Kyrgyzstan: human rights defenders demand justice for a patient in a psychiatric clinic

Lawyers from the Coalition against Torture intend to initiate an investigation concerning a suicide attempt by a patient of the Mental Health Center in Jalal-Abad.

The fact that the 28-year-old resident of Jalal-Abad, Kh.G., tried to commit suicide in a psychiatric hospital, human rights defenders became aware from a publication in the media. In a note on one of the electronic information resources it was said that the doctors of the psychiatric hospital had hidden the attempted suicide of one of their patients.

Coalition’s lawyers found that the young woman was placed in the Mental Health Center in Jalal-Abad in mid-January. Her mother brought her to the hospital.

A week later, the patient attempted suicide. It turned out that she decided to commit suicide due to the fact that she could not stop voluntary hospitalization and go home to her children. This circumstance was also confirmed by the mother.

Trying to kill herself, Kh.G. inflicted 4 stab wounds. The doctors of the Mental Health Center in Jalal-Abad hid this fact from the administration and began to treat the patient’s injuries caused by herself.

This treatment had no effect. As a result, they were forced to transfer the woman to an ordinary clinical hospital. Doctors, assessing the nature of the injuries, in accordance with the protocols, informed the National Center for the Prevention of Torture.

After that, for unknown legal reasons, the young woman was again placed in the Mental Health Center in Jalal-Abad.

However, the investigation into the concealment of a suicide attempt has not yet begun. In the Department of Internal Affairs of Jalal-Abad oblast, human rights activists were informed that the patient’s mother refused to write a statement, but the police were checking.

“Checking what?” The legality and validity of hospitalization? Attempted suicide or not suicide? Verifying that staff are performing their duties? In this situation, according to the current legislation of the Kyrgyz Republic, a statement from the woman’s mother is not required. Investigation of this case is in the interests of the state. The fact of concealing suicide attempts was simply to be registered in the Unified Register of Misconduct and Crime, after that a full investigation was to begin,” the lawyer said.

Human rights defenders have many questions concerning this story. In particular, they believe that the concept of “voluntary consent to hospitalization” is misinterpreted in the country.

“The question naturally arises, “To what extent can “delivery” to a psychiatric institution be considered voluntary hospitalization?” The law provides for two types of psychiatric care through voluntary or involuntary hospitalization. Voluntary hospitalization is acceptable after obtaining the full informed voluntary consent of the patient. The doctor is obliged to provide the person suffering from a mental disorder, in an accessible form for him/her and taking into account his/her mental state, with information about the nature of the mental disorder, goals, methods, including alternative ones, and the duration of the recommended treatment, as well as the possible risk, side effects and expected results,” explains the lawyer Arsen Ambaryan.

According to him, surveys conducted by the Public Foundation “Positive dialogue” among patients in psychiatric hospitals indicate that the delivery of patients by their relatives to hospitals is a sustainable practice.

At the same time, doubts about the voluntary hospitalization of some patients were expressed by the National Center for the Prevention of Torture. According to the NCPT, 30% of the number of patients, delivered by relatives, were delivered by fraud or by force. Cases of obtaining consent to treatment were noted not from the patient himself/herself, but from his/her relatives.

“I understand that the delivery of a patient to an institution by relatives can be caused by objective reasons. However, the delivery of patients by relatives should not in any way replace the voluntariness and consent of the patient himself/herself to hospitalization. Unfortunately, the law does not provide any serious legal guarantees against possible arbitrariness during hospitalization, both by relatives and doctors,” says Arsen Ambaryan.

In addition, according to the lawyer, voluntary hospitalization implies voluntary discharge from the hospital.

“The discharge of a patient who is voluntarily in a psychiatric hospital is made on his/her personal application, the application of his/her legal representative or by decision of the attending medical doctor. The wording is ambiguous, as it allows interference with the process of discharge of a legal representative or doctor, or a commission of doctors. True, in the latter case, the decision to turn voluntary hospitalization into involuntary hospitalization and to extend hospitalization should be considered by the court. In the described case, the patient, after finishing treatment in a clinical hospital, was again placed in a psychiatric institution without any court decision,” the lawyer emphasizes.

Currently, members of the human rights organization “Coalition against Torture” continue to seek an investigation into this incident. According to Arsen Ambaryan, the organization prepared and sent a statement to the Prosecutor’s office of Jalal-Abad with a request to start an investigation. In addition, human rights defenders appealed to the Ombudsman Institute to take control of this egregious case of human rights violations.