Nasinnik O. Involuntary psychiatric care (criteria for providing, clinic, therapy)

The thesis is devoted to systematic study of complex clinical, social and behavioural characteristics of patients with severe mental disorder that appeared prerequisite for providing mental health care in the enforcement order. Studied 499 patients who were urgent, including involuntary order (48,7 %), admitted to a psychiatric hospital. A comparative analysis of clinical and social characteristics of compulsory and voluntary patients, including before and after the law on psychiatric care. The paper established a leading value informed consent for mental health care, adherence to ethical and legal approaches to providing mental health care in the enforcement order. The influence of informed consent impaired competence, which temporarily aggravated psychotraumatic situation during emergency hospitalization the patient in the absence of sufficient information on mental health care. Determination of the leading concerns of the patient (refusal of admission, refusal of treatment or refusal to sign consent for hospitalization) is a reference to a focused advocacy for increasing motivation for treatment and assistance with the agreement. A typology of patients, based on provisions of their relationship to treatment and supportive role in facilitating the treatment of their relatives. A formula for forced hospitalization, which includes the triad of criteria: 1) medical (severe mental disorder), 2) behavioral (danger to self or others, and helpless condition) and 3) psychological (lack of informed consent in the impaired competence). Defined indications for outpatient mental health care in the enforcement order. The algorithm of decision-making and implementation at all stages of mental health care in the enforcement order that is compatible with modern ethical and legal approaches form the basis of a conceptual model that improves some help this species and reduce its negative impact.