COMUNICADO DO MGSM SOBRE A SITUACIÓN DAS PERSOAS QUE RESIDEN NOS HOSPITAIS PSIQUIÁTRICOS DE GALICIA E DOS/AS PROFESIONAIS QUE OS ATENDEN, E NECESIDADE DE VACINACIÓN PRIORITARIA.

Nos últimos días coñeceuse a existencia dun importante gromo de coronavirus no Hospital Psiquiátrico de Conxo, con 42 positivos (16 traballadores/as do centro sanitario e 26 residentes) a día de hoxe. Nunha das unidades do hospital, a chamada “somática”, onde residen persoas con diagnóstico de trastorno mental grave e importante comorbilidade física, contaxiáronse todos os pacientes, e algúns tiveron que ser derivados ao Hospital Clínico polo seu estado de maior gravidade.
A pesar de que desde a Xerencia da área sanitaria afirman que desde o inicio da pandemia, en marzo de 2020, se puxo en marcha un plan específico de continxencia para hospital psiquiátrico, isto non é certo, e xa o denunciamos publicamente no seu momento, recoñecendo o esforzo dos/as traballadores/as do centro para previr na medida do posible os contaxios e as súas consecuencias e suplir así a falta de dirección na xestión dos centros de saúde mental.
Isto é tan real como que, agora que existe unha situación de elevado risco polo número de contaxios nun centro pechado, de convivencia de máis de 300 persoas entre traballadores e residentes, non hai directrices claras e coñecidas por todos os implicados, e dá lugar a rumores, opinións diversas, criterios desiguais ou variables de día a día, sen coordinación efectiva que ordene o traballo e as medidas a implantar.
Máis que nunca saen á luz as carencias estruturais e funcionais do centro, xa denunciadas polo MNP-Defensor del Pueblo, xa que non hai espazos específicos para manter o illamento das persoas contaxiadas. Estes non poden manterse todo o tempo nos dormitorios porque na maioría das unidades non teñen habitacións con baño e case non hai habitacións individuais. As diferentes unidades teñen que permanecer pechadas convivindo nunha especie de grupos-burbulla en espazos moi reducidos que non permiten manter as distancias recomendadas para evitar os contaxios e sen posibilidade de manter certa intimidade.
O persoal está a soportar unha sobrecarga física e mental importante, desde a preocupación polos pacientes e os compañeiros/as ata o esforzo desesperado de paliar as carencias funcionais e limitacións da actividade asistencial habitual.
Non se actuou, por parte das autoridades sanitarias, con celeridade desde o inicio da pandemia e mantívose durante todos estes meses unha situación de desigualdade discriminatoria dos pacientes que alí residen (moitos deles levan décadas vivindo no Psiquiátrico) con respecto ás persoas que viven fora. Todos e todas estamos vivindo unha situación de excepcionalidade desde hai case un ano. Todos e todas vivimos un confinamento domiciliario durante meses, e actuais restricións perimetrais e cambios no noso estilo de vida, de ocio, familiar e social. Pero hai persoas que seguen a vivir nunha situación de restrición excepcional, como son os residentes dos hospitais psiquiátricos, que non se xustifican pola situación epidemiolóxica (variable) desde o inicio da pandemia.
Incumprindo o propio Plan de reactivación no ámbito hospitalario da Xunta de Galicia, os pacientes do Hospital Psiquiátrico de Conxo tiveron anuladas as saídas fora do recinto hospitalario nos tempos de ocio individuais. O réxime de permisos aos seus domicilios foi arbitrario, xa que non existiu un criterio homoxéneo para todas as unidades e equipos ou tiña que ser dunha duración mínima (15 días) que facía en moitos casos imposible que o paciente puidera ir ao seu domicilio, ben porque a súa situación clínica aconsellaba permisos máis breves, ou ben polas dificultades prácticas do seu entorno familiar. Tamén se deixaron de realizar ou se limitaron moi significativamente os tratamentos terapéuticos e de rehabilitación que adoitaban programarse.
Non estamos a falar do momento actual, de desborde da incidencia de novos contaxios e sobrecarga asistencial, que implica tomar as medidas oportunas durante o tempo estritamente necesario, senón que non houbo unha adaptación adecuada das medidas para garantir a actividade asistencial e de rehabilitación ao longo deste ano.
As visitas de achegados/as, os permisos aos domicilios, as saídas fora do recinto hospitalario, os programas de intervención e rehabilitación … forman parte tanto dos dereitos máis básicos como cidadáns como da tarefa rehabilitadora propia deste tipo de centros sanitarios. Son obxectivos, entre outros: o fomento da autonomía persoal, do autocoidado, de creación ou reforzo dos lazos afectivos e redes de apoio social e proxección de metas persoais formando parte dunha comunidade. O contrario é manter unha concepción asilar propia doutras épocas e que temos que desterrar definitivamente.
Esta é a situación desde marzo de 2020. A actualidade supera os peores temores, de rápido contaxio entre o persoal e residentes do Hospital Psiquiátrico. Xa son moitos meses de incerteza e paralización, que aumenta o malestar, a cronicidade e a vulnerabilidade das persoas ingresadas no centro. Aumenta tamén o malestar e sobrecarga dos/as profesionais. E a previsión non é de solución a curto prazo e recuperación da antiga normalidade.
No resto dos Hospitais Psiquiátricos de Galicia a situación é moi similar. Arredor de 500 pacientes e mais de 300 profesionais permanecen nesta especie de limbo entre o hospitalario e o residencial. E o mais fundamental: trátase de persoas que residen nun entorno pechado, de alto número de convivintes, con discapacidade recoñecida por trastorno mental grave, con frecuente comorbilidade física, en situación de vulnerabilidade socioeconómica e alto número de persoas de idade avanzada.
Dada esta grave situación, cremos imprescindible, e insistimos encarecidamente, que se teña en conta ao persoal e residentes dos hospitais psiquiátricos na planificación priorizada de vacinación da COVID-19 nesta primeira etapa e coa maior premura posible. Cumpren todos os criterios de priorización que asume o Ministerio de Sanidade e as CCAA: risco de gravidade, de exposición, de impacto e de transmisión, de intensidade alta en todos eles, e deberan estar asumidos no grupo I: persoas internas e persoal sanitario e sociosanitario en residencias de persoas maiores e con discapacidade.
Son aplicables todos os principios éticos que están a rexer na avaliación dos grupos de poboación a priorizar: igualdade en dignidade e dereitos, necesidade, equidade, protección das persoas con discapacidade en situación de vulnerabilidade, beneficio social e reciprocidade.
Non entendemos como non se indicou desde o inicio a súa prioridade de vacinación, pero aínda estamos a tempo de solventar este grave esquecemento.
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