Compulsory treatment in a psychiatric hospital: how to refer a person

Compulsory treatment of criminals is a special type of compulsory measures imposed by the state if there are medical indications for this. They mean the following: a person who has been convicted of committing a crime under the influence of a mental illness can be forcibly confined to a specialized closed medical institution. After this, medical workers are obliged to treat this patient in order to put his psyche in order and eliminate the danger to society.

Compulsory medical measures

Persons suffering from mental disorders or criminals are subject to involuntary psychiatric treatment. The measure of state coercion should not be confused with punishment. The main goal of therapy is to improve the patient’s condition in order to prevent the commission of actions dangerous to society. Such treatment can only be prescribed during a trial.

There are several types of compulsory treatment, which include:

outpatient observation and involuntary psychotherapy sessions;
therapy in a psychiatric department at a general hospital;
inpatient therapy in a specialized psychiatry department;
therapeutic measures in the psychiatry department at a specialized hospital; patients require intensive monitoring.

Grounds for placing a person in a mental hospital

Outpatient treatment is excluded in situations where a person may harm himself or others. During the trial, the nature of the mental disorder is established, confirmed by an independent expert in the field of psychiatry. The judge determines the type of treatment depending on the psychiatrist's opinion. The grounds for placement in a psychiatric clinic are:

lack of the patient's ability to satisfy his own basic needs;
presenting a danger to society from the actions of the patient;
a situation where a patient’s refusal to help will cause significant harm to his health.

What is a general psychiatric hospital?

A general psychiatric hospital is a medical institution designed to treat ordinary patients. It is here that therapy is carried out for patients who have committed unlawful acts not related to murder. The citizen does not pose a danger to the people around him, but at the same time they must be forcibly kept in hospital custody. Intensive monitoring is not required. Compulsory hospitalization in a psychiatric hospital can reduce the likelihood of re-committing a crime and normalize the patient’s mental state.

The following persons are sent to undergo compulsory treatment in a general hospital:

those who committed an illegal act and were in a state of insanity;
those suffering from dementia and mental disorders;
who committed crimes under the influence of external negative factors.

The duration of therapy is not specified in court. As a result, the patient is required to undergo an examination every 6 months to determine his mental state.

Important ! In the hospital, patients cannot leave the walls of the building. They also eat in a hospital setting.

Compulsory treatment in a psychiatric hospital

Compulsory hospitalization is intended for persons who have committed an illegal act or are in an insane, mentally unhealthy state. Such people are not sent to a correctional facility. However, it is not safe to release them. In this case, forced hospitalization in a psychiatric hospital will save the situation.

This measure is not a sentence, but only helps prevent the commission of new illegal actions that pose a danger to society. The type of mental illness and type of therapy are determined by the court. However, documents confirming the person’s mental state are taken into account.

The patient, not the criminal

Ilyasov regularly represents the interests of patients with psychiatric diagnoses. He told the Street that he often encounters a disdainful attitude towards the rights of patients - and laws in general. “In almost every hospital, one of the employees tries to be present at the meeting between the lawyer and the client,” Ilyasov gave an example. – You almost always have to conflict with them about this. Explain the legal provisions that provide that a mentally ill person has the right to communicate privately with a lawyer. They almost always move away, but still sit somewhere nearby, behind the slightly open door.”

The lawyer has the impression that employees of psychiatric clinics often do not understand the importance of the right to a confidential meeting. “According to many doctors, patients undergoing compulsory treatment are people who have committed a crime, but by luck ended up not in prison, but in a hospital. And doctors see them, first of all, as criminals who must serve a certain term in isolation from society,” explains Ilyasov.

He had complained to supervisory authorities before. So, in June he was twice not allowed to see another client at the Elizavetinskaya Hospital in St. Petersburg. Then he contacted the prosecutor's office, Rospotrebnadzor and the Ministry of Health. Three months have passed, but there is still no reaction, the lawyer says. The only answer to that story is the message from the prosecutor’s office that the complaint has been forwarded to the Ministry of Health. Now Ilyasov is going to complain about the lack of response from the ministry.

“The reason for the violations is impunity and lack of control,” the lawyer is sure. – A psychiatric hospital is a closed institution. They try to hide everything that happens inside as much as possible. Patients write complaints, but doctors say that it is their “mental state that has changed.” Nobody wants lawyers to come and start making some noise. Often hospitals try to quickly “write off” such patients to another institution in order to get rid of possible problems.”

According to Ilyasov, a mentally ill person placed in a hospital for compulsory treatment, like no one else, needs qualified legal assistance. “The patient’s condition can improve in a fairly short time if appropriate treatment is selected. But the hospital may not transfer him to another type of treatment solely out of reluctance, the lawyer is sure. – After all, in their eyes he is a criminal and must serve a certain period in isolation. And this period has nothing to do with his mental state.”

Lawyer of the St. Petersburg AP Ibragim Ilyasov
If a person does not have outside support, he can spend his whole life in such an institution.

Ilyasov says that his client once relayed the words of a hospital employee: “Until we want you to, you won’t leave here.” “The client asked - how long do I need to stay here? They answered him: they say, you would get three years in prison, and that’s how long you’ll spend in the hospital,” says the lawyer.

How to send for treatment

How to involuntarily admit someone to a psychiatric hospital? First of all, the psychiatrist must determine the presence of mental disorders and determine whether the patient poses a danger to others. The local doctor writes out a referral to see a psychiatrist. If the patient is unable to get to the clinic on his own, the doctor must come to the patient. Detected abnormalities in the mental state will be the reason for issuing a certificate allowing the patient to be involuntarily hospitalized. If the condition worsens, it is important to promptly call an ambulance and provide them with a document confirming the need for treatment in a psychiatric clinic. Compulsory treatment in a psychiatric hospital is carried out by court decision. Therefore, after the patient is taken by ambulance, relatives must file a claim in court within 48 hours.

There is a problem, but there are no complaints

In May, Svetlana Eliseeva, a member of the commission appointing the St. Petersburg AP, prepared a report on violations of the rights of lawyers representing patients with a psychiatric diagnosis. For example, defense attorneys are often not given documents of claim or are not allowed to visit clients in hospitals. Ibragim Ilyasov calls on his colleagues to solve this problem together. “If we have a group of lawyers in the city that will deal with the problems of the mentally ill and will constantly focus attention on this, then the situation can be changed,” argues Ilyasov. However, he emphasizes that he himself “would not dare” to lead such a fight: “This is a matter for the chamber, because its actions have a greater effect. If they want to look into this issue, then I am ready to contribute.” He himself has not yet decided to send a complaint to his ward.

The KZPA of St. Petersburg knows about the problem - but they just shrug their shoulders. “In recent years, we have not received any official requests from lawyers on this topic,” commission chairman Sergei Krause told Ulitsa. “That’s why, unfortunately, we don’t even have accurate statistics on this problem.” According to him, the main source of information about “lawyer” violations in psychiatric clinics is the media and “some third parties.” Krause calls for “highlighting this problem in the public space” and emphasizes that the chamber is ready to assist lawyers: “You can talk about this and contact both the regional and federal chambers.”

The Chairman of the Leningrad Region KZPA, Evgeniy Tonkov, also does not remember requests for denial of access to such patients. “And we do not replace the lawyers themselves,” he explained. “But the bodies of the chamber and defense lawyers may act in some outrageous situations.” “This is, in principle, a feature of our society, when the attitude towards mentally ill people - or those who want to be considered such - is not very adequate,” Tonkov added with regret.

Where to submit an application for forced hospitalization of a citizen

How to forcibly send a person for treatment to a mental hospital is often asked by the patient’s relatives. It is necessary to draw up and submit a statement of claim to the court, which is located in the area where the psychiatric clinic is located. The claim is accompanied by the conclusion of a psychiatric commission. The claim must be considered within 5 days. The Constitution clearly reflects human rights to:

immunity;
freedom of movement.

That is why, without a court decision, a psychiatric hospital cannot admit a patient for treatment. Failure to comply with this law results in criminal liability.

Specialized hospital with intensive observation

Before determining which treatment and prevention institution to send the offender for compulsory treatment, the court is obliged to carefully study all the circumstances of the case, as well as analyze all the main indicators, such as the degree of guilt in the committed act, as well as the degree of danger of the person to society.

The Criminal Code of the Russian Federation states that when determining a specific institution, it is also necessary to take into account the nature and severity of the offense that was committed. And if it is determined that a crime of a particularly serious nature has occurred, or as a result of the committed acts a situation has arisen in which there is a huge danger to society, then in this case the offender will be transferred for treatment to a specialized institution with intensive supervision.

The main feature of such hospitals is that they provide preventive treatment exclusively to those individuals who can create a dangerous situation. That is why they are always under control. This means that the entire time a person is in the hospital is accompanied by constant video surveillance, the presence of medical personnel and intensive preventive treatment measures.

Duration of compulsory treatment of a mentally ill person

The appointment of a compulsory measure of hospitalization of a citizen for treatment in a mental hospital is carried out only if there is an examination by a commission of psychiatrists. The event is held every 6 months. The procedure allows you to assess a person’s condition and, if necessary, stop therapy or extend it for some more time. A representative of the clinic where the treatment is carried out may be present at the court hearing. He will most reliably tell you about the course of the disease. According to the law, the following must be present:

prosecutor;
advocate, who is the legal representative of the patient.

Important ! If there is a reason to extend treatment, the court will decide on further inpatient stay in the psychiatric department.

Violation of patient rights and forced detention in a psychiatric hospital

The legislation of our country has determined the rights of patients undergoing treatment in a psychiatric institution. The patient's rights will be violated if:

refusal to provide medical care;
providing inadequate assistance that results in harm to health or even death;
collecting payment for medical services in an illegal manner;
abuse of official duties.

It would be a crime to carry out illegal admission to a clinic that provides psychiatric care without the consent of the patient who does not have a certificate from a psychiatrist. This method of hospitalization affects mentally healthy people who are hospitalized without reason. When illegally detaining a citizen who has been completely cured in a clinic, lawyers refer to Article 127 of the Criminal Code of the Russian Federation. Close relatives who have reached the age of 16 (not a child!) must be responsible for placing the person in a psychiatric ward. A healthy person is suffering and is illegally staying on the territory of a medical institution. Family members become accomplices in the process of illegally placing a person in a hospital.

When the illegality of the forced hospitalization procedure is proven in court, the perpetrators will be held accountable under Article 305 of the Criminal Code of the Russian Federation. The main qualifying signs of violation of rights include:

committing a crime while using one's official position;
the death of a patient due to failure to provide timely medical care.

The subject of the crime can be a doctor, relatives or neighbors who have placed a citizen in a psychiatric clinic at their own request. The psychiatric commission that certified the false illness will also have to bear responsibility for the fact that a person had to become mentally ill.

On psychiatric care and guarantees of citizens’ rights during its provision

LAW OF JULY 2, 1992 N 3185-1 ON PSYCHIATRIC CARE AND GUARANTEES OF CITIZENS’ RIGHTS DURING ITS PROVISION (as amended by Federal Law of July 21, 1998 N 117-FZ)

Recognizing the high value for every person of health in general and mental health in particular; considering that a mental disorder can change a person’s attitude towards life, himself and society, as well as society’s attitude towards a person; Noting that the lack of proper legislative regulation of psychiatric care may be one of the reasons for its use for non-medical purposes, causing damage to health, human dignity and the rights of citizens, as well as the international prestige of the state; Taking into account the need to implement in the legislation of the Russian Federation the rights and freedoms of man and citizen recognized by the international community and the Constitution of the Russian Federation, the Supreme Council of the Russian Federation adopts this Law. Section I. GENERAL PROVISIONS Article 1. Psychiatric care and principles of its provision (1) Psychiatric care includes examination of the mental health of citizens on the grounds and in the manner established by this Law and other laws of the Russian Federation, diagnosis of mental disorders, treatment, care and medical care. — social rehabilitation of persons suffering from mental disorders. (2) Psychiatric care for persons suffering from mental disorders is guaranteed by the state and is carried out on the basis of the principles of legality, humanity and respect for human and civil rights. Article 2. Legislation of the Russian Federation on psychiatric care (1) The legislation of the Russian Federation on psychiatric care consists of this Law and other legislative acts of the Russian Federation and republics within the Russian Federation, as well as legal acts of the autonomous region, autonomous okrugs, territories, regions, cities Moscow and St. Petersburg. (2) The Government of the Russian Federation and the governments of the republics within the Russian Federation, as well as ministries and departments, have the right to adopt legal acts on psychiatric care within their competence. (3) Legislative and other legal acts adopted in the Russian Federation and republics within the Russian Federation, autonomous region, autonomous okrugs, territories, regions, cities of Moscow and St. Petersburg cannot limit the rights of citizens and guarantees of their observance in the provision of mental health care provided for by this Law. (4) If an international treaty to which the Russian Federation participates establishes rules other than those provided for by the legislation of the Russian Federation on psychiatric care, then the rules of the international treaty apply. Article 3. Application of this Law (1) This Law applies to citizens of the Russian Federation when providing them with psychiatric care and applies to all institutions and persons providing psychiatric care on the territory of the Russian Federation. (2) Foreign citizens and stateless persons located on the territory of the Russian Federation, when providing them with psychiatric care, enjoy all the rights established by this Law, on an equal basis with citizens of the Russian Federation. Article 4. Voluntary application for psychiatric help (1) Psychiatric help is provided upon voluntary application of a person or with his consent, except for the cases provided for by this Law. (2) A minor under the age of 15, as well as a person recognized as legally incompetent, is provided with psychiatric care at the request or with the consent of their legal representatives in the manner prescribed by this Law. Article 5 . Rights of persons suffering from mental disorders (1) Persons suffering from mental disorders have all the rights and freedoms of citizens provided for by the Constitution of the Russian Federation, the Constitutions of the republics within the Russian Federation, the legislation of the Russian Federation and the republics within the Russian Federation. Restriction of the rights and freedoms of citizens associated with mental disorder is permissible only in cases provided for by the laws of the Russian Federation. (2) All persons suffering from mental disorders, when provided with psychiatric care, have the right to: respectful and humane treatment, excluding humiliation of human dignity; receiving information about their rights, as well as, in a form accessible to them and taking into account their mental state, information about the nature of the mental disorders they have and the treatment methods used; mental health care in the least restrictive setting, preferably in the community; detention in a psychiatric hospital only for the period necessary for examination and treatment; all types of treatment (including sanatorium and resort treatment) for medical reasons; provision of psychiatric care in conditions that meet sanitary and hygienic requirements; preliminary consent and refusal at any stage from the use of medical devices and methods, scientific research or educational process, photo, video or filming as an object of testing; inviting, at their request, any specialist involved in the provision of mental health care, with the latter’s consent, to work on the medical commission on issues regulated by this Law; assistance of a lawyer, legal representative or other person in the manner prescribed by law. (3) Restrictions on the rights and freedoms of persons suffering from mental disorders solely on the basis of a psychiatric diagnosis or the facts of being under dispensary observation in a psychiatric hospital or in a psychoneurological institution for social security or special education are not allowed. Officials guilty of such violations bear responsibility in accordance with the legislation of the Russian Federation and the republics within the Russian Federation. Article 6. Restrictions on performing certain types of professional activities and activities associated with a source of increased danger (1) A citizen may be temporarily (for a period of no more than five years and with the right to subsequent re-examination) declared unfit to perform certain types of professional activities and activities due to a mental disorder associated with a source of increased danger. Such a decision is made by a medical commission authorized by the health authority, based on an assessment of the state of mental health of the citizen in accordance with the list of medical psychiatric contraindications and can be appealed to the court. (2) The list of medical psychiatric contraindications for carrying out certain types of professional activities and activities associated with a source of increased danger is approved by the Government of the Russian Federation and is periodically (at least once every five years) revised taking into account accumulated experience and scientific achievements. Article 7. Representation of citizens who receive psychiatric care (1) When receiving psychiatric care, a citizen has the right to invite a representative of his choice to protect his rights and legitimate interests. Registration of a representative office is carried out in the manner established by the civil and civil procedural legislation of the Russian Federation. (2) The protection of the rights and legitimate interests of a minor under the age of 15 and a person recognized as incompetent in accordance with the procedure established by law, when providing them with psychiatric care, is carried out by their legal representatives (parents, adoptive parents, guardians), and in their absence - by the administration of a psychiatric hospital or a psychoneurological institution for social welfare or special education. (3) A lawyer can protect the rights and legitimate interests of a citizen when providing him with psychiatric care. The procedure for inviting a lawyer and paying for his services is provided for by the legislation of the Russian Federation. The administration of an institution providing psychiatric care provides the opportunity to invite a lawyer, with the exception of urgent cases provided for in paragraph “a” of part four of Article 23 and paragraph “a” of Article 29 of this Law. Article 8. Prohibition of demands for information about the state of mental health When a citizen exercises his rights and freedoms, demands for information about the state of his mental health or an examination by a psychiatrist are allowed only in cases established by the laws of the Russian Federation. Article 9. Maintaining medical confidentiality when providing psychiatric care Information about the presence of a mental disorder in a citizen, the facts of seeking psychiatric help and treatment in an institution providing such care, as well as other information about the state of mental health are medical secrets protected by law. To realize the rights and legitimate interests of a person suffering from a mental disorder, at his request or at the request of his legal representative, he may be provided with information about the state of mental health of this person and about the psychiatric care provided to him. Article 10. Diagnosis and treatment of persons suffering from mental disorders (1) The diagnosis of a mental disorder is made in accordance with generally accepted international standards and cannot be based solely on the citizen’s disagreement with the moral, cultural, political or religious values accepted in society or on other reasons directly not related to the state of his mental health. (2) For the diagnosis and treatment of a person suffering from a mental disorder, medical means and methods are used that are permitted in the manner established by the legislation of the Russian Federation on healthcare. (3) Medical means and methods are used only for diagnostic and therapeutic purposes in accordance with the nature of the disease disorders and should not be used to punish a person suffering from a mental disorder or for the benefit of other persons. Article 11. Consent to treatment (1) Treatment of a person suffering from a mental disorder is carried out after receiving his written consent, except for the cases provided for in part four of this article. (2) A doctor is obliged to provide a person suffering from a mental disorder, in a form accessible to him and taking into account his mental state, information about the nature of the mental disorder, goals, methods, including alternative ones, and the duration of recommended treatment, as well as pain, possible risks, side effects and expected results. The information provided is recorded in the medical documentation. (3) Consent to the treatment of a minor under the age of 15, as well as a person recognized as legally incompetent, is given by their legal representatives after providing them with the information provided for in part two of this article. (4) Treatment may be carried out without the consent of a person suffering from a mental disorder, or without the consent of his legal representative, only when compulsory medical measures are applied on the grounds provided for by the Criminal Code of the Russian Federation, as well as in case of involuntary hospitalization on the grounds provided for in Article 29 of this Law. In these cases, except for urgent ones, treatment is applied according to the decision of a commission of psychiatrists. (as amended by Federal Law No. 117-FZ dated 21.07.98) (5) In relation to the persons specified in part four of this article, the use of surgical and other methods for the treatment of mental disorders that cause irreversible consequences, as well as testing of medical devices and methods are not allowed. Article 12. Refusal of treatment (1) A person suffering from a mental disorder or his legal representative has the right to refuse the proposed treatment or terminate it, except for the cases provided for in part four of Article 11 of this Law. (2) The person refusing treatment or his legal representative must be explained the possible consequences of stopping treatment. Refusal of treatment, indicating information about possible consequences, is formalized by an entry in the medical documentation signed by the person or his legal representative and a psychiatrist. Article 13. Compulsory measures of a medical nature (1) Compulsory measures of a medical nature are applied by court decision in relation to persons suffering from mental disorders who have committed socially dangerous acts, on the grounds and in the manner established by the Criminal Code of the Russian Federation and the Criminal Procedure Code of the RSFSR. (as amended by Federal Law No. 117-FZ of July 21, 1998) (2) Compulsory medical measures are carried out in psychiatric institutions of health authorities. Persons placed in a psychiatric hospital by a court decision to apply compulsory medical measures enjoy the rights provided for in Article 37 of this Law. They are recognized as incapacitated for work for the entire period of stay in a psychiatric hospital and have the right to state social insurance benefits or a pension on a general basis. Article 14. Forensic psychiatric examination Forensic psychiatric examination in criminal and civil cases is carried out on the grounds and in the manner provided for by the Criminal Procedure Code of the RSFSR and the Civil Procedure Code of the RSFSR. Article 15. Psychiatric examination to decide the issue of a citizen’s suitability for service as a military member. Grounds and procedure for outpatient and inpatient examination when deciding on the suitability of a citizen based on his mental health to serve as a member of the Armed Forces, troops and security agencies, internal troops, railway troops and other military formations, commanding and rank and file personnel of internal affairs bodies, institutions and bodies of the criminal executive system are determined by this Law and the legislation of the Russian Federation on military service. (as amended by Federal Law dated July 21, 1998 N 117-FZ)

President of the Russian Federation B. YELTSIN Moscow, House of Soviets of Russia July 2, 1992 N 3185-1
Legislative information prepared and posted specifically for the website of the Kaslinskaya Central District Hospital