They are known in Mexico as "abandanodos," or abandoned ones. They are patients locked inside Mexico's psychiatric institutions, lost in a system that seems only to know how to sweep them away to a place like Samuel Ramirez Hospital.
The 200-bed psychiatric facility is in the heart of Mexico City. Its own director, Dr. César Bañuelos, calls it "hell."
Most patients walk around shoeless, some with badly swollen and bleeding feet. Their sleeping areas are sparse, there are no activities and there's little interaction between the patients and the staff. There is nothing for patients to do except lie there. Some rock back and forth endlessly.
"We are trying to do the best that we really can do without knowledge and experience right now, but it is not enough, as you can see," Bañuelos said.
Most of the patients appear to be profoundly disabled, but the reality is that they arrived with a variety of disabilities. Some came as children with no disabilities at all, and all are worse than when they arrived. San Francisco-based psychiatrist Dr. Robert Okin has traveled the world examining conditions in mental hospitals as an investigator with the advocacy group, Disability Rights International. He calls the human rights violations taking place at Mexican mental facilities "among the worst ... anyplace in the world." He visited Samuel Ramirez hospital at the same time as ABC News.
One patient at the facility hasn't gotten out of bed for 15 years. Another patient wears urine-soaked pants because the staff doesn't have enough clean clothes. Perhaps no single person better represents the agony of institutionalization than Juan Carlos, who lives in a helmet with his arms tied behind his back -- measures taken to keep him from constantly hitting his head.
During the visit, Dr. Okin said the staff at the hospital has to chose "between hurting him by restraining him and letting him hurt himself."
Bañuelos admitted it is not a good solution for Juan Carlos but said it's all they can do. In fact, he said Juan Carlos is so used to life this way that he becomes agitated when the restraints are off. After the staff took off Juan Carlos' helmet and untied the rope to clean a head wound, we saw this for ourselves. Juan Carlos started moaning.
ABC News' investigation started 10 years ago at another facility outside of Mexico City called Ocaranza. It was a notorious place. Patients could be found outside without clothes in the freezing cold. The floors were littered with feces and urine and the stench was unbearable.
After the last investigation, Mexico publicly pledged to clean up its act. It signed a new United Nations convention protecting the rights of persons with disabilities and closed Orcaranza.
Sixty Orcaranza patients ended up at Samuel Ramirez Hospital.
"They just put them in different facilities in order to appear like the transformed institution," Bañuelos said.
Despite the promises made 10 years ago, the system hasn't been cleaned up, said Eric Rosenthal, the director of Disability Rights International.
"What is shocking is that it's as if time stood still," Rosenthal said.
Disability Rights International today released "Abandoned and Disappeared," its report on Mexican psychiatric facilities. Over the past year, Rosenthal and his team have visited 20 institutions across the country.