Psychiatric treatment of mentally ill persons in custody – legal, medical and ethical issues

Abstract

Introduction The most recent legal regulations in the Republic of Croatia govern the process of criminal procedure for persons in pre-trial detention who have a temporary mental disturbance for which psychiatric treatment is needed. The Prison Director is in this case obliged to seek psychiatric treatment for such persons who are then hospitalized in a psychiatric institution instead of a prison hospital or prison that meets the requirements prescribed by law for the accommodation of pre-trial detainees. Forensic departments of the five psychiatric hospitals in Croatia accept mentally incapable persons subject to court order, but not persons in custody, i.e. in pre-trial detention. Pre-trial detention is a measure imposed in the previous proceedings to ensure that the person to whom the measure is imposed is present during the pre-trial stage and the hearing stage, i.e. after the final judgment has been rendered until it becomes final. According to Croatian laws, a person who has been sentenced to pre-trial detention and who has mental disorders is entitled to a range of rights that must be respected, and at the same time, there are strict restrictions in exercising those same rights for the reason of sentencing to pre-trial detention. Objectives The article points to several problems that have arisen in practice due to the under-regulation of pre-trial detention measures. Methods Perspective, opinion, and commentary article. Results Perspective, opinion, and commentary article. Conclusions The authors discuss legal, medical, and ethical issues, but also the financial framework of such a process.

Keywords

• forensic psychiatry
• pre-trial detention
• Mental Health Act
• hospital mental health services