What rights are mentally ill people unable to exercise? Right to mental health care

Recognizing the high value for every person of health in general and mental health in particular; Considering that a mental disorder can change a person's attitude towards life, himself and society, as well as society's attitude towards the 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 the limits of their competence.

(3) Legislative and other legal acts adopted in the Russian Federation and republics within the Russian Federation, autonomous region, autonomous okrugs, territories, regions, cities of Moscow and St. Petersburg cannot limit the rights of citizens and guarantees of their observance in the provision of mental health care provided for by this Law.

(4) If an international treaty to which the Russian Federation participates establishes rules other than those provided for by the legislation of the Russian Federation on psychiatric care, then the rules of the international treaty apply.

Article 3. Application of this Law

(1) This Law applies to citizens of the Russian Federation when providing them with psychiatric care and applies to all institutions and persons providing psychiatric care on the territory of the Russian Federation.

(2) Foreign citizens and stateless persons located on the territory of the Russian Federation, when providing them with psychiatric care, enjoy all the rights established by this Law, on an equal basis with citizens of the Russian Federation.

Article 4. Voluntary 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 treatment) for medical reasons;

provision of psychiatric care in conditions that meet sanitary and hygienic requirements;

preliminary consent and refusal at any stage from the use of medical devices and methods, scientific research or educational process, photo, video or filming as an object of testing;

inviting, at their request, any specialist involved in the provision of mental health care, with the latter’s consent, to work on the medical commission on issues regulated by this Law;

assistance of a lawyer, legal representative or other person in the manner prescribed by law.

(3) 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 guilty of such violations bear responsibility in accordance with the legislation of the Russian Federation and the republics within the Russian Federation.

Article 6. Restrictions on the performance of certain types of professional activities and activities associated with a source of increased danger

(1) A citizen may be temporarily (for a period of no more than five years and with the right 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 therapeutic purposes in accordance with the nature of the disease disorders and should not be used to punish a person suffering from a mental disorder or for the benefit of other persons.

Article 11. Consent to treatment

(1) Treatment of a person suffering from a mental disorder is carried out after receiving his written consent, except for the cases provided for in part four of this article.

(2) A doctor is obliged to provide a person suffering from a mental disorder, in a form accessible to him and taking into account his mental state, information about the nature of the mental disorder, goals, methods, including alternative ones, and the duration of recommended treatment, as well as pain, possible risks, side effects and expected results. The information provided is recorded in the medical documentation.

(3) Consent to the treatment of a minor under the age of 15, as well as a person recognized as legally incompetent, is given by their legal representatives after providing them with the information provided for in part two of this article.

(4) Treatment may be carried out without the consent of a person suffering from a mental disorder, or without the consent of his legal representative, only when compulsory medical measures are applied on the grounds provided for by the Criminal Code of the RSFSR, as well as in the case of involuntary hospitalization on the grounds provided for in Article 29 of this Law. In these cases, except for urgent ones, treatment is applied according to the decision of a commission of psychiatrists.

(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 examination when deciding on the suitability of a citizen, based on the state of his mental health, to serve as a soldier 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 settings;

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 in-patient psychiatric care, if possible at the place of residence of patients;

organizes general educational and vocational training for 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 of 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 health care fund, the 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 of 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 care is provided by a psychiatrist who has received a higher medical education and 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 have the right to benefits established by the legislation of the Russian Federation for persons engaged in activities in special working conditions, and are also subject to compulsory state insurance in case of harm to their health or death in the line of duty.

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 salary, 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, 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. The 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 the 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 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 received consent 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, while medical personnel respect 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 provide safe conditions for access to the hospitalized person and his examination. In cases where it is necessary to prevent actions that threaten the life and 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 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 the 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 conclusion 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 rituals, 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 with necessary 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 applications 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 involuntarily, 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, in the interests of other patients in a psychiatric hospital, be observed 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) The 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 to educate the minor 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) The basis for transferring a person from a psychoneurological institution for social security or special education to a similar general institution 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 can 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, within a month calculated from the day when the person became aware of the committing actions that infringe on his rights and legitimate interests.

(3) For a person who has missed the deadline for appealing for a valid reason, the missed deadline may 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 the Russian Federation
B.YELTSIN
Moscow, House of Soviets of Russia.

(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 rituals, 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 patients in psychiatric hospitals with the necessary 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 applications 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 involuntarily, 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 deliveries;

perform the functions of 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, in the interests of other patients in a psychiatric hospital, be observed 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.

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 Federal Law “On Psychiatric Care and Guarantees of the Rights of Citizens in its Provision” was adopted, 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

The law “On Psychiatric Care and Guarantees of the Rights of Citizens in its Provision” 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 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 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 socially dangerous actions (crimes) committed by them during illness.

6. Any determination that by reason of mental illness a person is incapacitated, and any determination that, as a result of such incapacity, a personal representative should be appointed shall be made only after a fair hearing by an independent and impartial judicial body established in accordance with domestic legislation. A person whose capacity is the subject of proceedings has the right to be represented by a lawyer. If the person whose legal capacity is the subject of the proceedings cannot independently provide himself with such representation, the latter must be provided to that person free of charge if he does not have sufficient means for this. A lawyer must not, during the same proceedings, represent a mental health facility or its staff, and must not represent a family member of a person whose capacity is the subject of the proceedings, unless the judicial authority is satisfied that there is no conflict of interest. Decisions regarding capacity and the need for a personal representative are subject to review at reasonable intervals in accordance with domestic law. The person whose competency is the subject of the proceeding, his personal representative, if any, and any other interested person shall have the right to appeal any such decision to a higher court.

7. If a court or other competent judicial authority determines that a mentally ill person is unable to manage his or her affairs, measures shall be taken to the extent necessary and taking into account the condition of such person to ensure the protection of his interests.

Principle 2
Protection of minors

Consistent with the purposes of these Principles and in the context of domestic laws relating to the protection of minors, special consideration should be given to protecting the rights of minors, including, if necessary, the appointment of a personal representative who is not a family member.

Principle 3
Life in society

Every person with a mental illness has the right, to the extent possible, to live and work in the community.

Principle 4
Diagnosis of mental illness

1. The diagnosis that a person suffers from a mental illness is made in accordance with internationally recognized medical standards.

2. A diagnosis of mental illness is never made on the basis of political, economic or social status or membership in a cultural, racial or religious group or for any other reason not directly related to the mental health condition.

3. Family or work conflict or inconsistency with the moral, social, cultural or political values ​​or religious views prevailing in the society in which the person concerned lives can never be a determining factor in making a diagnosis of mental illness.

4. History of past treatment or hospitalization as a patient does not, in and of itself, justify a diagnosis of present or future mental illness.

5. No person or authority may declare or otherwise indicate that a person is suffering from a mental illness, except for purposes specifically relating to the mental illness or the consequences of mental illness.

Principle 5
Medical examination

No person shall be compelled to undergo a medical examination for the purpose of determining whether he suffers from a mental illness, except in accordance with a procedure provided for by domestic law.

Principle 6
Confidentiality

The confidential nature of information relating to all persons to whom these Principles apply must be respected.

Principle 7
The role of community and culture

1. Every patient has the right, so far as possible, to receive treatment and care in the community in which he resides.

2. When treated in a mental health facility, the patient has the right, whenever possible, to receive treatment close to his own home or the home of his relatives or friends and has the right to return to his community as soon as possible.

3. Every patient has the right to treatment that is culturally appropriate.

Principle 8
Standards of care

1. Every patient has the right to such medical and social assistance as is necessary to maintain his health and has the right to care and treatment in accordance with the same standards as other patients.

2. Every patient shall be protected from harm to his or her health, including the unnecessary use of medications, abuse by other patients, staff or others, and other acts causing mental suffering or physical discomfort.

Principle 9
Treatment

1. Every patient has the right to be treated in the least restrictive environment and by the least restrictive or invasive methods necessary to maintain his or her health and protect the physical safety of others.

2. The care and treatment of each patient is based on an individually developed plan, which is discussed with the patient, regularly reviewed, modified as necessary and provided by qualified medical personnel.

3. Psychiatric care is always provided in accordance with the applicable ethical standards for mental health professionals, including internationally recognized standards such as the Principles of Medical Ethics relating to the role of health professionals, especially doctors, in protecting prisoners or detainees from torture and other cruel, inhuman or degrading treatment or punishment adopted by the General Assembly of the United Nations. Abuse of knowledge and skills in the field of psychiatry is not allowed

4. Treatment of each patient should be aimed at maintaining and developing individual autonomy.

Principle 10
Medicines

1. Medicines must be best suited to the patient's health needs, should be prescribed for therapeutic or diagnostic purposes only, and should never be used as punishment or for the convenience of others. Except as provided in Principle 11, paragraph 15 below, mental health professionals shall use only medications of known or proven effectiveness.

2. All medications are prescribed by a specialist working in the field of psychiatry authorized by law and recorded in the patient's medical history.

Principle 11
Consent to treatment

1. No treatment can be prescribed to a patient without his informed consent, except for the cases provided for in paragraphs 6,7,8,13 and 15 of this principle.

2. Informed consent is consent obtained freely, without threats or unjustified coercion, after adequately providing the patient, in a form and language understandable to him, with sufficient and clear information about:

A) preliminary diagnosis,

b) the purpose, methods, likely duration and expected results of the proposed treatment;

With) alternative treatment methods, including less invasive ones;

d) possible pain and discomfort, possible risks and side effects of the proposed treatment.

3. During the consent procedure, the patient may request the presence of a person or persons of his choice.

4. The patient has the right to refuse treatment or stop it, except for the cases provided for in paragraphs 6, 7, 8, 13 and 15 of this principle. The consequences of refusing or stopping treatment must be explained to the patient.

5. The patient should not be asked or encouraged to waive the right to informed consent. If the patient expresses a desire to waive this right, it must be explained to him that treatment cannot be carried out without his informed consent.

6. Except as provided in paragraphs 7, 8, 12, 13, 14 and 15 of this principle, a proposed course of treatment may be prescribed to a patient without his informed consent, subject to the following conditions:

A) the patient is currently hospitalized forcibly;

b) an independent authority, having all relevant information, including the information specified in paragraph 2 of this principle, is satisfied that the patient is not currently capable of giving or not giving informed consent to the proposed course of treatment or, if so provided by domestic law, that, having regard to the patient's own safety or the safety of others, the patient unreasonably refused to give such consent;

With) an independent authority has determined that the proposed course of treatment is in the best interests of the patient's health.

7. The provisions of paragraph 6 above do not apply to a patient who has a personal representative authorized by law to consent to treatment for the patient; however, except as provided in paragraphs 12, 13, 14 and 15 of this principle, treatment may be administered to such a patient without the patient's informed consent if the personal representative, having received the information specified in paragraph 2 of this principle, consents on behalf of the patient.

8. Except as provided in paragraphs 12, 13, 14 and 15 of this principle, treatment may also be prescribed to any patient without his or her informed consent if a legally authorized qualified mental health professional determines that it is urgently necessary to administer is treatment to prevent immediate or imminent harm to the patient or others. Such treatment shall not be extended beyond the period of time strictly necessary for this purpose.

9. Where any treatment is prescribed to a patient without his or her informed consent, every effort should nevertheless be made to inform the patient of the nature of the treatment and of any possible alternative methods and, to the extent possible, to involve the patient to develop a course of treatment.

10. Any treatment is immediately recorded in the patient's medical record, indicating whether the treatment is involuntary or voluntary.

11. Physical restraint or involuntary seclusion of a patient shall be used only in accordance with the officially approved procedures of the mental health facility and only when it is the only available means of preventing immediate or imminent harm to the patient or others. They shall not be extended beyond the period of time strictly necessary for that purpose. All cases of physical restraint or involuntary restraint, the reasons for their use, their nature and duration must be recorded in the patient's medical record. A patient subject to restraint or seclusion must be kept in humane conditions and provided with care and close and constant supervision by qualified medical personnel. The personal representative, if available and as appropriate, shall be promptly informed of any instances of physical restraint or involuntary seclusion of a patient.

12. Sterilization is never used as a treatment for mental illness.

13. A mentally ill person may undergo significant medical or surgical intervention only when permitted by domestic law, when it is considered to be in the best interests of the patient's health, and when the patient gives informed consent, but in cases where the patient does not able to give informed consent, this intervention is prescribed only after an independent assessment has been carried out.

14. Psychosurgery and other types of invasive and irreversible treatment of mental illness shall not, under any circumstances, be used in relation to a patient who has been involuntarily hospitalized in a psychiatric institution, and may be used, to the extent permitted by domestic law, in relation to any other patient only if where the patient has given informed consent and an independent external authority is satisfied that the patient's consent is in fact informed and that the treatment is in the best interests of the patient's health.

15. Clinical experiences and experimental treatments shall not, under any circumstances, be applied to any patient without his or her informed consent, except that clinical experiences and experimental methods may only be applied to a patient who is incapable of giving informed consent. permission from a competent independent supervisory authority specifically established for this purpose.

16. In the cases specified in paragraphs 6, 7, 8, 13, 14 and 15 of this principle, the patient or his personal representative, or any interested person, has the right to appeal to a judicial or other independent authority in relation to the application of any treatment to the patient .

Principle 12
Rights Notice

1. A patient in a mental health facility shall, as soon as possible after admission, be informed, in a form and language that he understands, of all his rights under these Principles and under domestic law, which information shall include an explanation of those rights and the order of their implementation.

2. If and while the patient is unable to understand such information, such patient's rights shall be communicated to the personal representative, if available and as appropriate, and to the person or persons who can best represent the patient's interests and is willing to do so.

3. A patient who has the necessary legal capacity has the right to designate any person to inform on his behalf, as well as a person to represent his interests before the administration of the institution.

Principle 13
Rights and conditions of detention in psychiatric institutions

1. Any patient detained in a psychiatric institution has the right, in particular, to full respect for his:

A) universal recognition as a subject of law;

b) rights to privacy;

With) freedom of communication, which includes freedom of communication with other persons within a given institution; freedom to send and receive private messages not subject to censorship; freedom to receive in private a lawyer or personal representative and, at all reasonable times, other visitors; and freedom of access to postal and telephone services, as well as newspapers, radio and television;

d) freedom of religion or belief.

2. The environment and living conditions in a psychiatric institution should be as close as possible to the normal life conditions of persons of a similar age and, in particular, include:

A) opportunities for leisure and recreation;

b) educational opportunities;

With) opportunities to buy or receive items necessary for everyday life, leisure time and communication;

d) opportunities - and encouragement to use such opportunities - to involve the patient in activities appropriate to his social situation and cultural characteristics, and to implement appropriate vocational rehabilitation measures for the purpose of his social reintegration. These measures should include career guidance, vocational training and placement services to enable patients to obtain or maintain employment in the community.

3. Under no circumstances may a patient be subjected to forced labor. To the extent consistent with the needs of the patient and with the requirements of the administration of the institution, the patient should be able to choose the type of work he wishes to perform.

4. The labor of a patient held in a psychiatric institution should not be exploited. Any such patient has the right to receive for the work performed by him the same remuneration as, under domestic law or custom, would be received for similar work by a person who is not a patient. Any such patient shall in all cases be entitled to receive a fair share of any remuneration paid to the mental health facility for its services.

Principle 14
Mental Health Resources

1. A mental health facility must have access to the same resources as any other health care facility, including, but not limited to:

A) a sufficient number of qualified medical personnel and other appropriate specialists and adequate facilities to provide each patient with privacy and to carry out the necessary and active course of treatment;

b) diagnostic and therapeutic equipment for the patient;

With) proper service by specialists;

d) adequate, regular and comprehensive treatment, including the supply of medications.

2. Every mental health establishment should be inspected with reasonable regularity by the competent authorities to ensure that the conditions of treatment and care for patients are in accordance with these Principles.

Principle 15
Principles of hospitalization

1. When a person requires treatment in a psychiatric institution, every effort must be made to avoid involuntary hospitalization.

2. Access to a mental health facility should be regulated in the same way as access to any other health facility for any other illness.

3. Every non-involuntarily admitted patient has the right to leave the mental health facility at any time, unless the criteria for involuntary detention in principle 16 below apply, and he must be informed of this right.

Principle 16
Forced hospitalization

1. Any person may be involuntarily admitted to a psychiatric institution as a patient, or already hospitalized as a voluntarily patient, may be involuntarily detained as a patient in a psychiatric institution, if and only if the person authorized for this purpose by law is qualified a mental health professional will determine, in accordance with principle 4 above, that the person is suffering from a mental illness and will determine:

A) that, as a result of this mental illness, there is a serious risk of immediate or imminent harm to that person or others; or

b) that in the case of a person whose mental illness is severe and whose mental faculties are impaired, refusal to hospitalize or maintain the person in a mental institution may result in a serious deterioration in his health or make it impossible to receive adequate treatment that could be provided by hospitalization in a mental health facility mental health facility in accordance with the principle of the least restrictive alternative.

In the case referred to in subparagraph b), it is necessary, if possible, to consult a second such specialist working in the field of psychiatry. In the event of such a consultation, hospitalization in a psychiatric institution or involuntary detention in it can only take place with the consent of a second specialist working in the field of psychiatry.

2. Hospitalization in a psychiatric institution or detention in it involuntarily is carried out initially for a short period determined by domestic legislation, for the purpose of observation and preliminary treatment before consideration of the issue of hospitalization or detention of the patient in a psychiatric institution by the supervisory authority. The reasons for hospitalization or detention are immediately communicated to the patient; the fact of hospitalization or detention and the reasons therefor shall also be reported promptly and in detail to the supervisory authority, the patient's personal representative, if any, and, if the patient does not object, to the patient's family.

3. A psychiatric institution may admit involuntarily hospitalized patients only if the institution has been designated for this purpose by a competent authority established in accordance with domestic legislation.

Principle 17
Supervisory authority

1. The supervisory authority is a judicial or other independent and impartial body established under domestic law and operating in accordance with procedures established by domestic law. In preparing his decisions he shall obtain the assistance of one or more qualified and independent mental health professionals and take into account their advice.

2. Subject to principle 16, paragraph 2 above, the initial review by a supervisory authority of a decision to admit or involuntarily commit a patient to a mental health facility shall take place as soon as practicable after such decision is made and should be carried out in accordance with the simplified and expedited procedures provided for in domestic legislation.

3. The supervisory authority periodically, at reasonable intervals determined by domestic legislation, reviews cases of involuntary hospitalization.

4. A patient hospitalized involuntarily may, at reasonable intervals determined by domestic law, apply to the supervisory authority to be discharged or to obtain the status of a patient hospitalized voluntarily.

5. At each review, the supervisory authority should consider whether the criteria for involuntary admission set out in principle 16, paragraph 1, above are still met and, if not, the patient should be discharged as an involuntary admission.

6. If at any time the mental health professional responsible for the case is satisfied that the conditions of the person's detention as an involuntary patient are no longer being met, that professional shall order the person's discharge as an involuntary patient. forcibly.

7. The patient, or his personal representative, or any interested person has the right to appeal to a higher court the decision to hospitalize the patient or to keep him in a psychiatric institution.

Principle 18
Procedural guarantees

1. The patient has the right to select and appoint counsel to represent the patient as such, including representation in any grievance or appeal proceedings. If the patient does not independently provide such services, the lawyer is provided to the patient free of charge insofar as the patient does not have sufficient funds to pay for his services.

2. The patient also has the right, if necessary, to use the services of an interpreter. When such services are necessary and the patient cannot provide them, they are provided free of charge to the patient to the extent that the patient does not have sufficient funds to pay for these services.

3. The patient and the patient's attorney may request and present at any hearing an independent psychiatric report and any other reports and written and oral evidence that are relevant and admissible.

4. Copies of the patient's medical history and any reports and documents to be produced shall be given to the patient or the patient's attorney, except in special cases where it is determined that disclosure of specific information to the patient would cause serious harm to the patient's health or jeopardize the safety of others. Domestic law requires that any document not provided to the patient must, where it can be done in confidence, be served on the patient's personal representative and attorney. In the event that any portion of any document is not provided to a patient, the patient or the patient's attorney, if any, will be notified of the failure and the reasons therefor, and the decision may be subject to judicial review.

5. The patient and the patient's personal representative and attorney have the right to attend, participate in, and be heard at any hearing.

6. If the patient, or the patient's personal representative or attorney, requests that a specific person be present at the hearing, that person shall be permitted to attend the hearing unless it is determined that his or her presence would cause serious harm to the patient's health or safety. other persons.

7. Any decision whether a hearing or part thereof will be open or closed and whether it will be communicated to the public must take into account the wishes of the patient, the need to respect the right of the patient and others to privacy, and the need to prevent serious harm to the patient's health or risk for the safety of others.

8. The decision made following the hearing and its reasons are stated in writing. Copies will be provided to the patient and the patient's personal representative and attorney. In deciding whether a decision will be published in whole or in part, full consideration should be given to the wishes of the patient, the need to respect his or her privacy and the privacy of others, the public interest in the open administration of justice and the need to prevent serious harm to the patient's health or safety. other persons.

Principle 19
Access to information

1. The patient (a term which in this principle also includes former patients) has the right to access information concerning him in the medical record maintained by the mental health institution. This right may be limited in order to prevent serious harm to the patient's health and risk to the safety of others. Domestic law requires that any such information not provided to the patient must, where it can be done in confidence, be communicated to the patient's personal representative and attorney. In the event that any such information is not communicated to the patient, the patient or the patient's attorney, if any, will be notified of the failure to communicate the information and the reasons therefor, and the decision may be subject to judicial review.

2. Any written comments by the patient or the patient's personal representative or attorney may, at the patient's request, be included in the patient's medical record.

Principle 20
Criminals

1. This principle applies to persons who are serving a prison sentence for a criminal offence, or to persons who are otherwise detained in the course of proceedings or investigations brought against them on a charge of a criminal offence, and who are found to have suffer from a mental illness or are expected to suffer from such an illness.

2. These persons should receive the best possible mental health care, as provided for in principle 1 above. These Principles apply to them to the fullest extent possible with only such limited modifications and exceptions as are necessary in the circumstances. None of such modifications or exceptions shall prejudice the rights of those persons as set out in paragraph 5 of principle 1 above.

3. Provisions of domestic law may authorize a court or other competent authority, on the basis of a competent and independent medical opinion, to order the placement of such persons in a psychiatric institution.

4. Treatment of persons diagnosed with a mental illness should, in all circumstances, be consistent with Principle 11 above.

Principle 21
Complaints

Every patient and former patient has the right to lodge a complaint in accordance with the procedures defined in domestic law.

Principle 22
Supervision and remedies

States shall ensure that appropriate mechanisms are in place to promote compliance with these Principles for the inspection of mental health facilities, for the presentation, investigation and resolution of complaints, and for the initiation of appropriate disciplinary or judicial proceedings in cases of breach of duty or patient rights.

Principle 23
Implementation

1. States shall give effect to these Principles through appropriate legislative, judicial, administrative, educational and other measures, which they review from time to time.

2. States shall make these Principles known to the general public through appropriate active means.

Principle 24
Scope of application of the principles in relation to mental health institutions

These Principles apply to all persons admitted to mental health facilities.

Principle 25
Retention of existing rights

No limitation or derogation of any existing rights of patients, including rights recognized in applicable international or domestic law, is permitted on the basis that these Principles do not recognize such rights or recognize them to a lesser extent.

4, appendix.