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Is a psychiatric hospital (still) a total institution?

Błażej Kmieciak

Affiliacja i adres do korespondencji
Psychiatr Psychol Klin 2017, 17 (2), p. 142–151
DOI: 10.15557/PiPK.2017.0017
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Streszczenie

The concept of a psychiatric hospital as a total institution was formulated by Erving Goffman half a century ago. In this type of facility, the personnel has a full control over the patient (their time and private life, mobility). A psychiatric hospital is a special place. Diseases whose symptoms are often unnoticeable and difficult to properly assess are treated here. These hospitals are also unique in the legal context. Under certain circumstances, no patient’s consent is necessary for admission to a psychiatric hospital; also direct coercion may be used in these institutions. The Mental Health Law, which protects the rights of patients affected by mental disorders, has been in force in Poland for 20 years now. The purpose of the Act was to introduce standards for defending the rights and freedoms of a psychiatric ward patient. The document also refers to the principles for the use of direct coercion in patients in psychiatric wards and residents of nursing homes, the principles for involuntary admission to a psychiatric hospital, the principle for the protection of the rights of psychiatric patients (including the competence of the guardianship court and the Ombudsman for Psychiatric Patients) as well as the principles for the confidentiality of information related to the patient experiencing mental disorders. At this point, it is worth considering whether the emergence of similar documents makes a psychiatric hospital lose its total nature. Perhaps elements that promote specific forms of relationships between the staff and the patient are of key importance. What socio-legal aspects should be included in a responsible mental health policy?

Słowa kluczowe
mental health protection, patient’s rights policy, human rights, total institution, psychiatric hospital