7 20. The Inter-American Court notes the various initiatives of general nature related to mental health services undertaken by the State. That notwithstanding, in order to evaluate the adjustment of these and other activities to the reparation measure ordered by the Court, it is necessary for the State to refer in its next report solely and exclusively to: i) the training activities carried out after the decision, whose content refers to “the principles that must govern the treatment given to individuals with mental disabilities pursuant to international standards on the subject and those set forth in the […] Judgment”;8 ii) the duration, periodicity and number of participants in those activities, and iii) whether they are mandatory. THEREFORE: THE INTER-AMERICAN COURT OF HUMAN RIGHTS, in exercise of its authority to monitor compliance with its decisions, pursuant to Articles 33, 62(1), 62(3), 65, 67 and 68(1) of the American Convention on Human Rights, Articles 25(1) and 30 of its Statute, and Article 30(2) of its Rules of Procedure,9 DECLARES: 1. That in accordance with the provisions of Considering clauses No. 13 and 20 of this Order, the Court will keep open the procedure to monitor compliance with the paragraphs that provide for the duty of the State to: a) secure, within a reasonable time, that the domestic proceedings instituted in order to investigate and punish those responsible for the events in the instant case be operative (Operative Paragraph No. 6 of the Judgment); and b) keep developing an education and training program for staff involved in health care, psychiatry, psychology, nursing, and for any person involved in the provision of mental health services, in particular, covering the principles that govern the treatment of patients with mental disabilities, according to international standards and the provisions of the instant Judgment (Operative Paragraph No. 8 of the Judgment). AND DECIDES: 8 Cf. Case of Ximenes Lopes v. Brazil. Merits, Reparations and Costs. Judgment of July 4, 2006. Series C No. 149, Operative Paragraph No. 8. 9 Approved by the Court during its XLIX Ordinary Period of Sessions, held from November 16 to 25, 2000, and partially reformed by the Court during its LXXXII Ordinary Period of Sessions, held from January 19 to 31, 2009.

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