State of Terror, States of Mind: Ladinas, Mental Health and Systems of Care, in Guatemala City

Abstract

This ethnography conducted in Guatemala City from October 2012 to April 2013 is based on in-depth interviews of mental health professional and women rights advocates, and the testimonios of Silvia and Teresa, two Ladinas having been diagnosed with a mental illness and having been interned in the system of care. This research brings to light the discrimination of mental health in a context of state terror. I critique the categories of mental illness and call instead to understand them as mental health needs in a context of acute everyday violence of post-peace accords Guatemala. The interviews provide the political context of in which the high demand for mental health services is met with a lack of investment in the mental health field and a neglect of policy and legislation. The testimonios of Teresa and Silvia give voice to the gender violence that leads Ladinas' to express mental health needs and the ways in which the system of care perpetrates this violence. I argue that the mental health care system is part of the mechanism of feminicide that discredits and silences Ladinas to secure the impunity of the state. Concluding with the finding that expressing a mental health need in Guatemala is related to the ability to exercise citizenship rights, I call for the development of a gendered citizenship project in order to resist state terror and promote mental health.