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

New edition Art. 101 of the Criminal Code of the Russian Federation

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.

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.

Commentary on Article 101 of the Criminal Code of the Russian Federation

1. The commented article establishes general criteria for the application of all types of PMMH related to the referral to a psychiatric hospital of a person who has committed a socially dangerous act provided for by the Criminal Code of the Russian Federation.

1.1. First of all, it is the existence of the grounds and conditions specified in Art. 97: a) the commission by a person of a socially dangerous act, provided for by the Special Part of the Criminal Code; b) due to a mental disorder, the possibility of causing significant harm to the legally protected interests of the patient either to himself or to other persons; c) the impossibility of providing a person with the necessary psychiatric assistance (examination, diagnosis, treatment, care, etc.) outside a psychiatric hospital. All these grounds and conditions must be reliably established both by the preliminary investigation body and by the court when appointing the IMMC.

1.2. When prescribing one or another type of IMMC, the court is obliged to assess both the real and predicted (by experts) mental state of the patient, the nature and degree of public danger of the act committed by him, the severity of the consequences, as well as the personality of the person in need of the application of the IMMC and appoint one or another of its types. strictly guided by the principle of the necessity and sufficiency of the realization of its goals.

2. Compulsory treatment in a general psychiatric hospital - an analogue of Part 1 of Art. 59 of the Criminal Code of the Russian Federation of the RSFSR, which provided for "placement in a psychiatric hospital with ordinary supervision."

2.1. At present, a general psychiatric hospital is an ordinary (district, city) psychiatric hospital with a variety of departmental profiles. In such a hospital, as a rule, mentally ill persons are placed who, due to their mental state and the nature of the act they have committed, need hospital maintenance and treatment on a compulsory basis, but do not require intensive monitoring by the treating or attending personnel.

2.2. The mental state of these patients should allow the possibility of their detention without special security measures, under the conditions of the usual regime, characteristic of ordinary psychiatric hospitals. Naturally, unlike other patients, persons to whom the indicated PMMC has been applied cannot refuse to implement the said measure. Their voluntary consent to treatment is also not required, since it is legitimately replaced by a court order on the application of this IMMC (Article 443 of the Code of Criminal Procedure).

3. In hospitals of a specialized type, on the contrary, only persons suffering from mental disorders are kept, who pose an increased social danger and therefore are sent for treatment on a compulsory basis. The specialized nature of a psychiatric hospital, the peculiarities of the regimen and treatment in it exclude the possibility of referring to it those patients whose psychiatric care is provided on a voluntary basis.

3.1. The need for constant monitoring in relation to these persons is objectively determined by the nature of the socially dangerous act committed by them, the degree and severity of their mental disorder, the tendency to repeated and systematic socially dangerous acts, the persistent antisocial orientation of the personality, and similar factors.

3.2. The degree of severity of these features, in turn, determines one or another type of specialized psychiatric hospital appointed by a court order (Article 443 of the Code of Criminal Procedure). Each of them is characterized by an ever-increasing degree of strictness of the regime of detention, additional security measures and staffing of medical, maintenance and security personnel, the degree of organization of external protection by security forces, and similar factors.

4. Compulsory treatment in a psychiatric hospital of a specialized type with intensive supervision is intended for persons suffering from mental disorders who, by the nature of the act they have committed (serious, especially serious crimes), their mental state, the course of the disease, negative personality traits, pose a special danger to persons protected by law. interests, for themselves or others, and therefore require constant and intensive monitoring.

4.1. As a criterion for the application of this measure, along with the noted ones, there may also be a systematic commitment of socially dangerous acts despite the repeated use of PMMC in the past, aggressive behavior of a mentally ill person towards medical and service personnel or other patients during the implementation of PMMC, stubborn refusal of prescribed treatment , gross violations of the regime, attempts to escape, suicide, etc. antisocial actions that pose an increased danger to others.

Another commentary on Art. 101 of the Criminal Code of the Russian Federation

1. The article establishes a general criterion for the application of compulsory medical measures associated with referral to a psychiatric hospital - the impossibility of providing a person with the necessary psychiatric assistance (examination, diagnosis, treatment) outside a psychiatric hospital.

2. Compulsory treatment in a psychiatric hospital of a general type consists in placing a person who has a mental disorder in an ordinary (city, district) psychiatric hospital (department), where mentally ill persons who have not committed socially dangerous acts are treated. According to their clinical features, patients referred for compulsory treatment in this hospital do not require intensive monitoring. This is due, firstly, to the fact that the mental disorder proceeds relatively favorably, since the patient's personality remains fairly intact; secondly, the absence of tendencies to gross violations of the hospital regime, since the socially dangerous acts of such patients are directly related to their psychotic experiences (crazy ideas, affective disorders, etc.).

Two categories of persons are placed in a general psychiatric hospital: a) persons who have committed socially dangerous acts in a psychotic state; b) persons suffering from dementia, or persons with mental defects of various origins, who have committed socially dangerous acts, being provoked by external adverse circumstances.

3. Psychiatric hospitals of a specialized type are psychiatric departments or hospitals intended only for compulsory treatment. The specialization of a psychiatric hospital lies in the fact that in the considered medical institution a regime has been established for keeping patients, excluding the possibility of them committing new socially dangerous acts or escapes. In the hospitals under consideration, additional external security is provided.

Compulsory treatment in a psychiatric hospital of a specialized type is assigned to a person who, due to his mental state, requires constant monitoring. The social danger of such a person is associated with persistent, irreversible deficient disorders and personality changes, as well as an antisocial life position formed on this basis. Such mental disorders are stopped with the help of both medications and psycho-corrective measures and labor rehabilitation.

Persons suffering from psychopathic disorders, various mental defects and personality changes are placed in a specialized psychiatric hospital.

4. Psychiatric hospitals of a specialized type with intensive supervision are intended for persons who, according to their mental state, taking into account the act committed, represent a special danger, since such patients are prone to aggressive actions, to a gross violation of the hospital regime (meaning attempts to attack staff, a tendency to escape, suicide, initiation of group riots). For such hospitals, special protection is provided, carried out on the terms and in the manner determined by the Federal Law of May 7, 2009 N 92-FZ "On Ensuring the Protection of Specialized Type Psychiatric Hospitals (Inpatient Hospitals) with Intensive Surveillance".

In psychiatric hospitals of a specialized type with intensive supervision, mentally ill persons are placed, who require constant and intensive supervision and the adoption of special security measures.

Article 101
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.
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.

(Part as amended by Federal Law No. 317-FZ of November 25, 2013. - See previous edition)

Commentary on Article 101 of the Criminal Code of the Russian Federation

1. The grounds for involuntary hospitalization of a person in a psychiatric hospital is the presence of a severe mental disorder in the patient, which causes:

1) immediate danger to himself or others;

2) helplessness, i.e. inability to independently meet the basic needs of life;

3) the possibility of significant harm to health due to the deterioration of the mental state, if the person is left without psychiatric care.

2. The law specifies three types of hospitals:

2) specialized;

3) specialized with intensive supervision.

Types of hospitals differ in the criteria for ensuring the safety of persons under treatment, the regime of their maintenance, the degree of intensity of monitoring of these persons.

Another commentary on article 101 of the Criminal Code of the Russian Federation

1. Compulsory treatment in a psychiatric hospital is a more severe type of compulsory medical measures in comparison with outpatient compulsory observation and treatment by a psychiatrist. The law provides for compulsory treatment in a psychiatric hospital: of a general type; specialized type; specialized type with intensive supervision.

2. Compulsory treatment in a general psychiatric hospital may be imposed on a person who, due to his mental state, needs inpatient treatment and observation, but does not require intensive observation (Part 2 of Article 101 of the Criminal Code).

A feature of a psychiatric hospital of a general type is that this hospital is not specifically designed for the application of compulsory medical measures. This is usually a normal psychiatric hospital. There are no special security measures here, the stationary mode corresponds to typical psychiatric medical institutions. In these institutions, persons who are prescribed compulsory medical treatment are in the same conditions as other patients admitted to a general hospital on a common basis.

Compulsory treatment in a psychiatric hospital of a general type is appointed by the court, taking into account the results of a forensic psychiatric examination. This takes into account the fact that a patient who has committed a socially dangerous act, by the time a decision is made on the type of compulsory medical measures, has no clearly expressed tendencies to gross violations of the hospital regime. At the same time, the likelihood of recurrence of psychosis remains.

3. Compulsory treatment in a psychiatric hospital of a specialized type has a special specificity. In accordance with the law (part 3 of article 101 of the Criminal Code), compulsory treatment in a specialized hospital can be assigned to a person who, due to his mental state, requires constant monitoring. The need for constant monitoring is primarily due to the fact that patients who are assigned this type of compulsory medical measures show (may show) active aggressiveness towards others. Medico-legal features of such patients do not allow them to be left unattended. They are characterized by a tendency to re-commit a socially dangerous act. In addition, the patient's behavior often turns out to be dangerous for himself (auto-aggressive behavior), and here it is impossible to do without outside help.

Constant monitoring concerns almost the entire process of the patient's stay in a specialized psychiatric hospital. This is the stage of drug treatment, and occupational therapy, and social adaptation at the stage of communication with others, etc.

4. Persons who have committed grave and especially grave acts under the Criminal Code of the Russian Federation and who continue to pose a particular danger to themselves and others (refuse treatment, show aggression in against medical staff and other patients, preparing to escape, attempting suicide, etc.). In this medical institution, the maintenance of the regime is carried out by properly trained personnel. Here, it is also permissible to use measures of physical restraint (fixing the patient with the help of special clothing). In order to avoid cases of abuse of this kind of means of deterring aggression, the forms and time of application of measures of physical constraint must be recorded in the relevant medical documents.

(as amended by Federal Law No. 317-FZ of November 25, 2013)

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 supervision that can only be carried out in a medical organization providing psychiatric care in an inpatient setting.
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.
(as amended by Federal Law No. 317-FZ of November 25, 2013)
Compulsory treatment in a medical organization providing psychiatric care in inpatient conditions, of a specialized type, can be assigned to a person who, due to his mental state, requires constant monitoring.
(as amended by Federal Law No. 317-FZ of November 25, 2013)
Compulsory treatment in a medical organization providing psychiatric care in inpatient conditions, of a specialized type with intensive supervision, may be prescribed to a person who, due to his mental state, poses a particular danger to himself or others and requires constant and intensive supervision.
(as amended by Federal Law No. 317-FZ of November 25, 2013)

Commentary on Article 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 maladaptation of the mentally ill, compulsory treatment in hospitals of a general type and in specialized hospitals, as a rule, is carried out at the place of residence of patients or their relatives. As for specialized hospitals with intensive supervision, the peculiarities 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.

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 specialized psychiatric hospitals. 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.