2003 issue 4

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Volume 12, issue 4

Case report

Between regulations and helplessness – the Mental Health Act in the practice of community psychiatry. A report of five cases

KATARZYNA MAJCHRZAK1, ZBIGNIEW MALESZAK1, JOLANTA MORAWSKA1
1. Środowiskowego Domu Samopomocy Stowarzyszenia na Rzecz Osób Zaburzonych Psychicznie i ich Rodzin „Przystań” w Katowicach
Postępy Psychiatrii i Neurologii, 2003, 12 (4), 499-504
Keywords: mental disorders, Mental Health Act

Abstract

Aim. The Mental Health Act specifies conditions under which the patient has the right to treatment. Moreover; the Act provides legal grounds for community-based psychiatric care delivery. One of tasks of the latter is to help persons with mental disorders who cannot or do not wish to receive psychiatric treatment despite clear medical indications. The aim of the article is to outline discrepancies between some regulations of the Act and feasibility of their implementation in practice.

Case reports. Five "typical" cases are described of patients who cannot be referred to treatment or placed in a nursing home despite indications in agreement with the provisions of Articles 29 or 39 of the Act, since Article 30 of the same Act requires that to ally motion brought forward to the court a certificate should be enclosed – and the certificate must be issued by a physician "employed in a public health care facility".

Comments. Due to specific features of their illness, it is often impossible for community psychiatry patients to obtain such a certificate. In the light of the law in force it is unfeasible to start their treatment without their consent. It follows from our experience that such a situation leads to their social degradation or deterioration of their illness, and sometimes even to premature death of these patients. In its current formulation the Act does not protect their interests.