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Patient's rights in the field of mental health

People receiving psychiatric treatment have the same rights as all patients in Poland. During psychiatric treatment, you have the right, inter alia, to: respect your dignity and intimacy, information about your health, keep your information confidential, consent to medical assistance, examinations and treatment, you have the right to access medical records, respect private life and family.

Certain rights, such as keeping medical confidentiality in psychiatry, are protected even more rigorously than in other areas of medicine. On the other hand, some rights, e.g. to consent to medical assistance, may be suspended in strictly defined situations related to psychiatric treatment, primarily treatment in a psychiatric ward.

The rule of thumb is that admission to a psychiatric hospital is based on the written consent of the patient (or, in precisely defined situations, his / her legal representative). It is not uncommon for a person with an exacerbation of a mental illness to come to the hospital or be brought to the hospital, requiring hospitalization, but not consenting to it, in the opinion of the doctor. Most often, such a patient will not be admitted to the hospital, which sometimes causes bitterness and resentment on the part of family or relatives. Let's look at this situation from the perspective of other diseases: a patient with exacerbation of diabetes can decide on his treatment and, for example, refuse hospitalization, even if everyone around him believes that it is needed.

Similarly - a mentally ill person may decide about his / her treatment, even if he / she makes not the most reasonable decisions. There are exceptions to this rule, described in detail in the Mental Health Protection Act (this is the basic Polish legal act concerning the protection of mental health). According to them, if the patient, due to the symptoms of a mental illness, directly threatens his own life or the life or health of other people, or requires psychiatric hospitalization, but due to his health condition, he is not able to consent to admission to hospital (this is the case, for example, in the case of people with advanced dementia) can be admitted to hospital without this consent.

Approximately 10% of all psychiatric hospitalizations is carried out without the patient's consent. The decision is made by the admission room doctor. In such a case, court proceedings are conducted by the Family and Juvenile Division of the District Court. Patients are often additionally concerned about a subpoena received. However, there is no reason to be concerned: this procedure is in no way conducted against the patient, but serves to check whether, in a specific case, doctors were entitled to decide on hospital treatment without the patient's consent. Minor misunderstandings are also related to the name of the court department, which controls compliance with the Mental Health Protection Act: this is not a mistake, in fact, in these cases, the Family and Juvenile Department is the competent court department, regardless of the patient's age.

Due to the specific situations described so far, which we may have to deal with during psychiatric treatment, the function of the Ombudsman for Patients' Rights in a Psychiatric Hospital was established. He provides help to patients of a psychiatric hospital or their relatives. The Defender is particularly interested in patients who are treated in a hospital without their consent or unable to express it, or in the use of direct coercion. The Ombudsman checks whether the rights of the person treated in a psychiatric hospital are respected, and can help in clarifying or resolving any complaints. The regular presence of the Ombudsman is undoubtedly important for patients, but it also facilitates the work of doctors and psychiatric ward staff.


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