Urgent Hospitalization of Mentally-Ill Persons Representing a Public Danger, August 1971 (28.9)

<< No 28 : 31 December 1972 >>

Excerpts from the directives approved on 9 August 1971 by N, Zhogin, Deputy Procurator-General of the USSR, and on 10 August by M. Uskov, Deputy USSR Minister of Internal Affairs, and confirmed on 26 August 1971 by A. Serenko, Deputy USSR Minister of Public Health.[1]

Printed at the print shop of the USSR Ministry of Public Health, L-74417 dated 2 September 1971, Order number 1722, 1,000 copies; as a consequence of which the analogous directives dated 10 October 1961[2] have ceased to have legal force. […]

(1) Where there is manifest danger from a mentally-ill person to those around him or to himself, organs of public health have the right, without the agreement of the patient’s relatives, his guardians, or other persons around him, to confine him (by way of urgent medical care) in a psychiatric hospital.

(2) The evidence necessary for urgent hospitalization is the social danger of the patient due to the following peculiarities of his sick state (there follows a list of six points — Chronicle). The above-listed sick states, which involve undoubted danger for the patient himself and society, may be accompanied by outwardly correct behaviour and dissimulation. In this connection extreme care is essential in evaluating the mental state of such persons, so that, without the dropping of a strict attitude concerning the evidence necessary for urgent hospitalization, at the same time, by means of prompt hospitalization, the possibility of the commission of socially-dangerous acts by the mentally-ill persons can be avoided.

(3) Affective reactions and anti-social forms of behaviour in persons not afflicted with mental illness but manifesting only such psychic deviations as psychopathic character traits or neurotic reactions, cannot serve as evidence for urgent hospitalization, […] In those cases where the socially dangerous behaviour of the person provokes suspicion of the presence in him of a mental disturbance, but the latter is not obvious, such a person is not subject to urgent hospitalization […]

(4) […] In cases of urgent hospitalization the physician ordering the confinement must set forth in detail the medical and social evidence which indicates the need for urgent hospitalization, and in conclusion must give his place of employment, his position, name, and the time of giving the order.

(5) Local organs of internal affairs (police) are obliged to assist medical workers who ask for their help in the urgent hospitalization of mentally ill persons representing a social danger in case of:

a) the possibility of the latter displaying resistance, aggression, or other acts threatening the life or health of medical personnel, or when they attempt to escape from them;

b) resistance on the part of relatives, guardians or others to the hospitalization of the sick person.

(6) At the psychiatric institution the hospitalized patient must, within one day, be examined by a special commission consisting of three psychiatrists, which considers the question of the correctness of his hospitalization and determines whether it is necessary for him to remain any longer in the hospital. No later than one day after examination of the patient by the commission, his nearest relatives are notified of his hospitalization.

(7) Persons who have been hospitalized must (at least once a month) be re-examined by a commission to decide whether further confinement in the hospital is necessary.

NOTES

[1] For the Politburo decision that preceded adoption of these new directives, see Bukovsky Archive (22 January 1970* (Pb 151/XIII).

[2] See full English text in Survey, London, number 81, Autumn 1971, pages 114-17; full Russian text in J. Saarma, Kohtupsuhhiaatria (Estonian for “Forensic Psychiatry”), Tallinn, Valgus Publishing House, 1970,pages 286-7.