Monitoring of the Polish Mental Health Act implementation in the years 1996–2005

Background

Monitoring of the Polish Mental Health Act of January 1995 (Articles 18, 23, 24, 26, 28, 29, 22.2 and 22.5) implementation in mental health care facilities.

Methods

The study was conducted in the years 1996–2005 using questionnaire data collected by mail every three months. While 87 psychiatric facilities, i.e. mental hospitals and psychiatric wards of general hospitals, were monitored in the year 1996, their number amounted to 114 in 2005.

Results

The proportion of urgent involuntary hospitalizations (Article 23) decreased in that period from 9.5 to 7.5% of the total number of admissions in mental hospitals, and from 8.5 to 6.5% in psychiatric wards of general hospitals. The ratio of involuntary admissions for psychiatric observation (Article 24) increased from 0.85 to 1.6% in mental hospitals, and in psychiatric wards from 0.8 to 1.4% of the total number of admissions. The number of involuntary admissions on the motion brought by the patient's family and legal representatives, and supported by the guardianship court (Art. 29) decreased from 0.45 do 0.25% in mental hospitals, and from 0.40 to 0.25% of the total number of admissions in psychiatric wards. On average, coercive treatment measures are used towards about 16% of the total number of patients in mental hospitals and about 10% of all patients in psychiatric wards of general hospitals.

Conclusion

Although a decrease was noted in the proportion of involuntary admissions (Articles 23 and 28 (coercive retaining of the patient during his hospitalization)) during the decade, nevertheless the absolute number of such involuntary admissions increased due to a general rising tendency in the global number of admissions to inpatient psychiatric facilities. Increase was noted in both the total number and proportion of involuntary admissions on the grounds of Art. 24, while the number and percentage of admissions without the patient's consent according to Art. 29. was decreasing.