community setting aimed at ensuring his mental health. Clearly, in the instant case the State’s omission is absolute and reflects a conception of mental disorders that automatically equates them with disability, and, in turn, a conception of persons with mental disabilities that assumes they have no autonomy to make decisions regarding their own health and treatment, which constitutes a form of discrimination. 183. In view of the foregoing considerations, the IACHR concludes that in relation to the treatment received by Luis Eduardo Guachalá, the State violated his rights to legal capacity, access to information so as to be able to give informed consent on health matters, the right to health, and the principle of equality and nondiscrimination, established at Articles 3, 5(1), 13(1), 24, and 26 of the American Convention, in relation to Articles 1(1) and 2 of the same instrument. 3. On the disappearance of Luis Eduardo Guachalá 184. In the present case, there is no controversy that Mr. Guachalá disappeared while he was institutionalized at the Julio Endara Psychiatric Hospital in January 2004. On the one hand, the State has argued that Mr. Guachalá escaped from said center on January 17, 2004. The hospital staff, in the context of the investigations initiated, stated that it was foreseeable to consider that Mr. Guachalá escaped while the walls of the mental health center are not high, so he could have climbed and get out. On the other hand, both the petitioners and the relatives of Mr. Guachalá have argued that the State has failed to prove that Mr. Guachalá effectively escaped from the hospital and that what happened rather is framed as a disappearance. The IACHR notes that a possible version has been alleged, supported by the statement of an institutionalized person in the hospital, which indicates that Mr. Guachalá would have suffered a heart attack and that center staff would have covered up his death. 185. The Commission recalls, first, that Mr. Guachalá was institutionalized in a public health center, that is, under the custody of the State. In this scenario, according to the repeated jurisprudence of the IACHR and the Court, what happens to a person for whom the State has the special duty of guarantor, state responsibility is presumed unless the State itself provides a convincing and satisfactory explanation of what happened. On this point, the European Court has argued that in cases where the affectation to the life or integrity of a institutionalized person with disability in a public mental health center is alleged, the State must present a satisfactory and convincing explanation of what happened for that purpose to dispute such allegations 333. 186. In the instant case, the Ecuadorian State has not succeeded in clarifying the disappearance of Mr. Guachalá, nor has it determined his fate or whereabouts. As will be analyzed in the next section, the internal investigations have not been diligent nor have they been carried out in a reasonable time, which, in addition to the legal implications in relation to denial of justice, has evidentiary implications in terms of what happened to the victim. This stems not only from the presumption that operates in the instant case stemming from Guachalá being in the custody of the State, but from the possible involvement of persons who act in the name of the State. On this last point, the Court has reiterated that the failure to investigate the alleged violations committed against a person when there are indicia of the participation of state agents “prevents the State from presenting a satisfactory and convincing explanation of the ill-treatment alleged, and disproves the arguments concerning its responsibility, with adequate probative elements.” 334 Accordingly, the Court has considered the failure to clarify as a factor to take into account for showing the alleged violation and consequent international responsibility. 335 187. In addition to the fact that the State has failed to offer a convincing and satisfactory explanation of what happened to Mr. Guachalá, the Commission takes note of other indications of State responsibility. ECHR. Valentin Campeanu v. Romania. Judgment of July 17, 2014, para. 131. I/A Court HR. Case of J. v. Peru. Preliminary Objection, Merits, Reparations and Costs. Judgment of November 27, 2013. Series C No. 275, para. 353. 335 I/A Court HR. Case of J. v. Peru. Preliminary Objection, Merits, Reparations and Costs. Judgment of November 27, 2013. Series C No. 275, para. 354. 333 334 34