7 that “due to the fact that [the Portugal family] failed to turn up for their appointments, it was not possible to perform an initial diagnosis to determine their ailments". However, the State “reassert[ed] its willingness to resume this treatment by performing a medical test and planning open appointments to treat the Portugal family", which was presented to the Court and which includes quotas in different moments of 2010. Moreover, regarding what the Commission and the representatives alleged as to the fact Mrs. Graciela De León permanently lives outside the city of Panama, “and therefore cannot be treated in Santo Tomas Hospital”, the State indicated that “Ministry of Foreign Affairs has requested by means of note [...] of May 24, 2010, to the Ministry of Health and the authorities of Santo Tomas Hospital […] the coordination with the Regional Health Center in Penonomé in order to provide Mrs. […] De León […] with medical and psychological care at [her] place of […] residence.” In addition, the State “consider[ed] it was appropriate to mention […] that measures have been adopted to provide special treatment to Mrs. Portugal and to inform the medical personnel of Santo Tomas Hospital of the case of [said] family […] and that it was mandatory to provide them with free medical and psychological care.” Regarding Room 25 of Psychiatry of Santo Tomas Hospital, the State indicated that “it is not a psychiatry room where there are people with mental disorders who are behaving improperly.” 25. The representatives pointed out that even though “on some occasions [they had] gone [to] Santo Tomas [Public] Hospital for emergencies, […] they [had] been treated as […] if they were not victims of human rights violations.” In that respect, Mrs. Patria Portugal indicated that “the two times [she went to the Hospital], one time to take [her] mother and another time for an emergency [she had], [they were] treated very badly." According to the representatives, “the State has given instructions through official letters [for the hospital] to treat them [...], but [that] has not been translated into a diagnosis or psychological care at all.” In addition, “so far the State has referred to the care for Mrs. Graciela [De León], who does not live in the capital city […] and therefore, the appointments they had […] arranged, do not comply with any of the aspects the Court established in its Judgment.” Hence, according to the representatives, “the State would [have assumed] the compliance with this measure as a set of different activities to be carried out at the beneficiaries’ request, without performing an initial diagnosis and planning their care." 26. Regarding the psychological – psychiatric treatment, Mrs. Patria Portugal pointed out that the State wanted for her and her family to go to “room 25 of Santo Tomas Hospital where people with mental disorders are,” and that even though she considered that “they were suffering from some psychological disease due to all the things they went through, […] they [are not] crazy” so as to be attended in said psychiatric area. The representatives made reference to a note of the Minister of Health of March 9, 2009, in which it was mentioned that the State "does not count on an Outpatient Service system and a trained personnel specialized in victims of grave human rights violations so as to offer them treatment in the way the Court recommends” and that, after consulting with the Pan American Health Organization, the State would have received as a response that “the people, who went through violent situations in different ways, [could] be treated within the framework of the health system in mental health services and according to the regional mental health program of the [PAHO].” Hence, the representatives insisted on that the obligation established by the Court includes, inter alia, the “hiring of personnel specialized in the subject or [...] adequate training for the existing personnel”. 27. Moreover, the Commission specified that “up to the present date, the beneficiaries […] have still not been provided with specialized psychological treatment,” “no diagnosis has been conducted regarding their medical needs, and no decision has been made as to the place where Graciela De León is going to be provided with medical care." Moreover, “it regretted to listen to what Mrs. Patria Portugal informed on several occasions [...] about the treatment provided.”