Compulsory treatment in a medical organization providing. Types of inpatient compulsory treatment and indications for their use

Such patients require constant and intensive monitoring and special security measures. That is why in such hospitals there is protection and supervision, which are carried out according to the established practice of the Ministry of Internal Affairs of the Russian Federation. 8. In order to prevent social maladjustment of mental patients, compulsory treatment in general hospitals and specialized hospitals should be carried out at the place of residence of patients or their relatives. As for specialized hospitals with intensive supervision, the characteristics of these institutions and the requirements for the regime of keeping patients do not allow organizing compulsory treatment in accordance with the above principle, and often patients in such medical institutions are on compulsory treatment at a considerable distance from home. 9.

Forced treatment in a psychiatric hospital

The negative saturation of life with meaning correlates with the autopsychic form of self-stigmatization, in which the patient justifies all his failures with illness and reduces the demand on himself. Further, we quite expectedly found that satisfaction from working with a psychologist or psychotherapist, especially group satisfaction, is positively correlated with the indicator of satisfaction from social support.

But, unfortunately, such components of compliance factors as satisfaction with therapy, psychotherapy, psychocorrection did not show any more specific or unexpected relationships. Thus, this issue requires further study.
Only 7 people succeeded in tracking the dynamics of the results obtained by the above methods in patients who completed the entire basic course of group psychological work from psychoeducation to anger management training.

Russian criminal law

Attention

Compulsory treatment in a psychiatric hospital may be prescribed to a person if there is a basis for the use of coercive medical measures, if the person’s mental disorder requires such conditions of treatment, care, maintenance and observation that can only be carried out in a psychiatric hospital (part 1 of article 101 of the Criminal Code of the Russian Federation) . For the appointment of compulsory treatment in a psychiatric hospital, in addition to the grounds provided for in Art.

Info

of the Criminal Code of the Russian Federation, the court must establish that the person in question needs inpatient psychiatric treatment. This means that the nature of a person’s mental disorder, in particular, the behavioral disorders caused by this disorder, as well as the unfavorable course of this disorder, does not allow for the treatment of this person, care for him, his maintenance and observation in conditions other than inpatients.

Unit for compulsory treatment in a general psychiatric hospital

Important

Naturally, they are confident in their adequacy and voluntarily refuse to be treated. Life with a dependent person brings a lot of problems, quarrels, material troubles.

That is why relatives are wondering how to send him for compulsory treatment in a mental hospital. If pronounced mental deviations are observed in drug and alcohol addictions, then only treatment is possible without the consent of the patient.
To be sent for compulsory treatment to a general psychiatric hospital, the following documents are required:
relatives statement;

conclusion of doctors about the presence of signs of inadequacy.

How to send for treatment First of all, the psychiatrist must determine whether there are mental disorders or not. In addition, it must be established whether their actions can carry a danger to other people.

The placement of a person who has committed an unlawful act in a psychiatric hospital depends on the severity of the mental disorder ascertained by the medical examination. Depending on the severity of a person's mental state, the law distinguishes three types of psychiatric hospitals: a general type hospital, a specialized type, and a specialized type with intensive supervision.

Types of psychiatric hospitals differ from each other mainly in the mode of detention, but not in the methods of treatment. Persons who have committed socially dangerous acts, as a rule, not related to an encroachment on the lives of citizens, and due to their mental state do not require intensive monitoring, but at the same time need hospital maintenance and treatment, are placed in a general psychiatric hospital.

Compulsory treatment in a medical organization providing psychiatric care in hospitals, of a general type, can be assigned to a person who, due to his mental state, needs treatment and observation in hospitals, but does not require intensive monitoring. 3. Compulsory treatment in a medical organization providing psychiatric care in inpatient conditions, of a specialized type, may be prescribed to a person who, due to his mental state, requires constant monitoring. 4. Compulsory treatment in a medical organization providing psychiatric care in inpatient conditions, of a specialized type with intensive supervision, may be assigned to a person who, due to his mental state, poses a particular danger to himself or others and requires constant and intensive supervision.< 1.

Compulsory treatment in a hospital of a general type and a specialized type

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1.
The specialization of a psychiatric hospital means that the medical institution has a special regime for keeping patients, including taking measures to prevent repeated socially dangerous acts and escapes, as well as specialized rehabilitation, preventive and correctional and educational programs, oriented in accordance with the characteristics of patients entering there. The specialized nature of a psychiatric hospital excludes the possibility of admission to it and keeping in it other patients who are not sent for compulsory treatment. At the same time, compulsory treatment in a psychiatric hospital of a general type does not actually differ in regime from that in which mentally ill people who have not committed socially dangerous acts are treated.
To determine the mental state of a person, you need to seek clarification from the local doctor. He will write a referral to a psychiatrist. If the patient cannot go to him, then he is obliged to come to the house himself. If deviations are found, the doctor writes out a document that allows you to send a person for compulsory treatment involuntarily. If the condition worsens, you should call an ambulance.

They need to show a certificate from a psychiatrist. After that, the staff must take the patient to a mental hospital for further treatment. Relatives have 48 hours from the moment a mental patient is placed in a general hospital to file a claim for referral to compulsory treatment.

Such cases are considered in the order of special proceedings. The application is written in any form in compliance with the requirements of Art.

302, 303 Code of Civil Procedure of the Russian Federation.

The timing of the application of measures of physical restraint and isolation is determined by the psychiatrist independently, depending on the prognosis of the patient's behavior and the relief of the aggressive state. When applying these measures, the patient is subject to special control in the form of a duty nurse-specialist, ready to provide the necessary assistance if necessary.

The forms and time of application of measures of restraint or isolation are recorded in the medical records. Local self-government bodies exercise control over the activities of institutions and persons providing psychiatric care.

Supervision over compliance with the law in the provision of psychiatric care, in particular, over the observance of the rights of patients, is carried out by the Prosecutor General of the Russian Federation and prosecutors subordinate to him. In addition, a service for protecting the rights of patients, independent of the health authorities, is being created in psychiatric hospitals.

Compulsory treatment in a medical organization providing psychiatric care in an inpatient setting

1. Compulsory treatment in a medical organization providing psychiatric care in an inpatient setting may be prescribed if there are grounds provided for in Article 3, if the nature of the mental disorder of a person requires such conditions of treatment, care, maintenance and supervision that can only be carried out in a medical organization, providing psychiatric care in an inpatient setting.

2. Compulsory treatment in a medical organization providing psychiatric care in inpatient conditions, of a general type, may be assigned to a person who, due to his mental state, needs treatment and observation in an inpatient setting, but does not require intensive observation.

3. Compulsory treatment in a medical organization providing psychiatric care in inpatient conditions, of a specialized type, may be prescribed to a person who, due to his mental state, requires constant monitoring.

4. Compulsory treatment in a medical organization providing psychiatric care in inpatient conditions, of a specialized type with intensive supervision, may be assigned to a person who, due to his mental state, poses a particular danger to himself or others and requires constant and intensive supervision.

Article 101 of the Criminal Code of the Russian Federation with comments

Based on part 1 of Art. 101 of the Criminal Code of the Russian Federation, it follows that compulsory treatment in a medical organization may be prescribed on the grounds specified in Article 97 of the Criminal Code of the Russian Federation, but only in cases where the nature of the mental disorder of a person requires such conditions of treatment, care, maintenance and supervision, which may be carried out only in a medical organization providing psychiatric care in an inpatient setting, namely:

Article 97 of the Criminal Code of the Russian Federation

1. Compulsory measures of a medical nature may be imposed by a court on persons:

a) committed the acts provided for by the articles of the Special Part of this Code, in a state of insanity;

b) who, after the commission of the crime, developed a mental disorder that makes it impossible to impose or carry out punishment;

c) committed a crime and suffering from mental disorders that do not exclude sanity;

d) expired. - Federal Law N 162-FZ of 08.12.2003;

e) who, at the age of over eighteen, has committed a crime against the sexual integrity of a minor under the age of fourteen, and who suffers from a sexual preference disorder (pedophilia) that does not exclude sanity.

2. Compulsory measures of a medical nature are prescribed for the persons specified in the first part of this article only in cases where mental disorders are associated with the possibility of causing other significant harm by these persons or with danger to themselves or other persons.

3. The procedure for the execution of compulsory medical measures is determined by the criminal executive legislation of the Russian Federation and other federal "laws".

4. With regard to the persons referred to in paragraphs "a" - "c" of part one of this article and who do not pose a danger in their mental state, the court may transfer the necessary materials to the federal executive body in the field of healthcare or the executive body of the subject of the Russian Federation in in the healthcare sector to resolve the issue of treating these persons in a medical organization providing psychiatric care, or referring these persons to stationary social service institutions for persons suffering from mental disorders, in the manner prescribed by the legislation in the field of health protection.

Purposes of application of medical measures

The purposes of applying compulsory medical measures are to cure the persons specified in Part 1, Article 97 of this Code, or to improve their mental state, as well as to prevent them from committing new acts provided for in the articles of the Special Part of this Code.

More information in the section " "

1. Compulsory treatment in a medical organization providing psychiatric care in an inpatient setting may be prescribed if there are grounds provided for in Article 97 of this Code, if the nature of the mental disorder of a person requires such conditions of treatment, care, maintenance and observation that can be carried out only in a medical organization providing psychiatric care in inpatient settings.

Comments to Art. 101 of the Criminal Code of the Russian Federation

1. The commented article fixes the grounds for hospitalization in a psychiatric hospital. A person suffering from a mental disorder may be referred to such a hospital if his treatment is possible only in hospital conditions, and the mental disorder is severe and causes: a) his immediate danger to himself or others; b) his helplessness, i.e. inability to independently meet the basic needs of life; c) significant harm to his health (due to the deterioration of his mental state), if the person is left without psychiatric assistance.

2. Compulsory treatment in a general psychiatric hospital is assigned to a person who, due to the nature of the disease, does not need intensive monitoring. As a rule, such patients do not show a tendency to violate the hospital regimen and have a favorable prognosis in relation to the therapeutic treatment of their disease.

Psychiatric hospitals of a general type include departments of psychiatric hospitals or other similar institutions (dispensaries, clinics, institutes, centers). Compulsory treatment is not among the main functions of these medical institutions.

Inpatient psychiatric care in general institutions is carried out in the least restrictive conditions that ensure the safety of a hospitalized person and other persons, while respecting his rights and legitimate interests by medical personnel (Article 37 of the Law "On Psychiatric Care and Guarantees of the Rights of Citizens in its Provision").

At the same time, patients are subject to certain restrictions: there is no free exit from the department, walks are carried out only on the territory of the hospital, and medical holidays are not provided.

3. Patients who, due to their condition, need constant intensive monitoring, are sent to psychiatric hospitals of a specialized type. Such patients tend to violate the hospital regimen, are characterized by persistent or frequently recurring morbid conditions, aggressive behavior, delusional states, are prone to affective outbursts and the repetition of socially dangerous acts.

In psychiatric hospitals of a specialized type, the use of measures of physical restraint and isolation is allowed. However, these measures are applied only in those cases, forms and for a period of time when, in the opinion of a psychiatrist, it is impossible to prevent the actions of a hospitalized person that pose an immediate danger to him or other persons by other methods, and are carried out under constant supervision of medical personnel.

At the same time, these hospitals are characterized by the use of general security measures (the presence of a burglar alarm, control over transmissions, isolated walking areas).

4. Hospitals of a specialized type with intensive supervision are independent medical institutions of federal subordination that serve the territories of several subjects of the Russian Federation. At these institutions, there are security units that are equipped with special means of control and signaling, carry out external security of the institution, monitor the behavior of patients inside the departments, during walks and rehabilitation activities.

5. When appointing this compulsory measure of a medical nature, the court does not establish the terms of detention in a psychiatric hospital. These terms depend on the mental state of the patient, methods of treatment, their duration. The specific institution where treatment should be carried out is determined by the health authorities.

Commentary on Art. 101 of the Criminal Code of the Russian Federation

1. Compulsory treatment in a psychiatric hospital may be applied if the nature of the mental disorder of a person requires such treatment, care, maintenance and supervision, which can only be carried out in hospital conditions. The need for inpatient psychiatric treatment arises when the nature and severity of the mental disorder are combined with the danger of the mentally ill to himself or others, or the possibility of causing them other significant harm, and exclude outpatient monitoring and treatment by a psychiatrist.

2. The nature of the mental disorder and the need for inpatient compulsory treatment must be established by the court on the basis of the opinion of expert psychiatrists, which indicates which type of IMCM is recommended and why for this person. When choosing a coercive measure recommended by the court, expert psychiatric commissions are based on the general principle of the necessity and sufficiency of this measure to prevent new socially dangerous acts on the part of a mentally ill person, as well as to carry out the necessary treatment and rehabilitation measures for him. Based on the assessment of the mental state of the person, the nature of his mental disorder and the act committed by him, and taking into account the conclusion of the forensic psychiatric examination, the court decides on the appointment of a specific IMMC and, when choosing inpatient compulsory treatment, indicates which type of hospital this person should be sent to. The current criminal law establishes three types of compulsory treatment in a psychiatric hospital. Psychiatric hospitals for involuntary treatment can be of general type, specialized type and specialized type with intensive supervision.

3. Compulsory treatment in a psychiatric hospital of a general type does not actually differ in regime from that in which persons suffering from mental disorders who have not committed socially dangerous acts are treated. It can be assigned to a person who, due to his mental state, needs hospital treatment and observation, but does not require intensive observation and, as a rule, is organized in departments of ordinary psychiatric hospitals. The need for compulsory treatment here is due to the fact that the likelihood of him committing a second socially dangerous act remains, or the patient does not have a critical attitude towards his condition. Hospitalization thus serves to consolidate the results of treatment and helps to monitor the sustainability of the improvement in the mental state of the patient. As a rule, this measure should be prescribed to patients who have committed socially dangerous acts in a state of insanity in the absence of pronounced tendencies to gross violations of the regime, but with the likelihood of recurrence of psychosis or with an insufficient critical assessment of their condition, as well as patients with dementia and mental defects of various origins who have committed acts provoked by external adverse circumstances.

4. Compulsory treatment in a psychiatric hospital of a specialized type may be prescribed to a person who, due to his mental state, requires constant monitoring. The specialization of a psychiatric hospital means that the medical institution has a special regime for keeping patients, including taking measures to prevent repeated socially dangerous acts and escapes, as well as specialized rehabilitation and preventive and correctional and educational programs. The specialized nature of a psychiatric hospital excludes the possibility of admission to it and keeping in it other patients who are not sent for compulsory treatment. Patients who have committed socially dangerous acts and pose a significant danger due to their tendency to repeat such acts are admitted to such hospitals. Most of the patients in such hospitals suffer from psychopathic disorders, various mental defects and personality changes.

5. Compulsory treatment in a psychiatric hospital of a specialized type with intensive supervision may be assigned to a person who, due to his mental state, poses a special danger to himself or others. Such a danger is presented by patients with psychotic conditions and productive symptoms, for example, schizophrenia and other psychoses with ideas of persecution, imperative hallucinations, as well as patients prone to systematic repeated socially dangerous acts and gross violations of the hospital regime, attacks on staff, escapes. As a rule, this type of inpatient compulsory treatment is assigned to those who have committed especially grave acts against a person, with a real possibility of their repetition, due to the clinical manifestations of a mental disorder and personality characteristics. The nature of the mental disorders of such patients, the characteristics of their personality, in particular the tendency to persistent asocial manifestations, exclude the possibility of their being in a general hospital or in a specialized hospital. Such patients require constant and intensive monitoring and special security measures. That is why in such hospitals there are enhanced security and supervision.

6. In order to prevent social maladjustment of mental patients, compulsory treatment in general hospitals and specialized hospitals is, as a rule, carried out at the place of residence of patients or their relatives. As for specialized hospitals with intensive supervision, the characteristics of these institutions and the requirements for the regime of keeping patients do not allow organizing compulsory treatment in accordance with the above principle, and often patients in such medical institutions are on compulsory treatment at a considerable distance from home.