Legal protection of the rights of mentally ill people. What did the struggle for the rights of the mentally ill lead to? The rights of the mentally ill
Upholding the rights of people with mental illness Human rights activists have been working for a long time and persistently. And in Lately laws have appeared that give such people much more freedom and opportunities.
It would seem that one can only rejoice at this. But free will for the mentally ill turns into a huge danger. For others, for loved ones, but first of all - for themselves. Because a mentally ill person, left to his own devices, becomes easy prey for unscrupulous people, and most often for criminals. Especially in our country. The circle closes: in an effort to protect the rights of the patient, on the contrary, he is deprived of the protection he needs so much.
This is that rare case when the sweet word “freedom” has a very bitter aftertaste. I will say more - when it is generally inappropriate.
The Law on psychiatric care and guarantees of citizens' rights during its provision, changes have been made almost every year since the late 90s. They touch on many things. For example, in most cases, psychiatric care in our country is provided only when a person voluntarily turns to specialists. A doctor cannot even simply give an injection to a patient with PND without the patient’s consent. And before starting treatment, the doctor is obliged to tell the patient “about the goals, methods and duration of the recommended treatment, as well as pain, possible risk, side effects and expected results”... However, nowhere is it said who should determine whether the patient is able to correctly understand the doctor...
And getting doctors to hospitalize those whose condition has become dangerous for themselves or those around them is generally a disastrous endeavor.
That is, the mentally ill were given the right to decide for themselves whether to be treated, whether to take medications... But people with a disordered psyche who refused necessary medications, not only destroy themselves, but are sometimes deadly to others. They can commit any crimes, including the most terrible ones. And only after a great disaster can the patient be hospitalized without his consent.
According to many psychiatrists, the struggle for the rights of the mentally ill led, in essence, to the collapse of the system of dynamic monitoring of them - as a result, all more people those with a disturbed psyche were at risk. In 2011, the Constitutional Court of the Russian Federation went even further, adopting a resolution allowing persons suffering from mental disorders to participate in court hearings to declare them incompetent on an equal basis with other participants in the process.
According to the law, bypassing guardians, doctors and guardianship authorities, incompetent citizens can apply to the courts to restore their legal capacity, which they do. Guardians, accordingly, are exempt from protecting sick people.
And that's what's scary. Having become capable, patients with persistent mental disorders receive the right to refuse to visit the ICP, to declare their deregistration and refusal of treatment. Everything is according to the law.
For many, restoring their rights becomes a road to nowhere.
“People with an unhealthy psyche do not consider themselves sick. Having given up the pills, they begin to look for enemies and grab knives - there are enough such cases. Relatives, neighbors, and random passers-by can become enemies,” says the doctor about the results of the ongoing reorganization medical sciences, psychiatrist-criminalist Mikhail Vinogradov. “Without drug support, they will do whatever they want.”
Inga Sergeevna Kulikova (name and surname have been changed), a 74-year-old Muscovite who has long suffered from a severe form of schizophrenia, no longer takes medications. It turned out to be beneficial for someone that she became “healthy” - and now the expert’s conclusion is ready for the court, confirming her adequacy, and soon a decision will be made to recognize Kulikova as legally competent.
Of course: Inga Sergeevna lives alone in a three-room apartment in Moscow.
And if the patient’s adequacy is judged not by expert opinions, but by her behavior and actions, then it becomes clear that Kulikova is a very tasty morsel for apartment swindlers.
* * *
“God forbid I go crazy, no, it’s better to have a staff and a bag” - Pushkin wrote this. But almost more than the mentally ill themselves, their relatives suffer. Responsibility for inadequate, but still loved and close people is a heavy burden that not everyone can bear.
Viktor Kulikov is one of those who survived. In recent years, he has been patiently and tenderly caring for his mother. Inga Sergeevna was declared incompetent in 2011, Victor became her guardian.
“Mom’s problems with her head began 25 years ago,” he says. “She started saying that they were following her, beating her in the subway, putting razors in her shoes, and following her. She burned the materials of her recently defended dissertation. She developed an insurmountable fear of infection - she called the SES, believing that the water was contaminated, and took a dosimeter with her everywhere. I didn’t allow my husband, my father, Georgiy Petrovich, to keep his things in the bathroom, since they were also “infected.” By the way, she simply hated her father, called him an informer, separated herself from him in the room with a curtain, and threw stones at his car. She wrote complaints and statements to the prosecutor's office, the Minister of Defense, the UN, even Prince Charles - against her husband, against me, against her brother. She demanded from all of them that my father be evicted from the apartment. She kept saying that her family wanted to sell her to Arab countries, that they were hanging her from a chandelier by her legs, etc.
In August 1991, Inga left for the village where the Kulikovs have a house. Neighbors called from there and said that she was walking around naked with a backpack on her back, climbing onto the roof and not allowing herself to be filmed. The husband and son called a medical team and took Inga to a psychiatric hospital, where she was diagnosed with “paroxysmal-progressive schizophrenia, affective-delusional attack.”
She was discharged under the guarantee of her husband and registered with PND No. 17.
“Our life turned into a kind of swing,” recalls ex-husband Ingi Georgy Petrovich Kulikov. - For some time, the wife took medication and behaved quietly. Then the aggression and delirium returned. Her hatred for me grew, she demanded a divorce, I considered myself responsible for my wife, but in the end she kicked me out of the house and filed for divorce. I left with only the essentials. The son was already living separately at that time. Inga was left alone in the three-ruble ruble, believing that everything around her belonged to her, and only to her.
Later, the court recognized the ex-husband’s right to half the apartment and house in the village. But he only had housing on paper - Inga changed the locks and shouted through the door that she wouldn’t let anyone in. Georgy Petrovich had to leave the apartment he had earned at one time and rent a room.
“I, of course, could insist on an exchange,” recalls Georgy Petrovich. - But I imagined what would happen to Inga... To move her, real violence would have to be used. I couldn’t agree to this: after all, despite her terrible character and behavior, she is the mother of my child...
After Inga felt like a complete mistress, things began for the housemates. hard times. They tell how a crazy woman poured urine from the windows onto passers-by, at night she pulled the wire in front of the entrance, and in the morning she watched people stumble and fall. Flights of stairs Inga sprinkled powder with broken glass as punishment for the cleaning lady who “cleaned up poorly.” And she wrote, wrote, wrote complaints to various authorities - about her ex-husband, about neighbors at the entrance, about the management of the housing cooperative, about her son, who allegedly keeps weapons and drugs at home, called riot police to his address, etc. 
Behind Last year Inga Sergeevna became addicted to alcohol.
“I have been living in an apartment since 2004. Until 2010, Kulikova did not let us live,” says Nastya, Inga Sergeevna’s neighbor. “At least once a week she called the local police officer and stated that I was a Mujahideen, Ukrainian or Belarusian. In short, the enemy. A squad arrived with machine guns, and I was pregnant at that time. Inga Sergeevna said that my husband and I “buried a child” under the windows, that I had a T-shirt with radioactive signs, that we sprinkled various mixtures with radiation on it. She accused us of climbing into her window every odd day at the beginning of the month, and climbing out a few days later. These days we steal from her bed sheets and medicines. She asked my husband to pull out snakes, etc., from under her bed.
Only at the end of 2010 was Inna able to be hospitalized - after her neighbors contacted the police with a collective letter. After long-term treatment and observations in the hospital. Gannushkina and in the 10th psychiatric hospital in 2011, she was declared legally incompetent, since the mental illness had no longer become paroxysmal, but continuous.
At the end of 2011, the woman returned home. The son, who took on the duties of a guardian, constantly came, looked after her, made sure that her mother visited doctors and took medications, fully supported her, and took her for walks and to the village. It seemed that everyone had somehow adapted to the difficult life with a mentally ill patient...
* * *
About a year ago, a new wave began in Inga Sergeevna’s condition: the 74-year-old woman developed an uncontrollable sexual attraction to young men. Products from sex shops and related literature began to appear in the apartment. Without hesitation, the mother began to turn to her son with requests to find her a “cowboy” for an intimate relationship...
Then she moved from talk to action. Neighboring young men from the category of those who are called asocial personalities often visited her home.
“I didn’t know what to do,” says son Victor. “Mom began to see me as an enemy who stood in her way to happiness. At first, she studied dating advertisements, hoping for a long-term relationship with a wealthy man. Then she began to become more and more fixated on intimacy itself. Neighbors reported that drunk men often come out of her apartment and spend the night there. Then, in an indecent state, they lie on the floor in the common vestibule. The guests extorted money from the pensioner and demanded that she buy vodka and beer. And it’s scary to remember her partners in the village where her mother spends the summer. Completely degraded homeless people with whom she drank alcohol and “consoled” almost every day.
Nastya, a neighbor next door, says: “For the past year now, men of about forty, drunk, dirty, smelly, looking like homeless people or drug addicts, have been constantly visiting her at night. They talk loudly and make noise, so I hear them coming. Early in the morning, around seven o'clock, they leave the apartment. Then they sit in our yard all day, smoke, drink, and wait until evening to go to Kulikova. They discuss her among themselves, they say that she is a crazy old woman, she is ready to do anything for the sake of intimacy. She buys them alcohol, food, and demands that they do this with her all night. They boast that they will soon move into her apartment. Inga Sergeevna has changed a lot this year, she has dropped. She was well-groomed, but now she is becoming like her drinking buddies...
By the way, none of the drugs prescribed by PND No. 17, where Kulikova is observed, can be combined with alcohol. Inga Sergeevna knows this and prefers alcohol - it helps to improve her personal life...
Victor repeatedly informed the attending physician T.V. Peregudin about what was happening to his mother. and guardianship authorities: “...due to the patient’s refusal to take medications prescribed by doctor PND No. 17, her mental state has deteriorated significantly... Kulikova I.S. needs supervision by a psychiatrist at a dispensary, as well as psychiatric care in outpatient setting, she was recommended to continue taking drug therapy, but the patient does not take any of the prescribed medications.”
* * *
But it turned out that this is not the worst thing.
Thunder struck in the spring of 2015, when Victor learned that his mother, who was in the already described “excellent” condition, filed an application with the Tushinsky District Court to recognize her as legally competent.
Who helped Inga Sergeevna collect all the documents? Who taught her how to write a statement correctly? Who put her in touch with lawyer Lomteva, who took on this case?
Further more. At dispensary No. 17, the district doctor Peregudina, who knew Inga Sergeevna well, quit. And the new doctor E.A. Kochurina, who observed her for only three weeks, concluded that the patient with a continuous course of chronic mental disorder was experiencing “stable remission.”
“All through May 2015, I ran to the PND, trying to get an appointment with the new district police officer to tell me what was really happening,” says Victor, “but Dr. Kochurina categorically refused to meet with me.
Further - even more. The examination ordered by the court was carried out at the Center. Serbian. Victor says that on the day of the examination, they prevented him from going with his mother in every possible way; they demanded that he give her his passport, although all the other subjects of the examination went through with their guardians and relatives without hindrance.
For such an important examination, the center needed only a few hours. No surveillance. No analysis of documents about the extremely painful and ridiculous behavior of a very elderly patient. There just happened a miraculous transformation of a woman suffering from a chronic and protracted mental disorder with persistent painful manifestations, into absolutely normal person. Experts recognized Kulikova as unexpectedly cured. With full criticism and understanding of what she is doing.
And further important point. Someone clearly prepared Kulikova to communicate with the commission of experts. In her notes made in the spring of 2015, Victor found a multi-page “cheat sheet” on how to behave during the examination at the Serbsky Center. And the woman tried very hard to follow the recommendations.
From the conclusion:
“The expert characterizes herself as calm, non-conflict, and indicates that she prefers to resolve complex issues “by good reasoning“,” “always thinks about her actions,” emphasizes that she “likes to live positively”... Indicates that she currently leads an active lifestyle, takes full care of herself, strives to improve herself, reads books, goes to literary evenings.”
And - no reaction to any document that would prevent Kulikova from being restored to legal capacity. On Inga Sergeevna’s painful sexual behavior, her connections with degenerate alcoholics and the emerging craving for alcohol. To her own statements that she was allowed to rent out Georgy Petrovich’s room to a young resident of Tula at the PND, and her husband’s cousin (?!) also gave his consent. In response to Kulikova’s claim that her ex-husband registered her with the PND in order not to repay a debt in the amount of 9,000 rubles, which were allegedly given to him in the late 80s. Her plans to fight in court with the head of Sberbank German Gref, because the “electronic queue” introduced by Sberbank is her invention, which Gref “stole” from her. The intention, having become legally capable, is to start suing almost all relatives and relatives of relatives, because they are all rich and greedy... 
At the same time, from the board of the housing cooperative of the house where the “non-conflict” and “emotionally restrained” Kulikova lives, complaints are received from her guardian Viktor:
“... your ward Kulikova I.S. pours out the products of his own vital activity on the landing of the first floor and in the elevator... places unknown substances near mailboxes, motivating his actions by the need to fight rats and dogs.”
For some reason, all these facts from documents and court records did not become the subject of research by experts, and there is not a word about them in the conclusion.
* * *
Despite the right of the legal representative to familiarize himself with all the materials of the case, including documents on the state of health of his mother and ward, Judge Moiseeva persistently does not allow the guardian to familiarize himself with the medical records and does not attach to the case those documents that would be very important for the experts to read.
Viktor Kulikov has repeatedly applied to Judge Moiseeva to provide him with copies of the medical record from PND No. 17, where his mother is being observed, and where it should be reflected how changes occurred in the consciousness of the once seriously ill patient.
The applications were denied.
Everything suggests that there are interested parties in this matter. The scheme is well known: a mentally ill grandmother is given back her legal capacity and passport, and married to one of her favorite “cowboys.” Then the “young wife” will be persuaded to transfer her share of the apartment to the so-called. husband, after which it will be removed forever, the housing will be occupied, and the co-owner of the apartment, Georgy Petrovich, will have no choice but to transfer his share to the scammers for symbolic money. All this is a classic of the genre, as a result of which the housing ends up with the author of the entire scam.
“For almost a year now, Mikhail, born in 1974, has been regularly visiting his mother during the day and at night,” says Victor. - This is confirmed, among other things, by recordings from the CCTV camera at the entrance. This comrade does not work, drinks alcohol, moves in a criminal environment, and is registered with the PND. He drinks and eats at his mother's expense, and has sex with her. intimate relationships, regularly receives money from her. She also has another boyfriend - Maxim, born in 1967. He knows that his mother is mentally ill, but neither he nor his friends care. Alcohol as a condition for sex is what he needs. He not only comes himself, but also brings his drinking companions to her for drinking and sexual intercourse.
Victor wrote a statement about this to the local police department.
And on October 2 of this year, when the son came to visit his mother, at the door of her apartment he found a strong man behind him. He explained his presence in the entrance by the fact that he, being a student at VGIK, was filming the windows of Inna Sergeevna’s apartment, where there were still old frames. Victor was unable to find out why he had to go into the entrance to do this. But we managed to find a note: “Call this phone, you won’t regret it”...
It is difficult to understand where in this story the negligence and indifference of government agencies ends, and where crime begins. But it seems like both are happening. We really hope that specialists both in the field of psychiatry and the law enforcement system will understand all its details.
In the interests of Inga Sergeevna. In the interests of her family and neighbors. It is in the interests of all Moscow residents, each of whom may be unexpectedly affected by the fact that a mentally ill person is left to his own devices.
In this case, everyone’s interests coincide. They do not coincide only with the interests of criminals.
Reference
According to research, most criminals have various types of mental disorders. According to the results of forensic psychiatric examinations, almost 70% of convicts were found to have neuropsychiatric disorders. Among murderers, more than 71% have various mental illnesses.
Reference
According to the chief psychiatrist of the Ministry of Health of the Russian Federation, Zurab Kekelidze, in Russia the number of people suffering from mental disorders (who are registered) exceeds four million. At the same time the doctor Science Center mental health at the Research Institute of Psychiatry of the Ministry of Health of the Russian Federation, Olga Shchelokova says that in our country there are about 21 million 680 thousand people with mental illnesses, which is 14% of the Russian population.
For the first time, “Regulations on the conditions and procedure for providing psychiatric care aimed at protecting the rights of the mentally ill” were adopted by the Decree of the Presidium of the Supreme Soviet of the USSR on January 5, 1988. Subsequently (1993), a special law “On psychiatric care and guarantees of the rights of citizens” was adopted when providing it,” according to which qualified psychiatric care is provided free of charge, taking into account all the achievements of science and practice. This law is based on regulations according to which the dignity of the patient must not be violated when providing psychiatric care. This law also regulates the procedure for conducting psychiatric examinations. This law states that psychiatric examination and preventive examinations are carried out only at the request or with the consent of the person being examined, and examinations and examinations of a minor under 15 years old - at the request or with the consent of his parents or legal representative.
When conducting a psychiatric examination, the doctor is obliged to introduce himself to the patient, as well as his legal representative, as a psychiatrist. The exception is those cases when the examination can be carried out without the consent of the subject or his legal representative: in the presence of a severe mental disorder with an immediate danger of the patient to himself and others, if the subject is under dispensary observation. Outpatient psychiatric care for persons with mental illnesses is provided depending on medical indications and is carried out in the form of consultative and therapeutic care and dispensary observation.
Persons with mental disorders are placed under dispensary observation, regardless of their consent or the consent of their legal representative (in cases where they are declared legally incompetent). At the same time, the attending physician constantly monitors the state of their mental health through regular examinations and provision of the necessary medical and social assistance.
In cases inpatient treatment patient with mental disorders must consent to this treatment in writing, with the exception of patients undergoing compulsory treatment by court decision, as well as patients involuntarily hospitalized by law enforcement agencies. Without the consent of the patient, i.e. involuntarily, persons with mental disorders that make them dangerous to themselves and others, as well as patients in conditions where they are unable to satisfy basic life needs (for example, catatonic stupor, severe dementia) and can cause significant harm to their health due to deterioration mental state if they are left without psychiatric help.
A patient admitted to a hospital as a result of involuntary hospitalization must be examined within 48 hours by a commission of doctors, which determines the validity of hospitalization. In cases where hospitalization is considered justified, the commission’s conclusion is submitted to the court to decide the issue of the patient’s further stay in the hospital at the location of the hospital.
The patient's involuntary stay in a psychiatric hospital lasts as long as the reasons for the involuntary hospitalization remain (aggressive actions due to delusions and hallucinations, active suicidal tendencies).
To extend involuntary hospitalization, a re-examination by the commission is carried out once a month for the first six months, and then once every 6 months.
Recognizing the high value for every person of health in general and mental health in particular; considering that 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 and 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 the republics within the Russian Federation, as well as legal acts of the autonomous region, autonomous districts, territories, regions, cities of 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 the guarantees of their observance in the provision of psychiatric 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 nature of seeking psychiatric help
(1) Psychiatric assistance 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;
all types of treatment (including sanatorium-resort) according to medical indications;
provision of psychiatric care in conditions that meet sanitary and hygienic requirements;
preliminary consent and refusal at any stage from use as a test object medical supplies and methods scientific research or educational process, from photography, video or filming;
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) Restriction of the rights and freedoms of persons suffering from mental disorders solely on the basis of a psychiatric diagnosis, the facts of being under dispensary observation in a psychiatric hospital or in a psychoneurological institution for social security or special education is not allowed. Officials those guilty of such violations are liable in accordance with the legislation of the Russian Federation and the republics within the Russian Federation.
Article 6. Limitations of execution individual species professional activity and activities related to the source increased danger
(1) A citizen may be temporarily (for a period of no more than five years and with the right of subsequent re-examination) declared unfit to perform certain types of professional activities and activities associated with a source of increased danger due to a mental disorder. 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 providing 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
psychiatric hospital or psychoneurological institution for social security 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. Administration of the institution,
providing psychiatric care, ensures the possibility of inviting 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.
When a citizen exercises his rights and freedoms, demands to provide information about the state of his mental health or to be examined 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 whether a citizen has a mental disorder, 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 moral, cultural, political or religious values accepted in society or on other reasons not directly 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 medicinal purposes according to the nature of the disorder and should not be used to punish a person suffering from a mental disorder or for the benefit of others.
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 incompetent in accordance with the procedure established by law, 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 RSFSR, as well as in the event 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.
(5) In relation to the persons specified in part four of this article, the use of surgical and other methods that cause irreversible consequences for the treatment of mental disorders, 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 medical measures
(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 RSFSR and the Criminal Procedure Code of the RSFSR.
(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 resolve the issue of a citizen’s suitability for service as a military personnel
The grounds and procedure for outpatient and inpatient examinations when deciding on the suitability of a citizen, based on the state of 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 are determined this Law and the legislation of the Russian Federation on military service.
SECTION II
PROVIDING PSYCHIATRIC CARE AND SOCIAL PROTECTION FOR PERSONS SUFFERING WITH MENTAL DISORDERS
Article 16. Types of psychiatric care and social protection, guaranteed by the state
(1) The state guarantees:
emergency psychiatric care; consultative, diagnostic, therapeutic,
psychoprophylactic, rehabilitation assistance in out-of-hospital and inpatient conditions;
all types of psychiatric examination, determination of temporary disability;
social assistance and assistance in employment of persons suffering from mental disorders;
resolving custody issues;
consultations on legal issues and other types of legal assistance in psychiatric and psychoneurological institutions;
social services for the disabled and elderly,
those suffering from mental disorders, as well as caring for them; training for people with disabilities and minors suffering
mental disorders;
psychiatric assistance during natural disasters and catastrophes.
(2) To provide for persons suffering from mental
disorders, psychiatric care and their social protection, the state:
creates all types of institutions providing out-of-hospital and inpatient psychiatric care, if possible at the place of residence of patients;
organizes general education and professional education minors suffering from mental disorders;
creates medical and industrial enterprises for labor
therapy, training in new professions and employment at these enterprises of persons suffering from mental disorders, including people with disabilities, as well as special production, workshops or areas with easier working conditions for such persons;
establishes mandatory quotas of jobs in enterprises, institutions and organizations for the employment of persons suffering from mental disorders;
applies methods of economic stimulation for
enterprises, institutions and organizations providing jobs for people suffering from mental disorders;
creates hostels for people suffering from mental disorders who have lost social ties;
takes other measures necessary for social support persons suffering from mental disorders.
(3) Providing all types of psychiatric care and social protection to persons suffering from mental disorders is carried out by federal bodies of state power and administration, bodies of state power and administration of republics within the Russian Federation, autonomous region, autonomous districts, territories, regions, the cities of Moscow and St. -Petersburg, local government bodies in accordance with their competence determined by the legislation of the Russian Federation.
Article 17. Financing of mental health care
Financing of the activities of institutions and persons providing psychiatric care is carried out from the healthcare fund, medical insurance fund and other sources not prohibited by the legislation of the Russian Federation, in amounts that ensure a guaranteed level and high quality psychiatric care.
SECTION III
INSTITUTIONS AND PERSONS PROVIDING PSYCHIATRIC CARE. RIGHTS AND OBLIGATIONS OF MEDICAL WORKERS AND OTHER SPECIALISTS
Article 18. Institutions and persons providing psychiatric care
(1) Psychiatric care is provided by state, non-state psychiatric and psychoneurological institutions and privately practicing psychiatrists who have received permission to do so. The procedure for issuing licenses to provide mental health services is established by the legislation of the Russian Federation.
(2) Types of psychiatric care provided by psychiatric and psychoneurological institutions or private practicing psychiatrists are indicated in statutory documents or licenses; information about them should be available to visitors.
Article 19. The right to provide mental health care
(1) The right to medical practice to provide
psychiatric assistance is provided by a psychiatrist who has received a higher education medical education and has confirmed his qualifications in the manner established by the legislation of the Russian Federation.
(2) Other specialists and medical personnel involved in the provision of psychiatric care must, in the manner established by the legislation of the Russian Federation, undergo special training and confirm their qualifications for admission to work with persons suffering from mental disorders.
(3) The activities of a psychiatrist, other specialists and medical personnel in providing psychiatric care are based on professional ethics and are carried out in accordance with the law.
Article 20. Rights and obligations of medical workers and other specialists when providing mental health care
(1) Professional rights and obligations of a psychiatrist, other specialists and medical personnel when providing
psychiatric care are established by the legislation of the Russian Federation on healthcare and this Law.
(2) Establishing a diagnosis of mental illness, making a decision to provide psychiatric care on an involuntary basis, or issuing an opinion to consider this issue is the exclusive right of a psychiatrist or a commission of psychiatrists.
(3) The conclusion of a doctor of another specialty on the state of mental health of a person is preliminary in nature and is not the basis for deciding the issue of limiting his rights and legitimate interests, as well as for providing him with benefits provided by law for persons suffering from mental disorders.
Article 21. Independence of a psychiatrist in the provision of psychiatric care
(1) When providing psychiatric care, a psychiatrist is independent in his decisions and is guided only by medical indications, medical duty and the law.
(2) A psychiatrist whose opinion does not coincide with the decision of the medical commission has the right to give his opinion, which is attached to the medical documentation.
Article 22. Guarantees and benefits for psychiatrists, other specialists, medical and other personnel involved in the provision of mental health care
Psychiatrists, other specialists, medical and other personnel involved in the provision of psychiatric care are entitled to benefits, established by law of the Russian Federation for persons engaged in activities in special working conditions, and are also subject to compulsory state insurance in the event of harm to their health or death in the performance of official duties.
In the event of harm to health resulting in temporary loss of ability to work of a person involved in the provision of psychiatric care, he is paid an insurance amount within the limits of his annual monetary allowance depending on the severity of the damage caused. Upon the occurrence of disability, the insurance amount is paid in the amount of an annual to five-year salary, depending on the degree of disability of the person, and in the event of his death, the insurance amount is paid to his heirs in the amount of ten times the annual salary.
SECTION IV
TYPES OF PSYCHIATRIC CARE AND PROCEDURE FOR ITS PROVISION
Article 23. Psychiatric examination
(1) A psychiatric examination is carried out to determine whether the person being examined suffers from a mental disorder, whether he needs psychiatric help, as well as to decide on the type of such help.
(2) Psychiatric examinations, as well as preventive examinations, are carried out at the request or with the consent of the person being examined; in relation to a minor under the age of 15 - at the request or with the consent of his parents or other legal representative; in relation to a person recognized as legally incompetent - at the request or with the consent of his legal representative. If one of the parents objects or in the absence of parents or other legal representative, the examination of the minor is carried out by decision of the guardianship and trusteeship authority, which can be appealed to the court.
(3) A doctor conducting a psychiatric examination is obliged to introduce himself to the subject and his legal representative as a psychiatrist, except for the cases provided for in paragraph “a” of part four of this article.
(4) A psychiatric examination of a person may be carried out without his consent or without the consent of his legal representative in cases where, according to available data, the person being examined commits actions that give reason to assume that he has a severe mental disorder, which causes:
a) his immediate danger to himself or others, or b) his helplessness, that is, his inability to independently satisfy the basic needs of life, or
(5) A psychiatric examination of a person may be carried out without his consent or without the consent of his legal representative if the person being examined is under dispensary observation on the grounds provided for in part one of Article 27 of this Law.
(6) The data of the psychiatric examination and the conclusion about the state of mental health of the subject are recorded in the medical documentation, which also indicates the reasons for contacting a psychiatrist and medical recommendations.
Article 24. Psychiatric examination of a person without his consent or without the consent of his legal representative
(1) In the cases provided for in paragraph “a” of part four and part five of Article 23 of this Law, the decision on a psychiatric examination of a person without his consent or without the consent of his legal representative is made by a psychiatrist independently.
(2) In the cases provided for in paragraphs “b” and “c” of part four of Article 23 of this Law, a decision on a psychiatric examination of a person without his consent or without the consent of his legal representative is made by a psychiatrist with the approval of a judge.
Article 25. The procedure for filing an application and making a decision on a psychiatric examination of a person without his consent or without the consent of his legal representative
(1) The decision on a psychiatric examination of a person without his consent or without the consent of his legal representative, except for the cases provided for in part five of Article 23 of this Law, is made by a psychiatrist upon an application containing information about the existence of grounds for such an examination listed in part four Article 23 of this Law.
(2) An application may be submitted by relatives of a person subject to a psychiatric examination, by a doctor of any medical specialty, officials and other citizens.
(3) In urgent cases, when, according to information received, a person poses an immediate danger to himself or others, the statement may be oral. The decision on a psychiatric examination is made immediately by a psychiatrist and is recorded in the medical documentation.
(4) If there is no immediate danger of a person to himself or others, the application for a psychiatric examination must be in writing, contain detailed information justifying the need for such an examination and an indication of the refusal of the person or his legal representative to consult a psychiatrist. A psychiatrist has the right to request additional information necessary to make a decision. Having established that the application does not contain data indicating the presence of circumstances provided for in paragraphs “b” and “c” of part four of Article 23 of this Law, the psychiatrist, in writing, with reason, refuses a psychiatric examination.
(5) Having established the validity of an application for a psychiatric examination of a person without his consent or without the consent of his legal representative, the psychiatrist sends to the court at the place of residence of the person his written reasoned conclusion on the need for such an examination, as well as an application for examination and other available materials. The judge decides whether to issue a sanction within three days from the receipt of all materials. The actions of a judge can be appealed to a court in the manner established by the Civil Procedure Code of the RSFSR.
Article 26. Types of outpatient psychiatric care
(1) Outpatient psychiatric care for a person suffering from a mental disorder, depending on medical indications, is provided in the form of consultative and therapeutic care or dispensary observation.
(2) Consultative and therapeutic assistance is provided by a psychiatrist upon independent treatment of a person suffering from a mental disorder, at his request or with his consent, and in relation to a minor under the age of 15 years - at the request or with the consent of his parents or other legal representative.
(3) Dispensary observation may be established regardless of the consent of a person suffering from a mental disorder or his legal representative in the cases provided for in part one of Article 27 of this Law, and involves monitoring the state of the person’s mental health through regular examinations by a psychiatrist and providing him with the necessary medical care. and social assistance.
Article 27. Dispensary observation
(1) Dispensary observation may be established for a person suffering from a chronic and protracted mental disorder with severe, persistent or frequently exacerbating painful manifestations.
(2) The decision on the need to establish dispensary observation and its termination is made by a commission of psychiatrists appointed by the administration of a psychiatric institution providing outpatient psychiatric care, or by a commission of psychiatrists appointed by a health care authority.
(3) The reasoned decision of the commission of psychiatrists is documented in the medical documentation. The decision to establish or terminate dispensary observation may be appealed in the manner established by Section VI of this Law.
(4) Previously established dispensary observation is terminated upon recovery or significant and persistent improvement in the mental state of the person. After the termination of dispensary observation, outpatient psychiatric care, at the request or with the consent of the person or at the request or with the consent of his legal representative, is provided in a consultative and therapeutic form. If there is a change in mental state, a person suffering from a mental disorder may be examined without his consent or without the consent of his legal representative on the grounds and in the manner provided for in part four of Article 23, Articles 24 and 25 of this Law. Dispensary observation can be resumed in such cases by decision of a commission of psychiatrists.
Article 28. Grounds for hospitalization in a psychiatric hospital
(1) The grounds for hospitalization in a psychiatric hospital are the presence of a mental disorder and the decision of a psychiatrist to conduct an examination or treatment in an inpatient setting, or a judge’s decision.
(2) The basis for placement in a psychiatric hospital may also be the need to conduct a psychiatric examination in cases and in the manner established by the laws of the Russian Federation.
(3) The placement of a person in a psychiatric hospital, with the exception of cases provided for in Article 29 of this Law, is carried out voluntarily - at his request or with his consent.
(4) A minor under the age of 15 is placed in a psychiatric hospital at the request or with the consent of his parents or other legal representative. A person recognized as legally incompetent is placed in a psychiatric hospital at the request or with the consent of his legal representative. If one of the parents objects or in the absence of parents or other legal representative, the placement of a minor in a psychiatric hospital is carried out by decision of the guardianship and trusteeship authority, which can be appealed to the court.
(5) The consent obtained for hospitalization is documented by an entry in the medical documentation signed by the person or his legal representative and a psychiatrist.
Article 29. Grounds for involuntary hospitalization in a psychiatric hospital
A person suffering from a mental disorder may be hospitalized in a psychiatric hospital without his consent or without the consent of his legal representative until a judge’s decision, if his examination or treatment is possible only in an inpatient setting, and the mental disorder is severe and causes:
a) his immediate danger to himself or others, or
b) his helplessness, that is, his inability to independently satisfy the basic needs of life, or
c) significant harm to his health due to a deterioration in his mental state if the person is left without psychiatric help.
Article 30. Security measures when providing mental health care
(1) Inpatient psychiatric care is provided in the least restrictive conditions that ensure the safety of the hospitalized person and other persons, subject to medical personnel his rights and legitimate interests.
(2) Measures of physical restraint and isolation during involuntary hospitalization and stay in a psychiatric hospital are applied only in those cases, forms and for that period of time when, in the opinion of a psychiatrist, it is impossible by other methods to prevent the actions of a hospitalized person that pose an immediate danger to him or other persons, and are carried out under the constant supervision of medical personnel. The forms and time of application of physical restraint or isolation measures are recorded in the medical documentation.
(3) Police officers are obliged to assist medical workers during involuntary hospitalization and ensure safe conditions for access to and examination of a hospitalized person. In cases where it is necessary to prevent actions, life-threatening and the health of others on the part of the person being hospitalized or other persons, as well as if it is necessary to search for and detain a person subject to hospitalization, police officers act in the manner established by the Law of the RSFSR “On the Police”.
Article 31. Examination of minors and persons declared incompetent, placed in a psychiatric hospital at the request or with the consent of their legal representatives
(1) A minor under the age of 15 years and a person recognized as legally incompetent, placed in a psychiatric hospital at the request or with the consent of their legal representatives, are subject to mandatory examination by a commission of psychiatrists of a psychiatric institution in the manner prescribed by part one of Article 32 of this Law. During the first six months, these persons are subject to examination by a commission of psychiatrists at least once a month to decide on the extension of hospitalization. When hospitalization is extended beyond six months, examinations by a commission of psychiatrists are carried out at least once every six months.
(2) If a commission of psychiatrists or the administration of a psychiatric hospital discovers abuses committed during hospitalization by the legal representatives of a minor under 15 years of age or a person recognized as legally incompetent, the administration of the psychiatric hospital notifies the guardianship and trusteeship authority at the place of residence. ward.
Article 32. Examination of persons placed in a psychiatric hospital involuntarily
(1) A person placed in a psychiatric hospital on the grounds provided for in Article 29 of this Law is subject to mandatory examination within 48 hours by a commission of psychiatrists of a psychiatric institution, which decides on the validity of hospitalization. In cases where hospitalization is considered unfounded and the hospitalized person does not express a desire to remain in a psychiatric hospital, he is subject to immediate discharge.
(2) If hospitalization is recognized as justified, then the conclusion of the commission of psychiatrists is sent within 24 hours to the court at the location of the psychiatric institution to decide the issue of the person’s further stay in it.
Article 33. Appeal to court on the issue of involuntary hospitalization
(1) The issue of involuntary hospitalization of a person in a psychiatric hospital on the grounds provided for in Article 29 of this Law is decided in court at the location of the psychiatric institution.
(2) An application for involuntary hospitalization of a person in a psychiatric hospital is submitted to the court by a representative of the psychiatric institution in which the person is located.
The application, which must indicate the legal grounds for involuntary hospitalization in a psychiatric hospital, must be accompanied by a reasoned opinion of a commission of psychiatrists on the need for the person’s continued stay in a psychiatric hospital.
(3) By accepting the application, the judge simultaneously gives permission for the person to stay in a psychiatric hospital for the period necessary to consider the application in court.
Article 34. Consideration of an application for involuntary hospitalization
(1) A judge shall consider an application for involuntary hospitalization of a person in a psychiatric hospital within five days from the date of its acceptance on the premises of the court or in a psychiatric institution.
(2) A person must be given the right to personally participate in the judicial consideration of his hospitalization. If, according to information received from a representative of a psychiatric institution, the mental state of a person does not allow him to personally participate in the consideration of the issue of his hospitalization in the courthouse, then the application for hospitalization is considered by a judge in a psychiatric institution.
(3) Participation in the consideration of the application of the prosecutor, a representative of the psychiatric institution applying for hospitalization, and a representative of the person in respect of whom the issue of hospitalization is being decided is mandatory.
Article 35. Judge’s decision on an application for involuntary hospitalization
(1) Having considered the application on its merits, the judge grants or rejects it.
(2) The judge’s decision to satisfy the application is the basis for hospitalization and further detention of the person in a psychiatric hospital.
(3) The judge’s decision, within ten days from the date of issuance, may be appealed by a person placed in a psychiatric hospital, his representative, the head of a psychiatric institution, as well as an organization that is granted the right by law or its charter (regulations) to protect the rights of citizens, or by a prosecutor in accordance with the procedure , provided for by the Civil Procedure Code of the RSFSR.
Article 36. Involuntary extension of hospitalization
(1) A person’s involuntary stay in a psychiatric hospital continues only as long as the grounds for which the hospitalization was carried out persist.
(2) A person placed in a psychiatric hospital involuntarily, during the first six months, at least once a month, is subject to examination by a commission of psychiatrists of the psychiatric institution to decide on the extension of hospitalization. When hospitalization is extended beyond six months, examinations by a commission of psychiatrists are carried out at least once every six months.
(3) After six months from the date of involuntary placement of a person in a psychiatric hospital, the conclusion of a commission of psychiatrists on the need to extend such hospitalization is sent by the administration of the psychiatric hospital to the court at the location of the psychiatric institution. The judge, in accordance with the procedure provided for in Articles 33 - 35 of this Law, may, by order, extend hospitalization. In the future, the decision to extend the hospitalization of a person placed in a psychiatric hospital involuntarily is made by a judge annually.
Article 37. Rights of patients in psychiatric hospitals
(1) The patient must be explained the reasons and purposes of his placement in a psychiatric hospital, his rights and the rules established in the hospital in the language he speaks, which is recorded in the medical documentation.
(2) All patients undergoing treatment or examination in a psychiatric hospital have the right to:
contact directly the chief physician or head of the department regarding treatment, examination, discharge from a psychiatric hospital and compliance with the rights granted by this Law;
submit uncensored complaints and statements to the bodies of representative and executive power, the prosecutor's office, the court and the lawyer;
meet with a lawyer and a clergyman alone; perform religious ceremonies, observe religious canons, including fasting, and, in agreement with the administration, have religious paraphernalia and literature;
subscribe to newspapers and magazines;
receive education according to the program of a general education school or a special school for children with intellectual disabilities, if the patient is under 18 years of age;
receive, on an equal basis with other citizens, remuneration for work in accordance with its quantity and quality, if the patient participates in productive work.
(3) Patients also have the following rights, which may be limited on the recommendation of the attending physician by the head of the department or chief physician in the interests of the health or safety of patients, as well as in the interests of the health or safety of other persons:
conduct correspondence without censorship;
receive and send parcels, parcels and money transfers;
use the telephone;
receive visitors;
have and purchase basic necessities, use their own clothing.
(4) Paid services(individual subscriptions to newspapers and magazines, communication services, etc.) are carried out at the expense of the patient to whom they are provided.
Article 38. Service for protecting the rights of patients in psychiatric hospitals
(1) The state shall create a service to protect the rights of patients in psychiatric hospitals, independent of the health authorities.
(2) Representatives of this service protect the rights of patients in psychiatric hospitals, accept their complaints and statements, which are resolved with the administration of this psychiatric institution or sent, depending on their nature, to the bodies of representative and executive power, the prosecutor's office or the court.
Article 39. Responsibilities of the administration and medical staff of a psychiatric hospital
The administration and medical staff of a psychiatric hospital are obliged to create conditions for the exercise of the rights of patients and their legal representatives provided for by this Law, including:
provide for those in a psychiatric hospital
patients needed medical care;
provide the opportunity to familiarize yourself with the text of this Law, the internal regulations of a given psychiatric hospital, addresses and telephone numbers of state and public bodies, institutions, organizations and officials who can be contacted in case of violation of the rights of patients;
provide conditions for correspondence, sending complaints and statements from patients to representative and executive authorities, the prosecutor's office, the court, and also to a lawyer;
within 24 hours from the moment the patient is admitted to a psychiatric hospital on an involuntary basis, take measures to notify his relatives, legal representative or other person at his direction;
inform the patient’s relatives or legal representative, as well as another person at his direction, about changes in his health status and emergency incidents with him;
ensure the safety of hospitalized patients,
control the contents of parcels and transfers;
act as a legal representative in relation to
patients recognized as legally incompetent, but who do not have such a representative;
establish and explain to religious patients the rules that must be observed in the interests of other patients in a psychiatric hospital during the performance of religious rites, and the procedure for inviting a clergyman, to promote the exercise of the right to freedom of conscience of believers and atheists; perform other duties established by this Law.
Article 40. Discharge from a psychiatric hospital
(1) A patient is discharged from a psychiatric hospital in cases of recovery or improvement in his mental state, in which no further inpatient treatment is required, as well as completion of the examination or examination that served as the basis for placement in the hospital.
(2) The discharge of a patient who is voluntarily staying in a psychiatric hospital is carried out upon his personal application, the application of his legal representative or the decision of the attending physician.
(3) The discharge of a patient hospitalized in a psychiatric hospital involuntarily is carried out based on the conclusion of a commission of psychiatrists or a judge’s decision to refuse to extend such hospitalization.
(4) Discharge of a patient to whom compulsory medical measures have been applied by court decision is carried out only by court decision.
(5) A patient placed in a psychiatric hospital voluntarily may be refused discharge if the commission of psychiatrists of the psychiatric institution establishes the grounds for involuntary hospitalization provided for in Article 29 of this Law. In this case, the issues of his stay in a psychiatric hospital, extension of hospitalization and discharge from the hospital are resolved in the manner established by Articles 32 - 36 and part three of Article 40 of this Law.
Article 41. Grounds and procedure for placing persons in psychoneurological institutions for social security
(1) The grounds for placement in a psychoneurological institution for social security are a personal statement of a person suffering from a mental disorder and the conclusion of a medical commission with the participation of a psychiatrist, and for a minor under the age of 18 or a person recognized as legally incompetent - a decision of the guardianship and trusteeship body made on the basis of the conclusion of a medical commission with the participation of a psychiatrist. The conclusion must contain information about the presence of a mental disorder in a person that deprives him of the opportunity to stay in a non-specialized institution for social security, and in relation to a competent person - also about the absence of grounds for raising the question of declaring him incompetent before the court.
(2) The guardianship and trusteeship authority is obliged to take measures to protect the property interests of persons placed in psychoneurological institutions for social security.
Article 42. Grounds and procedure for placing minors in a psychoneurological institution for special education
The grounds for placing a minor under the age of 18 suffering from a mental disorder in a psychoneurological institution for special education are the application of his parents or other legal representative and the mandatory conclusion of a commission consisting of a psychologist, teacher and psychiatrist. The conclusion must contain information about the need for the minor to be educated in a special school for children with intellectual disabilities.
Article 43. Rights of persons living in psychoneurological institutions for social security or special education, and responsibilities of the administration of these institutions
(1) Persons living in psychoneurological institutions for social security or special education enjoy the rights provided for in Article 37 of this Law.
(2) The responsibilities of the administration and staff of a psychoneurological institution for social security or special training to create conditions for the realization of the rights of persons living in it are established by Article 39 of this Law, as well as the legislation of the Russian Federation on social security and education.
(3) The administration of a psychoneurological institution for social security or special education is obliged to conduct examinations of persons living in it at least once a year by a medical commission with the participation of a psychiatrist in order to decide the issue of their further maintenance in this institution, as well as the possibility reviewing decisions on their incapacity.
Article 44. Transfer and discharge from a psychoneurological institution for social security or special education
(1) Grounds for transfer of a person from a psychoneurological institution for social security or special education to a similar institution general type is the conclusion of a medical commission with the participation of a psychiatrist about the absence of medical indications for living or studying in a specialized psychoneurological institution.
(2) Discharge from a psychoneurological institution for social security or special education is carried out:
upon a personal application of a person in the presence of a conclusion from a medical commission with the participation of a psychiatrist stating that for health reasons the person is capable of living independently;
at the request of parents, other relatives or a legal representative who undertake to care for a discharged minor under the age of 18 years or for a person recognized as legally incompetent.
SECTION V
CONTROL AND PROSECUTORAL SUPERVISION OF PSYCHIATRIC CARE ACTIVITIES
Article 45. Control and prosecutorial supervision over the provision of psychiatric care
(1) Control over the activities of institutions and persons providing mental health care is carried out by local government bodies.
(2) Control over the activities of psychiatric and psychoneurological institutions is carried out by federal, republican (republics within the Russian Federation), autonomous region, autonomous districts, regional, regional, cities of Moscow and St. Petersburg health authorities, social security and education, as well as ministries and departments that have such institutions.
(3) Supervision over compliance with the law in the provision of psychiatric care is carried out by the Prosecutor General of the Russian Federation, prosecutors of the republics within the Russian Federation and prosecutors subordinate to them.
Article 46. Control of public associations over compliance with the rights and legitimate interests of citizens in the provision of psychiatric care
(1) Public associations of psychiatrists and other public associations, in accordance with their charters (regulations), can exercise control over compliance with the rights and legitimate interests of citizens at their request or with their consent when providing them with psychiatric care. The right to visit psychiatric and psychoneurological institutions must be reflected in the charters (regulations) of these associations and agreed upon with the bodies in charge of psychiatric and psychoneurological institutions.
(2) Representatives of public associations are required to agree on the terms of the visit with the administration of a psychiatric or psychoneurological institution, familiarize themselves with the rules in force there, comply with them and sign an obligation of non-disclosure of medical confidentiality.
SECTION VI
APPEALING ACTIONS TO PROVIDE PSYCHIATRIC CARE
Article 47. Procedure and terms of appeal
(1) Actions of medical workers, other specialists, social security and education workers, medical commissions that infringe on the rights and legitimate interests of citizens when providing them with psychiatric care may be appealed, at the choice of the person bringing the complaint, directly to the court, as well as to a higher authority (superior official) or prosecutor. (2) A complaint may be filed by a person whose rights and legitimate interests have been violated, his representative, as well as an organization that is granted the right by law or its charter (regulations) to protect the rights of citizens, in month period, calculated from the day when the person became aware of the commission of actions that infringed his rights and legitimate interests.
(3) A person who has missed the deadline for appealing good reason, the missed deadline can be restored by the body or official considering the complaint.
Article 48. Procedure for considering a complaint in court
(1) Complaints against the actions of medical workers, other specialists, social security and education workers, as well as medical commissions, which infringe on the rights and legitimate interests of citizens when providing them with psychiatric care, are considered by the court in the manner prescribed by Chapter 24.1 of the Civil Procedure Code of the RSFSR and this article .
(2) Participation in the consideration of the complaint of a person whose rights and legitimate interests have been violated, if his mental state allows, his representative, the person whose actions are being appealed, or his representative, as well as the prosecutor, is mandatory.
(3) The costs associated with the consideration of the complaint in court are borne by the state.
Article 49. Procedure for consideration of a complaint by a higher authority (by a higher official)
(1) A complaint submitted to a higher authority (higher official) is considered within ten days from the date of application.
(2) The decision of a higher authority (superior official) on the merits of the complaint must be motivated and based on the law.
(3) A copy of the decision of a higher body (superior official) within three days after consideration of the complaint on the merits is sent or handed to the applicant and the person whose actions are being appealed.
(4) The decision of a higher authority (superior official) can be appealed to a court in the manner prescribed by Chapter 24.1 of the Civil Procedure Code of the RSFSR.
Article 50. Liability for violation of this Law
Criminal liability for violation of this Law is established by the legislation of the Russian Federation. Administrative and other liability for violation of this Law is established by the legislation of the Russian Federation and the republics within the Russian Federation.
President of Russian Federation
B.YELTSIN
Moscow, House of Soviets of Russia.
The law “On Psychiatric Care and Guarantees of Citizens’ Rights in its Provision” is based on regulations according to which the patient’s dignity must not be violated when providing psychiatric care. This law also regulates the procedure for conducting psychiatric examinations. This law states that psychiatric examinations and preventive examinations are carried out only at the request or with the consent of the person being examined, and examinations and examinations of a minor under 15 years of age - at the request or with the consent of his parents or legal representative.
When conducting a psychiatric examination, the doctor is obliged to introduce himself to the patient, as well as his legal representative, as a psychiatrist. Outpatient psychiatric care for persons with mental illnesses is provided depending on medical indications and is carried out in the form of consultative and therapeutic care and dispensary observation.
Persons with mental disorders are placed under dispensary observation regardless of their consent or the consent of their legal representative.
In cases of inpatient treatment of a patient with mental disorders, written consent to this treatment is required, with the exception of patients undergoing compulsory treatment by court decision, as well as patients involuntarily hospitalized by law enforcement agencies. Without the consent of the patient, i.e. involuntarily, persons with mental disorders that make them dangerous to themselves and others, as well as patients in conditions where they are unable to satisfy basic life needs (for example, catatonic stupor, severe dementia) and can cause significant harm to their health due to deterioration of their mental state if left without psychiatric help.
A patient admitted to a hospital as a result of involuntary hospitalization must be examined within 48 hours by a commission of doctors, which determines the validity of hospitalization.
In cases where hospitalization is considered justified, the commission’s conclusion is submitted to the court to decide the issue of the patient’s further stay in the hospital at the location of the hospital.
The patient's involuntary stay in a psychiatric hospital lasts as long as the reasons for the involuntary hospitalization remain (aggressive actions due to delusions and hallucinations, active suicidal tendencies).
To extend involuntary hospitalization, a re-examination by the commission is carried out once a month for the first six months, and then once every 6 months.
An important achievement in respecting the rights of mentally ill citizens is the release of them from responsibility for public acts committed by them during their illness. dangerous actions(crimes).
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Rights mentally sick of people rights citizens during its provision”, there are regulations according to which dignity should not be infringed upon in the provision of psychiatric care sick. -
Rights mentally sick of people.
Sick suffering from chronic mental diseases, are in psychoneurological boarding schools, where they receive the necessary treatment. -
Rights mentally sick of people.
Mental automatism - alienation sick own mental processes and motor acts... more details ”. -
Rights mentally sick of people. The basis of the Law “On Psychiatric Care and Guarantees rights citizens when it is provided” lie post. Loading. -
“Previous question. Constitutional rights and freedom of citizens of the Russian Federation.
5) acts committed by minors that outwardly fall within the scope of the law are not considered offenses, mentally sick people. -
Rights person are based on the principle of equal dignity for all of people. Belongs to every representative human kind, right respect for his dignity presupposes... -
Mental features according to E. Kretschmer. According to the statements of the German psychiatrist E. Kretschmer, People, suffering
Sometimes of people, sick schizophrenia, hormonal imbalances are clearly expressed: men are eunuchoid, and women are muscular. -
3) study mental manifestations of various diseases in their dynamics; 4) study of developmental disorders psyche; studying the nature of relationships sick person with medical personnel and the surrounding microenvironment -
...psychic activity person; psychotherapy that studies and uses tools mental effects for treatment sick; psychoprophylaxis
Legal psychology – examines psychological issues related to the implementation of the system rights. -
1. TAT - thematic apperception test 2. Rosenzweig's pictorial frustration technique 3. Szondi's technique (1939), 48 standard cards with portraits mentally sick of people for 8 diseases...
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Citizens suffering from mental disorders have all the rights and freedoms provided for by the Constitution of the Russian Federation and federal laws (Article 5), including: obtaining information about their rights, the nature of the mental disorders they have and the methods of treatment used;
all types of treatment (including sanatorium-resort treatment) for medical reasons;
preliminary consent or 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;
assistance of a lawyer or legal representative;
maintaining medical confidentiality when providing psychiatric care, etc.
Officials guilty of restricting the rights and freedoms of citizens only on the basis of a psychiatric diagnosis are liable in accordance with the legislation of the Russian Federation
Rights of patients in psychiatric hospitals.
The patient must be explained the reasons and purposes of his placement in a psychiatric hospital, his rights and the rules established in the hospital in the language he speaks, which is recorded in the medical documentation (Article 37).
In addition, all patients have the right to:
Contact the head physician or department head directly
Submit complaints and statements without caesura to the authorities, the prosecutor's office, the court and the lawyer;
Meet with the lawyer and the clergyman alone;
Perform religious rituals, canons, including fasting;
Subscribe to newspapers and magazines.
Rights that may be limited due to mental state:
Conduct correspondence without censorship;
Receive and send parcels, parcels and money transfers;
Use the telephone;
Receive visitors.
On July 2, 1992 the ball was accepted The federal law“On psychiatric care and guarantees of the rights of citizens during its provision,” the provisions of which form the basis of the activities of the psychiatric service. (full text of the law)
Psychiatric assistance is provided upon the voluntary application of a citizen or with his consent, with the exception of the cases provided for in Articles 23 and 29 on involuntary examination and hospitalization, if the mental disorder is severe and causes:
a) the patient poses an immediate danger to himself or others, or
b) his helplessness, that is, his inability to independently satisfy the basic needs of life, or
c) significant harm to his health due to a deterioration in his mental state if he is left without psychiatric help.
Involuntary initial examination.
The decision to conduct a psychiatric examination of a citizen without his consent is made by a psychiatrist upon the application of the interested person, which must contain information about the existence of grounds for such an examination.
Having established the validity of the application for the need for a psychiatric examination without the consent of the citizen, the doctor sends his reasoned conclusion about this need to the court. The judge decides whether to issue a sanction and a three-day period from the date of receipt of the materials.
If, based on the application materials, the signs of point “a” are established, the psychiatrist may decide to examine such a patient without the sanction of a judge.
Involuntary hospitalization.
In case of involuntary hospitalization for the reasons stated above, the patient must be examined by a commission of hospital psychiatrists within 48 hours.
If hospitalization is recognized as unfounded and the hospitalized person does not want to remain in the hospital, he is subject to immediate discharge.
Otherwise, the commission’s conclusion is sent to the court within 24 hours. The judge, within 5 days, considers the hospital’s application for involuntary hospitalization and, in the presence of the inpatient, gives or does not authorize the further detention of the person in a psychiatric hospital.
Subsequently, the involuntarily hospitalized person is subject to monthly examination by doctors, and after six months, the commission’s conclusion, if there is still a need to continue treatment, is sent by the hospital administration to the court at the location of the psychiatric hospital to obtain permission to extend treatment