Compulsory psychiatric treatment – ​​course, legal basis, appeal

A decision on a referral for compulsory psychiatric treatment is issued by the guardianship court only in situations strictly defined by law. For example, a person who poses a threat to themselves or others or a person whose health condition does not allow for conscious treatment may be referred for compulsory psychiatric treatment. The rules regarding compulsory psychiatric treatment are regulated by the provisions of the Act of August 19, 1994 on mental health protection.

Admission to a psychiatric hospital without the patient’s consent

Compulsory psychiatric treatment is used in several cases. It is worth noting that admission to a psychiatric hospital without the patient’s consent may take place in two modes:

• In the application mode in order to obtain the consent of the guardianship court to commence compulsory psychiatric treatment – an application to refer a mentally ill person to compulsory treatment in a psychiatric hospital may be submitted by direct and collateral relatives (e.g. parents, grandparents, siblings), descendants (e.g. son, daughter , grandchildren), spouse, legal representative of the sick person, person providing actual care for the mentally ill person and social welfare authority. You can ask the Municipal or Municipal Social Welfare Center for help in starting the procedure;
• In an emergency – applies to people who, due to their health condition (e.g. exacerbation of mental illness), pose a threat to themselves or other people. In this case, the doctor who admits the patient, after consulting another specialist, may decide on the need to refer the patient for psychiatric observation. The head of a psychiatric hospital or another hospital with a general psychiatric ward must notify the guardianship court about forced hospitalization. A doctor who admits a mentally ill person to hospital is obliged to inform him or her about the reasons for his or her decision and about the sick person’s rights.

Importantly, in the case of the application procedure, the important issue is not the nuisance of a mentally ill person, but his or her health condition, and relatives should not apply for compulsory psychiatric treatment out of self-interest.

Compulsory psychiatric treatment – ​​legal basis

Pursuant to the Act of August 19, 1994 on mental health protection, admission to a psychiatric hospital without the patient’s consent may only occur if the following conditions are met:

• a mentally ill person due to mental disorders is unable to independently meet basic life needs,

• a mentally ill person due to mental disorders may pose a direct threat to their own life or health,

• a mentally ill person due to mental disorders may pose a threat to the life or health of other people;

• treatment in a psychiatric hospital will improve the health of a mentally ill person,

• treatment in a psychiatric hospital will prevent a significant deterioration of the health condition of a mentally ill person;

• all possibilities of effective outpatient treatment have been exhausted and it is not possible to provide the sick person with any other type of help, e.g. due to refusal to take medications.

As already mentioned, admission to a psychiatric hospital may be made at the request of, among others, a statutory representative of a mentally ill person, a person providing actual care for a mentally ill person, and a psychiatrist.

A written application submitted to the guardianship court must include:

• reasons for admission to a psychiatric hospital;

• detailed information about the patient’s behavior leading to compulsory psychiatric treatment and information about his or her mental health;

• an opinion from another specialist confirming the need for admission to a psychiatric ward without the patient’s consent.

If it is not possible to conduct a psychiatric examination and issue a health certificate because a mentally ill person does not cooperate with a doctor due to mental disorders, the court may decide to carry out the examination without the consent of the sick person. Due to the court’s decision, a mentally ill person may be brought in and subjected to a psychiatric examination at the request of the court.

The procedure of admission to a psychiatric hospital without the patient’s consent

Both in the case of the application procedure and the emergency procedure, there are specific procedures that must be completed in order for a referral for compulsory psychiatric treatment to be lawful.

An application for a referral for compulsory psychiatric treatment must be submitted to the guardianship court competent for the place of residence of the sick person.

If admission to a psychiatric hospital without the patient’s consent is an emergency, it must be reported by the head of the psychiatric hospital to the guardianship court competent for the place of residence of the sick person within 72 hours. After considering the application and reviewing the documentation, the guardianship court is obliged to appoint a judge who will meet with the sick person within 48 hours and then issue a ruling on the compliance or incompatibility of admission to a psychiatric hospital. If the judge decides that the patient was unjustifiably placed in a psychiatric facility, the proceedings are discontinued and the patient is immediately discharged from the hospital ward. If the conditions for placement in a psychiatric facility without the patient’s consent are met, court proceedings begin and a hearing should be held within 14 days – the court appoints a legal advisor or a court-appointed lawyer to the sick person.

Before the hearing, the court reviews the medical documentation and other information about the mentally ill person and may seek the opinion of forensic psychiatric experts.

If, based on the received medical documentation and expert opinion, as well as information obtained, among others, If the court decides from the patient’s relatives that admission to a psychiatric hospital is justified, it decides on the need to continue compulsory treatment. If there are doubts as to the validity of psychiatric treatment without the patient’s consent, the court may order the patient’s immediate discharge from the hospital or decide on the need to conduct further tests and consultations.

Compulsory psychiatric treatment – ​​appeal against the court’s decision

A person staying in a psychiatric facility, as well as the statutory representative of the sick person, have the right to appeal against the decision of the guardianship court to a higher court within 7 days from the date of receiving notification of the court’s decision. An appeal does not suspend the execution of the judgment.

A mentally ill person or his or her legal representative may also request discharge from a psychiatric hospital at any time. If the referring doctor decides to refuse to discharge the patient, he or she shall immediately notify the guardianship court, which will hear the case urgently. The court may approve a refusal to be discharged from a psychiatric hospital or order the discharge of a sick person.

Please remember that compulsory psychiatric treatment is a procedure strictly defined by law. The main purpose of admission to a psychiatric hospital without the patient’s consent is to ensure health protection for people who are unable to meet their basic life needs on their own and for people whose behavior indicates that they may threaten their own life and health and pose a threat to others. Compulsory psychiatric treatment is always administered under judicial supervision.

Sources:

• Act of 19 August 1994 on mental health protection, Journal of Laws 1994 No. 111 item 535

• Regulation of the Minister of Health and Social Welfare of November 23, 1995 regulating the detailed manner of operation of a psychiatric hospital in matters of admission to and discharge from a psychiatric hospital (Journal of Laws of 1995, No. 150, item 736)