The Constitutional Court ordered Health Providing Entities (EPS) and prepaid medicine entities to refrain from imposing barriers in the provision of mental health services for children and adolescents in Colombia.
For the high court, in matters of mental health, Entities must ensure that minors are provided with the service in terms of promptness, continuity, effectiveness and efficiency, without any economic or administrative obstacle being acceptable..
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Thus, it ordered the EPS and prepaid medicine entities to guarantee the timely provision of the physical and mental health services and technologies required by children and adolescents, as well as that refrain from imposing administrative barriers that hinder the continuity of treatment, especially those that relate to mental health.
The Second Review Chamber, after analyzing a guardianship presented on behalf of a 15-year-old adolescent who suffered from anxiety and depression and who, for this reason, took her own life, concluded that the EPS and the prepaid medicine entity to which she was linked violated the rights to health and life of the young woman, given that they did not guarantee continuity in the provision of the service she required.
The teenager’s mother invoked the protection every time that, despite hiring a prepaid medicine entity to care for her daughter’s health condition, did not receive the pertinent services because, in the opinion of the insurer, it was not his responsibility to assume such assistance given that there were exemption clauses in the policy signed.
Although the teenager was being treated at a center specialized in mental health that was part of the service network attached to the prepaid medicine entity, she was transferred to another medical center linked to the EPS, to which she was affiliated, where she was with his hospitalization. Faced with this scenario, her mother filed guardianship over her, since the continuity of the treatments that had already begun was abruptly altered.
In the first instance, protection was denied and, in the second instance, guardianship was declared inadmissible. During the processing of the action, before it came to review by the Constitutional Court, the teenager took her own life.. Due to this fatal event, the Court confirmed the existence of the consummated damage. However, he proceeded to make a fundamental statement and reproached the fact that both the EPS and the prepaid medicine entity decided not to cover the treatment that had already begun, thereby ignoring the importance of timely and continuous intervention for the evolution of diagnosis and treatment. of the young woman.
For the Court, it is clear that the provision of health services in favor of the adolescent could not be subject to financial or contractual situations, which would end up interfering with the continuity of the treatment provided by the doctors of the first institution in which she was admitted.
The Constitutional Court reiterated that the right to mental health is an inalienable guarantee, which includes access to clinical care in a timely, continuous and effective manner, without administrative or bureaucratic barriers on the part of the responsible entities.
In this understanding, jurisprudence has said that the EPS and the entities that offer additional health plans They must guarantee a higher level of provision when those requesting the service are minorssince any delay or denial in the provision of that can irreversibly affect the medical condition of children and adolescents, and affect their relational processes with their environment.
Likewise, the entity has estimated that patients with mental illnesses, such as anxiety and depression disorders, are in a state of manifest weakness due to the characteristics of these pathologies. The above, because they affect multiple aspects of the lives of those who suffer from them, prevent the normal and adequate performance of daily activities, such as study or work, and imply a risk to life, since they can be the cause of suicide.
