Inpatient Psychiatric Care in Bulgaria and Human Rights December 2001
Inpatient Psychiatric Care in Bulgaria and Human Rights Report of the Bulgarian Helsinki Committee December 2001
Table of Contents: Introduction General review of the system of inpatient psychiatric care in Bulgaria and of the scope of involuntary and compulsory treatment Organization, state of facilities, and hygiene Placement Treatment Seclusion and restraint Nutrition Staff Inspections Recommendations to the Government of Bulgaria Annex: Bulgarian legislation on medical measures of compulsion
Introduction
This report summarizes the research findings of the Bulgarian Helsinki Committee (BHC) on the situation of human rights in the system of inpatient psychiatric care in Bulgaria. The Bulgarian Helsinki Committee has been concerned with the human rights of the mentally ill for several years. In 1994 and 1995 BHC researchers visited several psychiatric hospitals, and the results of this assessment were included in the Committee's first special report on the situation in detention centers.[1] In 1996-1997, a number of BHC researchers conducted a second survey of another group of psychiatric hospitals and homes for the mentally handicapped. The results of this assessment were included in a special issue of the magazine Droits de l'homme sans frontieres [Human Rights without Frontiers], published by the Belgian non-governmental organization "Droits de l'homme sans frontieres."[2[ Within the framework of its continuing institutional monitoring projects, BHC has visited all of the homes for mentally handicapped children in Bulgaria, as well as several homes for severely mentally retarded adults and adults with mental illness. In September 2001 the Committee launched a follow-up project for monitoring homes for severely mentally handicapped children. These monitoring efforts resulted in a number of publications in the Bulgarian mainstream media, which called forth widespread public reaction.[3] The present study focuses on the rights of the mentally ill who are placed in psychiatric institutions for compulsory and involuntary treatment by the state, but it inevitably also touches on the situation of patients admitted for voluntary treatment. The study included seven separate, but interlinked components: 1. An examination of the legislation on the organization of psychiatric care in Bulgaria, of the compulsory and involuntary treatment of mentally ill persons and of the patients' rights; 2. A study of international standards and foreign experience with the treatment of persons with mental disabilities; 3. Visits to state psychiatric hospitals (SPH) and municipal psychiatric dispensaries (These visits were carried out jointly with representatives of the Bulgarian Psychiatric Association (BPA)); 4. Interviews with prosecutors, magistrates and physicians directly involved in the procedure of placement, discharge, and treatment of those mentally ill, who are subject to compulsory or involuntary treatment;