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Argenis Giménez is one of those emblematic characters that exists in almost any city in the world: someone who, due to his particularities, everyone knows.
In Barquisimeto, in the Venezuelan state of Lara, many call this 61-year-old man “the crazy man with the banner.”
The reason: for more than 30 years, this homeless man invented a peaceful, public and innovative way to protest against repression in psychiatric hospitals.
He calls it a “psychiatric avant-garde of liberation,” inspired by the renowned Italian psychiatrist Franco Basaglia.
With a banner he made himself, Argenis walks around the city of Barquisimeto every day to raise awareness about the condemnation of being “crazy and poor.”
A “protest therapy”, as he himself defines it, of someone already entrenched in the collective memory who wants to break the silence and a pattern of indifference towards the situation of violence suffered by those suffering from mental illness.
A problem that comes from afar: “The historical debt towards this issue in my country is rooted further back than the Bolivarian revolution,” he acknowledges.
And it has worsened in recent years as the deep crisis that Venezuela is experiencing progresses, which directly affects cases of depression, anxiety, mental disorders and also the possibility of receiving adequate treatment.
Argenis Giménez protests against the repression of psychiatric hospitals in Barquisimeto. Diego Battistessa
The World Health Organization (WHO) considers mental health as “a fundamental human right and an essential element for personal, community and socioeconomic development.”
In Venezuela, the crisis that the country is experiencing and the psychosocial vulnerability make it difficult to access this right, especially for women, people over 65 years of age, young people between 18 and 24 years old and those with a lower educational level, according to the Piscodata study. Venezuela, published by the School of Psychology of the Andrés Bello Catholic University in 2023. And although the study shows that the Venezuelan economic and social crisis, which has lasted more than a decade, has considerably deteriorated the mental health of the population, This continues to be a taboo topic in the South American country.
From Caracas, Siboney Pérez Villalobos, a psychologist with more than 40 years of professional practice and president of the NGO Psychologists without Borders Venezuela confirms the existence of the cocktail of enormous generalized difficulty added to the lack of resources to care for people with some type of mental health affectation.
On the one hand, explains Siboney, “we find psychiatric patients with a disease diagnosed according to the International Classification of Diseases - CE11 or the Diagnostic and Statistical Manual of Mental Disorders (DMS-5).”
These are cases where "there is already a mental disorder in the person that allows them to be classified as a psychiatric patient and that requires medical attention and in some cases hospitalization."
On the other hand, people who struggle every day with the mental burden emanating from the uncertainty due to sudden power outages, hyperinflation (193% in 2023), the high rate of violence, the enormous levels of corruption and the diffuse precariousness: elements that generate anguish, despair, depression, hopelessness, insomnia and fatigue, among others.
The trauma of migration
Psychiatric patients require high-cost medications that are in short supply in the country (almost always accessible through insurance and private clinics) and need adequate hospital structures with trained health personnel.
“We are faced with health centers that lack structural maintenance, lack of specialized personnel who in many cases have left the hospitals or the country directly, and where the places available to patients for stays and/or treatments are limited. ”says the director of the NGO.
Siboney believes that this deterioration has accelerated in recent years, since 2016, due to the humanitarian crisis.
But precise data on the magnitude of the problem is unknown, since the Government of Venezuela does not offer statistics.
Dr. Mariemma Antor Troconis, clinical psychologist and director of the School of Psychology at the Central University of Venezuela, says that the crisis “affects all public hospitals and especially those few psychiatric centers that continue to function.”
Without a doubt, Antor continues, “psychiatric hospitals are the great forgotten ones of the Venezuelan health system.”
A patient at the psychiatric hospital in Caracas (Venezuela), in 2019.Andrea Hernandez (Getty Images)
The director of the school of psychology, which has 1,100 students in charge, delves deeper, for her part, into the social trauma caused by mass migration, which already has the character of an exodus, due to which nearly 8 million people have left the country in recent years, according to the UN, a fifth of the country's population.
“Every family in Venezuela has someone who has been forced to migrate and this generates trauma, sadness, anguish and a state of extreme loneliness in the case of older people, who have seen how their children have had to leave the country” , emphasizes the doctor.
A situation that generates post-traumatic stress that, if not properly treated, leads to cases of serious mental health problems, such as depression.
“This is how we understand why anxiolytics are among the most consumed medications in Venezuela and why today there is more talk about suicide in the country,” she adds.
According to the Venezuelan Observatory of Violence (OVV), in 2023 there were seven suicides a day in the country.
It is a rate of 8.2 self-inflicted deaths per 100,000 inhabitants, a trend that also represents a considerable increase compared to the previous year (7.7 deaths per 100,000 inhabitants).
In addition, the report Somos Noticias Mental Health Chapter, from the NGO Cecodap, registers an increase in suicidal ideas among Venezuelan adolescents.
The Ministry of Popular Power for Health (MPPS) and the Pan American Health Organization (PAHO) are working to increase access to mental health treatments throughout the country.
However, explains Dr. Antor, "there are still many people in Venezuela today who have to decide what part of the therapy they can afford, because their salary is not enough to buy all the medicines included in the medical treatment."
Despite all these difficulties, they continue to fight “with their nails,” says the director of the School of Psychology.
As an example, she remembers that last November the IV Venezuelan Congress of Psychology was held, which highlighted the need for a massive awareness and education campaign in mental health to prioritize this right and stop seeing the subject as taboo.
This reminds us, in Mariemma's words, that if basic needs are not covered, there can be no mental health.
And in today's Venezuela, this is the reality.