ETYKA W PSYCHIATRII

ETYKA W PSYCHIATRII - Przeglądy aktów prawnych

Long-term mental health care for people with severe mental disorders

• „Nowadays there is a broad consensus on the need to shift from the model of care based on the traditional large psychiatric institutions to modern comprehensive community-based models of care, including acute patient units at general hospitals.” (s. 2)

• „The stark reality is that in many countries, often those that are least economically developed, people with these disorders continue to reside in large psychiatric hospitals or social care institutions with poor living conditions, inadequate clinical assistance and frequent human rights violations (Muijen, 2008).” (s. 2)

• „Today, a large number of people with mental disorders continue to be ostracised and isolated from society, and experience discrimination in relation to employment, education and physical health care. For those in hospital, many are subject to inhumane conditions, for example, being put in seclusion for long periods of time with no human contact, some are unjustifiably detained and have treatment imposed upon them without their informed consent. Many are denied their civil and political rights and lack access to mechanisms to protect their rights.” (s. 3-4)

• „Consider the example of a woman with schizophrenia living with her elderly mother, who has provided her with care and support throughout her adult life but has now developed cognitive problems, or the young man with schizophrenia made redundant from his job at the factory who becomes despondent and starts to relapse. Both scenarios are social and health problems requiring an integrated response from a sophisticated network of community services provided by the public and voluntary sector.” (s. 4)

• „Community mental health services, based on mental health teams or mental health centres, are responsible for the provision of outpatient and home interventions, and form the cornerstone of cooperation with primary care, general hospital units and non health services and programmes. They are fundamental for prevention, treatment and rehabilitative interventions. General hospital units are essential for inpatient treatment of acute episodes and liaison with other medical specialties. If it is true that there are no studies proving that hospital treatment alone is sufficient for the treatment of people with longer-term mental disorders, it is also true that available evidence supports a balanced approach, including both hospital and community services (Thornicroft & Tansella, 2004).” (s. 14)

• „Specific measures should be developed to support families coping with problems associated to the longer term mental disorder of their beloved ones. These measures must include access to crisis intervention services 24 hours a day, seven days a week, involvement in programmes designed to decrease family burden and psychological support if needed.” (s. 15)