involuntary hospitalization in greece

7/28/2019 Involuntary Hospitalization in Greece

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Involuntary psychiatric

hospitalization

in Greece

A protective mechanism or

deprivation of personal

freedom?


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Protection Freedom


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Involuntary hospitalization

A challenge to:

The psychiatric patient His/her family

Mental health professionals

Society at large


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0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

GREECE EUROPE

60%

10%

European and Greek average percentage of involuntary

commitments


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Greece has been twice sentenced by

the European Court of Human Rights

for human rights breaches during i.h.

process


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Patient profile

Male

40 years old

Lives with family in Urban area

Unemployed

Suffers from schizophrenia/psychotic disorder Is not addicted to drugs or alcohol


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Background and Legal Framework

Involuntary hospitalization in

Greece is regulated by

Act2071/1992


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Definition...

According to the Act 2071/1992 (Article 95)

Involuntary hospitalization is

the admission and stay of apatient in a therapeutic unit

without their consent


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Pre-requisites

The person suffers from a mental disorder He/she is in need of therapy

The person is not capable to decide based on

his/her healths best interest Abstinence from therapy would lead to

deterioration of his/her condition

The person is violent either tohimself/herself or toward others

He/she refuses to receive treatment


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Procedure

The procedure of involuntary hospitalization is

initiated and overlooked by a prosecutor

1. Evidence of mental illness +unwillingness to

receive evaluation or treatment

2. The prosecutor orders i.h. (for initial

evaluation)

3. Evaluation time should not exceed 48 hours

during which there should be 2 independent

psychiatric evaluations sent to the

prosecutor who decides about further stay


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4. Within 13 days of i.h. order the One Member

First Instance Court()must decide on the patients

stay or not and issues a temporary 28-day

hospitalization order

5. In the great majority of cases, the person is

taken to the hospital by the police (instead ofambulance)and may even be temporarily

detained at holding cells


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6. When the person is finally admitted for

evaluation, he/she must be informed of theirrights and obligations, most importantly theright to be present in court and appealagainst their admission

Involuntary hospitalization must not exceed 6

months When i.h. order ceases to be valid the person

is no longer considered to be a patient


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Criticisms

Traumatizing , stigmatizing and highly stressfulprocedure

Patient may be handcuffed and subjected toviolence

Police uneducated on emergency psychiatry issues

Coercive measures usedinside the hospital (forcedmedication, mechanical restraint, seclusion)

Psychiatrists often use vague labels in theirevaluation forms (e.g. )

The two evaluations are often made into one that issimply signed by two psychiatrists

Non-compliance with time limits


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In many cases the patient is not represented in court

and not informed of their rights

80% of all i.h. admissions is accommodated by themajor psychiatric hospitals in urban areas

long way to travel/inappropriate coexistence with

non i.h. patients/overpopulation/inability to

establish therapeutic relationship /care workers are

reduced to prison guards

Abuse of the system for other reasons (e.g. cases of

family/personal dispute)


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Psychiatric

reform notapplied

Racismtowards thementally ill

Law notapplied


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involuntary hospitalization in greece

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