preventable deaths to soar.
At El Peñon hospital, one of the capital’s main psychiatric facilities, doctors — who spoke on the condition of anonymity out of fear of government reprisals — said shortages of medical staff and drugs, including antipsychotic medications, have made deaths unavoidable. The hospital and Health Ministry did not respond to requests for comment. As public health has deteriorated, officials have stopped publishing data.
More Venezuelans are manifesting crisis-related stress, which doctors say has worsened mental illnesses, addiction and suicide rates. Pedro Delgado, a leading private psychiatrist, said demand for substance-abuse treatment at his clinic has more than doubled in the past year. Yet the number of patients he can treat has steadily gone down, because fewer patients can afford treatment. He said he has offered discounts and worked with a nonprofit foundation that covers mental health care for those who can’t pay.
“The biggest burden is on families,” he said. “Taking care of their relatives without treatment is the definition of a nightmare.”
Relatives are struggling to treat the mentally ill at home in part because the mental health hospitals have all but collapsed.
The Psychiatric Hospital of Caracas — one of the capital’s largest — is mostly unlit, because management can’t afford bulbs. Administrators have no food to give patients. The rooms are in such disrepair that the 200-bed hospital now accommodates only 20 patients. The washing machines don’t work, leaving patients in dirty clothes, even after soiling themselves. There’s no potable water at the hospital. Patients survive off supplies brought by relatives, or drink filthy water.
“The entire country is in crisis and we’re in the middle of it,” said Peter Williams Contreras, a union official at the hospital.
Dorelis Luz Díaz, 38, who has bipolar disorder, said she has been kept in close quarters with a woman who has schizophrenia and who has been convicted of killing.
“The other day, in the middle of the night, she came and choked me, saying she wanted to take my clothes,” Díaz said.
Without medicine, Díaz said, “we get worse.”
She looked down, gaunt, from behind the locked bars.
“I miss food,” she said.