Silent Rape: The Right to Mental Health as a Consequence of Torture and Repression​

According to the United Nations Convention against Torture and Other Cruel, Inhuman or Degrading Treatment or Punishment, torture is defined as any act by which severe pain or suffering, whether physical or mental, is intentionally inflicted on a person for the purpose of obtaining information or a confession from that person or a third party. It is also considered torture if it is committed to punish that person for an act that they have committed, or are suspected of having committed, or to intimidate or coerce that person or others. It is crucial to emphasize that torture must be inflicted by a public official or other person acting in an official capacity, or with their instigation, consent, or acquiescence.

Repression and state violence encompass a broad spectrum of actions that go beyond explicit torture. These include practices such as arbitrary detention, enforced disappearance, extrajudicial execution, forced exile, and sexual violence used as a weapon of war or political control. These actions seek to silence dissent, instill fear in the population, and maintain power by force. Often, these forms of violence leave no obvious physical scars, but they have a devastating impact on the mental health of the victims and their communities.

The human rights legal framework provides the basis for condemning torture and repression. The Universal Declaration of Human Rights (1948) establishes in Article 5 that "No one shall be subjected to torture or to cruel, inhuman, or degrading treatment or punishment." This principle has been reinforced by a series of international treaties and conventions, such as the International Covenant on Civil and Political Rights and the aforementioned Convention against Torture. These regulations not only prohibit these acts, but also oblige States to prevent, investigate, and punish those responsible, as well as to guarantee reparation to the victims. The prohibition of torture is a jus cogens rule, that is, a peremptory norm of international law that admits no exception or derogation.

Post-traumatic stress disorder (PTSD) is one of the most common and well-studied consequences of torture. Survivors constantly relive traumatic events through recurring nightmares, intrusive flashbacks, and distressing thoughts that make them feel as if they are reliving the moment of the assault. They also develop constant hyperarousal, resulting in irritability, difficulty sleeping, and a feeling of constant danger. To avoid the pain, many resort to avoidance, distancing themselves from people, places, or situations that remind them of the trauma, leading to social isolation.

Torture and repression often trigger severe depression and anxiety. Depression manifests as a persistent feeling of sadness, hopelessness, and loss of interest in once-pleasurable activities. Survivors may experience chronic fatigue, changes in appetite, and suicidal thoughts. Anxiety, on the other hand, presents as a constant state of worry, panic attacks, and a general sense of fear. Both conditions are an understandable response to the loss of control, extreme vulnerability, and the destruction of trust.

Prolonged trauma affects the brain's ability to process information and regulate emotions, resulting in cognitive and affective impairment. Victims may have difficulty concentrating, remembering events, and making decisions. On an emotional level, they experience anhedonia, or the inability to feel pleasure, and emotional dysregulation, manifested in abrupt mood swings and an inability to manage intense feelings. Torture shatters perceptions of the self and others, generating a profound distrust of the world.

Complex trauma is a term used to describe the consequences of severe, prolonged, interpersonal trauma, such as torture. Unlike PTSD, complex trauma affects a person's identity, interpersonal relationships, and belief system holistically. Survivors of complex trauma often have difficulty establishing safe relationships, suffer from profound shame and guilt, and view the world as an inherently dangerous place. This concept highlights that damage is not limited to a single event but is a deep wound that permeates all aspects of life.

Several human rights treaties establish the right to mental health, although often indirectly. The International Covenant on Economic, Social and Cultural Rights (ICESCR) recognizes the right of every person to "the enjoyment of the highest attainable standard of physical and mental health." Similarly, the Convention on the Rights of the Child and the Convention on the Rights of Persons with Disabilities also incorporate mental health as a crucial aspect of well-being. The Universal Declaration of Human Rights and the Convention against Torture explicitly prohibit acts that cause severe mental harm, implying that redressing this harm is a State obligation.

The prohibition of torture is not limited to preventing these acts. States have a fundamental responsibility to guarantee care and reparation to victims. This obligation stems from the principle that, having failed to prevent torture, the State must mitigate its consequences. Reparation must be comprehensive, including medical and psychological rehabilitation. This implies the provision of accessible, free, and quality mental health services, without discrimination. Reparation also encompasses restitution, compensation, satisfaction, and guarantees of non-repetition, which seek to restore the victim's dignity and prevent future abuses.

Caring for survivors of torture requires a specialized and multidisciplinary approach. Psychosocial support programs are crucial, as they go beyond individual therapy. They include the creation of safe spaces for sharing experiences, the promotion of support networks among survivors, and the rebuilding of the social fabric. A comprehensive approach recognizes that trauma is not just an individual problem but also affects the community. Support should be culturally sensitive and person-centered, helping survivors regain control over their lives, rebuild their identity, and reconnect with others.

Survivor narratives are a fundamental pillar in making visible the "silent violence" left by torture. Through their stories, we can understand how trauma manifests itself in everyday life. Many stories echo the sense of loss of identity, difficulty trusting others, and self-imposed social isolation. One survivor might recount how a common sound or smell transports them back to a dungeon, while another might describe the struggle to establish emotional bonds with family after being dehumanized. These narratives defy oblivion and become an act of resistance and healing.

Analysis of landmark cases, both at the individual and group levels, provides concrete evidence of psychological damage. For example, studies of survivors of military dictatorships in Argentina and Chile reveal consistent patterns of complex PTSD, depression, and anxiety disorders that persist decades later. These studies often document impaired quality of life, high suicide rates, and the breakdown of family structures. The Center for the Rehabilitation of Torture Victims (CEREVITA) in Denmark, to name one, has documented thousands of cases, providing a vast body of evidence on the long-term consequences and demonstrating the need for specialized and sustained care.

One of the most devastating facets of torture trauma is its intergenerational legacy. Studies have shown that children of survivors can inherit, not genetically, but through their environment and family dynamics, the consequences of their parents' trauma. This manifests itself in patterns of anxiety, difficulty expressing emotions, and the internalization of fears and unspoken silences. Trauma is transmitted like an echo, affecting the way children perceive the world and their own relationships. Breaking this cycle of pain requires not only healing the survivors, but also providing support to their families and, in particular, to the new generations who bear the weight of a history they did not directly experience.

Despite the urgent need, torture survivors face numerous barriers to accessing mental health care. Often, the fear of social stigmatization or revictimization keeps them silent. Mental health institutions in many countries are unprepared to handle complex traumas of this nature, and a lack of personnel trained in culturally sensitive and trauma-informed therapies is a widespread problem. Furthermore, economic and geographic constraints prevent many from accessing care centers. Distrust in state institutions, which were often the perpetrators of the harm, is perhaps the most profound barrier.

To overcome these obstacles, effective public policies and reparations programs are needed. It is critical that governments recognize torture and repression as crimes against humanity and commit to comprehensive reparations that include mental health. This involves the creation of specialized centers that offer free and confidential therapy, psychosocial support, and medical care. These programs must be holistic, combining psychological care with legal, social, and economic assistance so that survivors can rebuild their lives with dignity.

Civil society organizations and NGOs play a vital role. By operating outside of government structures, they often gain the trust of survivors. These organizations are crucial in documenting cases, providing direct support services, and advocating for human rights policies. Their awareness-raising work is essential for educating society about the reality of trauma and combating the associated stigma.

Torture and repression are not only acts of physical violence, but a silent and devastating violation of the right to mental health. Their consequences, such as complex PTSD, depression, and cognitive impairment, persist for decades, affecting not only the victims but also their families. International human rights law condemns these acts and requires States to provide comprehensive reparations, including psychological rehabilitation.

The need for a comprehensive response cannot be ignored. Trauma is a deep wound that requires more than the passage of time. Healing demands specialized programs, community support, and a commitment from governments to guarantee access to mental health care. Recognizing this right is an act of justice and humanity.

This report is a call to action. It is imperative that the international community, governments, and society as a whole unite to prevent torture, protect victims, and guarantee their right to mental health. The ultimate goal must be a future in which torture and repression are a thing of the past, and in which dignity and inner peace are an inviolable right for all.