In some cases, a person requires treatment because he poses a danger to himself and others. This happens not only in cases of drug or alcohol addiction, which lead to loss of control over one’s behavior, but also in the presence of contagious diseases that require the patient to be isolated from society.

Legislation

The issue of compulsory treatment is quite complex. After all, in essence, a person is deprived of his freedom, although he has not committed an illegal act. In different countries of the world this issue is solved in different ways.

Compulsory medical measures in the legislation of the world

Medical measures are provided for by the legislation of most countries of the world. Under international law, criminals suffering from mental illness are required to undergo compulsory treatment. It is believed that a criminal who suffers from a mental disorder cannot bear responsibility and fully understand the significance of his actions.

Treatment is usually considered as a “security measure,” that is, an opportunity to protect citizens from a person who poses a danger to them. In a similar sense, the law on compulsory treatment is interpreted by the legislation of most European countries.

Compulsory medical measures in Russian criminal law

In Russian legislation, the first mention of compulsory treatment of insane criminals appeared in 1823. Criminals were to be placed in mental homes, where they were kept separate from other patients.

In 1845, this law was amended: now treatment was required for people who were insane from birth, or for patients who had committed murder, arson, or attempted suicide.

In 1923, a law was passed according to which compulsory treatment was considered a “measure of social protection”. In 1960, forced hospitalization was described in more detail. In particular, under the new law, depending on the severity of the offense committed, criminals could be kept either in a regular psychiatric hospital or in a hospital that was part of the Ministry of Internal Affairs.

Compulsory medical measures combined with the execution of punishment

Currently, the procedure for providing medical care under duress is considered by criminal, executive and procedural legislation, in particular, it is described in the law “On the fundamentals of protecting the health of citizens in the Russian Federation.” The decision to impose a punishment is made by the court: otherwise, the provision of medical care without the consent of the citizen is illegal.

The legislation in the field of compulsory psychiatric care is best developed. Depending on the severity of the disorder and the committed act, either outpatient or inpatient treatment is prescribed. A stay in a specialized hospital may also be prescribed. This is done if the offender must be under round-the-clock supervision by specialists. In this case, the time spent in hospital is counted towards the term of serving the sentence. If the need for detention in a medical institution disappears, the offender is discharged from the hospital, and before discharge, an examination of his condition is carried out.

IMPORTANT! The decision to terminate therapy combined with punishment is made only by the court.

Principles of compulsory treatment

According to the Criminal Code, compulsory treatment measures may be taken in the following cases:

• the person committed a dangerous act while in an insane state, for example, in a state of passion, which must be proven during a forensic psychological examination;
• a mental disorder developed after the commission of a crime, as a result of which the punishment provided for by the Criminal Code of the Russian Federation is impossible;
• the person who committed the crime suffers from a mental illness that does not exclude sanity;
• the offender committed an assault on the sexual integrity of a person under the age of consent.

When making a decision, the court must take into account how dangerous the offender is to society and whether he is capable of committing similar acts in the future. The question of predicting the behavior of a criminal suffering from a mental disorder is quite complex. Abroad, it is believed that forced hospitalization should be carried out in all cases where the offender shows an increased level of aggression. In this regard, compulsory treatment as a punishment is used quite widely. In our country, judges and experts take into account the severity of the condition, the prognosis, the presence of drug or alcohol addiction, the presence of a family, their own home, and a number of other factors. At the same time, as practice has shown, it is social indicators (committing criminal acts in the past, relationships with loved ones, level of social adaptation) that have the maximum significance for predicting the behavior of a criminal.

Compulsory treatment measures

A criminal can receive outpatient treatment if the person does not require constant medical supervision. This usually happens if a person is aware of the presence of a mental disorder, follows the doctor’s recommendations, and also does not have significant behavioral deviations. Outpatient treatment is given to people whose mental disorder was transient in nature and ended by the time the court decision was made.

Inpatient hospitalization is required if the offender's disorder requires constant monitoring. In this case, the type of hospital (general, specialized, intensive observation) is determined by the court.

IMPORTANT! As a rule, the choice of hospital is made depending on the patient’s place of residence, which allows maintaining social connections and receiving the necessary support from relatives.

Types of forced treatment

The type of compulsory treatment depends on the disorder that is identified in the offender.

Drug addicts

Forced rehabilitation of drug addicts is carried out in drug treatment clinics and rehabilitation centers. Moreover, treatment can be prescribed not only after consideration of criminal cases: rehabilitation can also be prescribed after administrative offenses. In this case, treatment is carried out both outpatient and inpatient.

The issue of compulsory treatment of drug addiction is quite controversial: experts argue that in order to achieve the desired effect, motivation is required on the part of the patient, which, as a rule, is absent among experienced drug addicts.

Alcoholics

In the USSR, there was a system of dispensaries in which alcoholics who committed administrative or criminal offenses underwent forced treatment and rehabilitation. However, such a system has now been abolished, and therefore criminals suffering from alcoholism can, by court decision, be treated in drug treatment clinics or centers. Compulsory treatment is possible only if experts have established the fact of alcohol dependence.

If a criminal committed an illegal act while intoxicated, but does not suffer from alcoholism, it is impossible to send him for compulsory treatment.

Mentally ill

Most often, mentally ill criminals undergo compulsory treatment. However, treatment does not cancel the fact of serving a sentence if the offender has been declared sane. The period of hospitalization may be counted towards serving the sentence.

Patients with tuberculosis

According to paragraph 2 of Article 10 of the Law “On Preventing the Spread of Tuberculosis in the Russian Federation,” people suffering from open forms of tuberculosis and violating sanitary and epidemiological regulations, as well as evading examinations and therapy, can be forcibly hospitalized. Forced hospitalization of tuberculosis patients is carried out after a court decision, an application to which is submitted by the management of the organization in which the patient is under observation.

Compulsory treatment for tuberculosis in Russia is a rather acute issue. Can a patient with tuberculosis refuse hospitalization? This depends on the form of the disease, the presence or absence of Koch bacilli, and the accuracy in carrying out medical prescriptions and examinations.

Other types

In some countries, chemical castration is used as a punishment for rape and other sexual crimes. The offender is required to take drugs that reduce sexual desire or make it impossible to have sexual intercourse. This practice is widespread in the United States, but it is not used in Russia.

Why is compulsory hospitalization necessary?

Compulsory hospitalization is necessary in the following cases:

• the offender poses a danger to others (due to the presence of a mental disorder, dependence on narcotic and psychotropic substances, etc.);
• the patient suffers from a contagious disease (for example, open form of tuberculosis), and hospitalization is necessary to prevent the spread of infection;
• the offender is not aware of his actions and cannot be punished by serving time in prison.

Grounds for applying compulsory medical measures

Compulsory hospitalization may be prescribed in the following cases:

• a crime was committed while in a state of insanity;
• after committing a crime, the offender was found to have a mental disorder;
• the offender suffers from a disease that does not preclude sanity;
• a criminal over 18 years of age committed an act against the sexual integrity of a person under 14 years of age.

Use of forced treatment

The decision to cancel their compulsory treatment is made by the court on the basis of a petition from the medical institution where the patient is kept. Treatment can also be prescribed for criminals who are already serving a sentence in prison: a person may develop a mental disorder or tuberculosis while in prison.

The period of treatment is counted towards the term of serving the sentence (one day of treatment for one day of imprisonment).

Statement of claim for involuntary hospitalization

A claim for forced hospitalization can only be filed by a representative of the medical institution where the person is being treated. This usually occurs if the doctor discovers that the patient is a danger to himself or others, is incapable of self-care, or suffers from a serious mental disorder without realizing it and refusing hospitalization.

The court made a positive decision: what next?

If the court makes a positive decision, according to the law on compulsory hospitalization, the patient must go to an appropriate institution for treatment, or must begin outpatient treatment.

Consequences of avoiding hospitalization

If hospitalization is avoided, the court may reconsider its decision. For example, instead of outpatient treatment, inpatient treatment may be prescribed. The treatment period may also be extended.

Terms of application of compulsory medical measures

As a rule, the use of compulsory treatment measures begins immediately after the court verdict. Moreover, these measures are indefinite, that is, they can have any duration. Discontinuation of treatment is possible if the patient's condition improves.

Extension, modification and termination of compulsory medical measures

Compulsory medical measures can be extended, changed or terminated only at the request of a doctor who has noted positive dynamics in the patient’s condition and filed a corresponding statement of claim. The issue of conversion of treatment is decided by the court.

A criminal can be forcibly hospitalized only by a court decision. In all other cases, treatment without the patient's consent is illegal. It is impossible to avoid court-ordered hospitalization, especially if the offender is found to pose a danger to society.

Some people who commit an illegal act are insane or mentally ill.

Naturally, in this state they cannot be sent to correctional institutions, but releasing into freedom seems dangerous to the life and health of respectable citizens.

What to do in such cases? Chapter 15 of the Criminal Code of the Russian Federation provides for the possibility of applying medical measures to them. There are several types of them, but in this article we will analyze in detail the features of compulsory treatment in a general psychiatric hospital.

General overview

Compulsory psychiatric treatment is a measure of state coercion for persons suffering from any mental disorder and who have committed a crime.

It is not a punishment and is imposed solely by court decision. The goal is to improve the condition or completely cure patients in order to prevent them from committing new acts dangerous to society.

According to Art. 99 of the Criminal Code of the Russian Federation (as amended on July 6, 2020) There are 4 types of compulsory medical measures:

1. Compulsory outpatient observation and treatment by a psychiatrist.
2. Treatment in a general psychiatric hospital.
3. Treatment in a specialized psychiatric hospital.
4. Treatment in a specialized psychiatric hospital with intensive supervision.

Compulsory treatment is used when a person with a mental disorder requires such maintenance, care and supervision that can only be provided in an inpatient setting.

The need for treatment in a hospital arises if the nature of the disorder of a mentally ill person poses a danger to both him and others. In this case, the possibility of treatment with a psychiatrist on an outpatient basis is excluded.

The nature of the mental disorder and type of treatment are determined by the judge. He makes a decision based on expert opinion, which states what medical measure is required for a given person and for what reason.

Psychiatric expert commissions act on the principle of sufficiency and necessity of the chosen measure to prevent new crimes by a sick person. It also takes into account what treatment and rehabilitation measures he needs.

What is a general psychiatric hospital?

This is an ordinary psychiatric hospital or other medical organization that provides appropriate inpatient care.

Here Ordinary patients are also being treated according to the direction of a specialist.

Compulsory treatment is given to patients who have committed an unlawful act that does not involve an attack on the lives of other people.

Due to their mental state, they do not pose any danger to others, but they require compulsory hospitalization. Such patients do not require intensive monitoring.

The need for compulsory treatment lies in the fact that there remains a high probability of a mentally ill person committing a repeat crime.

Staying in a general hospital will help consolidate the results of treatment and improve the patient’s mental state.

This measure is prescribed to patients who:

1. Committed an illegal act while insane. They do not have a tendency to violate the regime, but there is a high probability of recurrence of psychosis.
2. Suffer from dementia and mental illness of different origins. They committed crimes as a result of the influence of external negative factors.

Issues regarding extension, change and termination of treatment are also resolved by the court based on the conclusion of a commission of psychiatrists.

The duration of compulsory measures is not indicated when making a decision, since it is impossible to establish the period necessary to cure the patient. That's why the patient undergoes examination every 6 months to determine your mental state.

Treatment in a general hospital combined with execution of punishment

If the offender is serving a prison sentence and there is a deterioration in his mental state, then in this case The law provides for the replacement of the term with compulsory treatment.

This is enshrined in Part 2 of Art. 104 of the Criminal Code of the Russian Federation. In this case, the convicted person is not released from punishment.

The time spent in a psychiatric hospital is counted towards the term of serving the assigned sentence.. One day of hospitalization is equal to one day of imprisonment.

When the convicted person recovers or his mental health improves, the court terminates treatment in a general hospital on the proposal of the body executing the punishment and on the basis of the conclusion of the medical commission. If the term has not yet expired, the convicted person will continue to serve it in a correctional institution.

Compulsory treatment in a psychiatric hospital

Dangerous persons can be referred to a special clinic for such treatment only by a court ruling. Based on a statement from relatives or a call, a person cannot be admitted to a mental hospital. That's why In court you need to provide serious and compelling evidence.

Most alcoholics and drug addicts deny their addiction, while turning the lives of their loved ones into a complete nightmare. Naturally, they are confident in their adequacy and refuse treatment voluntarily.

Living with an addict brings a lot of problems, quarrels, and material problems. That is why relatives are wondering how to send him for compulsory treatment to a mental hospital.

If pronounced mental abnormalities are observed in drug and alcohol addiction, then only then is treatment possible without the consent of the patient.

To be sent for compulsory treatment to a general psychiatric hospital The following documents are needed:

• statement from relatives;
• doctor's conclusion about the presence of signs of inadequacy.

How to send for treatment

First of all, the psychiatrist must identify whether there are mental disorders or not.

In addition, it must be established whether their actions pose a danger to other people.

To determine a person’s mental state, you need to seek clarification from your local doctor. He will write a referral to a psychiatrist.

If the patient cannot go to him, then he is obliged to come to the house himself. If deviations are detected, the doctor writes out a document that allows send a person for compulsory treatment involuntarily.

If the condition worsens, you should call an ambulance. They need to show a certificate from a psychiatrist. After this, the staff must take the patient to a mental hospital for further treatment.

From the moment a mentally ill person is placed in a general hospital, relatives have 48 hours to file a claim for referral to compulsory treatment.

Such things are considered as special proceedings. The application is written in any form in compliance with the requirements of Art. 302, 303 Code of Civil Procedure of the Russian Federation.

The claim is filed in the district court at the location of the psychiatric hospital. The applicant must indicate all the reasons for placement in a mental hospital, citing the rules of law. The claim must be accompanied by the conclusion of a psychiatric commission.

The law defines special conditions for legal proceedings in such cases:

• the application is reviewed within 5 days;
• a mentally ill citizen has the right to be present at trial;
• The court decision is made on the basis of a medical psychiatric examination.

The Russian Constitution includes rights such as personal integrity and freedom of movement. In order to comply with them, the law strictly prescribes place citizens for compulsory treatment in psychiatric hospitals only by court decision. Otherwise, criminal liability arises.

Video: Article 101. Compulsory treatment in a medical organization providing psychiatric care

Reasons for outpatient compulsory treatment by a psychiatrist

The application of compulsory medical measures is possible only to those persons who have committed acts characterized by a public danger and enshrined as features of certain articles of the Criminal Code. Such measures are manifested in the form of medical care aimed at curing the subject of the crime, improving his mental indicators, which is necessary to prevent him from committing criminal acts in the future.

Persons who have become subjects of crimes, in relation to whom there are doubts regarding the usefulness of their mental state, are subject to referral for forensic psychiatric examination. The expert's conclusion about the person's insanity is the basis for the termination of the case. In this situation, the subject of the crime is subject to mandatory compulsory medical intervention.

Legislators have identified an exhaustive range of grounds that may affect the need to use compulsory medical actions:

• the presence of a state of insanity in the person who committed the act of a socially dangerous nature;
• the presence of a mental disorder, which excludes the possibility of both determining the level of punishment and its execution upon conviction;
• establishment of a mental disorder that does not exclude sanity;
• establishing the need for compulsory treatment for diseases associated with alcoholism or drug addiction.

The appointment of compulsory treatment measures can be carried out in cases where the presence of a mental disorder becomes the basis for the emergence of confidence in the social danger of a person and the possibility of causing harm to himself and to those around him. Thus, the purpose of medical intervention is justified by the need to protect society not from a criminal act, but from the possibility of its commission.

At the time of imposing compulsory treatment measures, the court is obliged to take into account the existing medical indicators of the person and his social danger. The level of gravity of the committed act is not taken into account. The act itself can only be perceived as a symptom of a disease.

The court does not have the right to establish compulsory treatment measures in relation to persons who have become subjects of crimes, in the absence of one of the four above grounds.

Appointment and visit of treatment with a psychiatrist

Considering the materials of each specific criminal case, and studying the characteristics of the person who committed the criminal act, the court is obliged to make a decision on the need to apply compulsory treatment measures to the offender.

In cases where one of the grounds for prescribing such measures exists, the court is obliged to refuse to establish a punishment and determine medical measures that must be forcibly applied to the person in order to recover and prevent the commission in the future.

When assessing the social danger of the subject himself, the court determines the measures of medical intervention that may be expressed in the prescription:

• outpatient compulsory observation by a psychiatrist or treatment by him;
• inpatient treatment in a psychiatric clinic;
• inpatient treatment in a specialized medical institution;
• inpatient treatment in a specialized psychiatric clinic, combined with high intensity observation.

The court determines the type of treatment required based on recommendations that are justified by the result of a forensic psychiatric examination. According to its internal conviction, the court may go beyond the recommendations.

The appointment of outpatient compulsory observation and treatment is carried out by the court, regardless of his sanity or insanity. Compulsory observation and treatment by a psychiatrist on an outpatient basis is a measure that is necessary to create security for both the subject of the crime and the society around him.

Persons in respect of whom a decision has been made to recognize their insanity may be transferred to guardianship. At the same time, the application of compulsory psychiatric treatment measures to them may not be mandatory. In such cases, the court orders compulsory medical observation, with the person being registered with a medical institution that provides psychiatric treatment, in accordance with his place of residence.

Providing psychiatric medical care is mandatory for medical institutions.

Persons whose insanity has not been recognized and for whom a non-custodial sentence has been imposed may be required to undergo outpatient compulsory observation and treatment procedures. This duty must be fulfilled regardless of the wishes of the convicted person.

The time period required for the complete recovery of persons who have committed criminal acts cannot be established by a court decision. The reason for this is the impossibility of determining the specific period of time required for the complete cure of the criminal subject.

Such a period can be determined exclusively by a medical institution on the basis of indications that are noted in the process of its treatment.

On the part of the administration of the psychiatric clinic, a submission is sent to the court indicating the cure of the criminal. Completion of compulsory treatment, which has a positive result, is the basis for its termination on the basis of a procedural document issued by a judicial authority.

If doubt arises about the mental fitness of a person who has committed a socially dangerous act, provided for by the Special Part of the Criminal Code, in relation to him, by virtue of clause 2 of Art. 79 of the Code of Criminal Procedure, a forensic psychiatric examination must be ordered, which resolves issues of a person’s sanity or insanity, or the presence of mental disorders that do not exclude sanity.
If a person is declared insane, the court issues a ruling to terminate the criminal case and at the same time imposes a compulsory medical measure.

Outpatient compulsory observation and treatment by a psychiatrist as a compulsory medical measure is prescribed if a person, due to his mental state, does not require placement in a psychiatric hospital. The mental state of the person must be stated in the conclusion of the forensic psychiatric examination and assessed by the court.
It should be noted that, in accordance with the law, the use of compulsory medical measures is the right of the court. Therefore, the court, assessing the conclusion of the forensic psychiatric examination, must decide on the use or non-application of such a measure, based on the requirements of Art. 98 of the Criminal Code, bearing in mind both medical and legal purposes of using such measures.
Compulsory observation and treatment by a psychiatrist is carried out only on the condition that the person does not need to be placed in a psychiatric hospital. Ensuring this measure should be entrusted by a court ruling to the internal affairs bodies.
Compulsory treatment in a psychiatric hospital
When applying compulsory treatment, the law provides for the possibility of assigning various types of psychiatric hospitals.
In accordance with Art. 101 of the Criminal Code of the Russian Federation, compulsory treatment in a psychiatric hospital is prescribed in cases where a person, due to his mental state, can cause significant harm or pose a danger to himself and others, and outside the conditions of a psychiatric hospital it is impossible to provide him with the necessary treatment.
A general psychiatric hospital is an ordinary psychiatric hospital where treatment is voluntary. However, the mental state of the person forcibly undergoing treatment there must allow for the possibility of his detention without special security measures, i.e. not requiring intensive monitoring. In practice, persons to whom such a compulsory measure of a medical nature has been applied are kept in ordinary psychiatric hospitals along with patients admitted to them on a general basis.
Compulsory treatment in a specialized psychiatric hospital is prescribed to persons whose mental state requires constant monitoring, i.e. they need appropriate treatment, and their mental disorder is such that they pose a public danger to themselves and others.
Therefore, such hospitals have special security departments, the activities of which are regulated accordingly. Patients in such hospitals are kept in conditions that exclude the possibility of them committing socially dangerous acts.
Compulsory treatment in a specialized psychiatric hospital with intensive supervision is prescribed to persons whose mental state poses a particular danger to themselves and others. When deciding whether to prescribe treatment in a specialized psychiatric hospital with intensive observation, the court must take into account the recommendations contained in the conclusion of the forensic psychiatric examination. Persons suffering from severe mental disorders, prone to committing serious and especially serious crimes, or systematically committing socially dangerous acts are placed in such hospitals. Extension, modification and termination of the application of compulsory medical measures

The time period for applying compulsory medical measures in connection with mental disorders is not limited to any period. Therefore, in order to monitor the progress of treatment, the law provides for examination of persons to whom compulsory medical measures have been applied at least once every six months.
Issues related to the extension, change of type and cancellation of compulsory medical measures are decided by the court based on the conclusion of a commission of psychiatrists.
If a commission of psychiatrists comes to the conclusion that there are no grounds for terminating the application of a compulsory medical measure, then the administration of the institution that carries out compulsory treatment submits a conclusion to the court on the extension of compulsory treatment. The first examination is carried out after six months from the start of treatment. If the court, based on the first conclusion, extended compulsory treatment, then in the future it is carried out annually if there is a corresponding representation from the administration of the medical institution, based on the conclusion of a commission of psychiatrists.
In the event that a commission of psychiatrists comes to the conclusion that there are no grounds to continue compulsory treatment or to change a compulsory measure of a medical nature, the court, upon the proposal of the administration of the institution providing compulsory treatment, based on a medical opinion, may make a ruling to terminate the use of compulsory treatment or on changing a compulsory medical measure. Since the mental state of a person to whom a compulsory medical measure has been applied may change for both the better and the worse, the court has the right to choose any of the compulsory medical measures provided for in Art. 99 of the Criminal Code.
Upon termination of the application of compulsory medical measures, the court may transfer materials regarding this person to the health authorities to resolve the issue of his treatment in accordance with the Law of the Russian Federation of July 2, 1992 No. 3185-1 “On psychiatric care and guarantees of the rights of citizens in its provision.”
When compulsory treatment for persons who have been temporarily released from serving their sentence is terminated due to recovery, they are sent to serve their sentence.
In cases where the criminal case was suspended due to a person’s mental illness after he committed a crime, upon termination of the application of compulsory medical measures, the court decides on the issue of sending the case for an inquiry or preliminary investigation.

$1. Outpatient compulsory observation and treatment by a psychiatrist

Outpatient compulsory observation and treatment by a psychiatrist in accordance with the law (Article 100 of the Criminal Code) “may be prescribed if there are grounds provided for in Article 97 of this Code, if the person, due to his mental state, does not need to be placed in a psychiatric hospital.”

The general basis for prescribing compulsory measures of a medical nature is “danger to oneself or other persons” or “the possibility of causing other significant harm” by the insane, of limited sane, alcoholics and drug addicts who have committed crimes, as well as by persons whose mental disorder occurred after committing crimes. According to experts, outpatient compulsory observation and treatment by a psychiatrist can be prescribed to persons who, due to their mental state and taking into account the nature of the act committed, pose a low social danger or do not pose a danger to themselves and other people. The last statement clearly contradicts the law (Part 2 of Article 97) that compulsory medical measures are prescribed only in cases where mentally ill persons can cause harm or are dangerous to themselves or others.

The legislator, as a circumstance allowing the court to prescribe compulsory outpatient treatment and treatment with a psychiatrist, provides for a mental state in which the person who committed a dangerous act does not need to be placed in a psychiatric hospital. The Criminal Code does not provide criteria for this mental state. Forensic psychiatrists believe that outpatient compulsory treatment can be applied to persons who, due to their mental state, are able to independently satisfy their life needs, have sufficiently organized and orderly behavior and can comply with the outpatient treatment regimen prescribed to them. The presence of these signs allows us to conclude that a mentally ill person does not need inpatient compulsory treatment.

However, the legal criteria for a mental state in which the patient does not require inpatient treatment are:

1. the ability to correctly understand the meaning and significance of the outpatient observation and treatment used by a psychiatrist;

2. the ability to manage one’s behavior during the process of compulsory treatment.

The medical criteria for the mental state in question are:

1. temporary mental disorders that do not have a clear tendency to recur;

2. chronic mental disorders in remission due to compulsory treatment in a psychiatric hospital;

3. alcoholism, drug addiction, other mental disorders that do not exclude sanity.

In accordance with the law, for persons who have committed a crime in a state of sanity, but suffer from alcoholism, drug addiction or other mental disorder within the limits of sanity, if there are grounds, the court may prescribe compulsory medical treatment only in the form of outpatient observation and treatment by a psychiatrist (Part 2 of Art. 99 of the Criminal Code).

The location of compulsory outpatient treatment depends on the type of punishment imposed by the court:

o persons sentenced to imprisonment undergo outpatient treatment at the place of serving their sentence, that is, in correctional institutions;

o persons sentenced to non-custodial sentences receive compulsory treatment from a psychiatrist or narcologist at their place of residence.

In essence, compulsory outpatient observation and treatment by a psychiatrist is a special type of dispensary observation and as such consists of conducting regular examinations by a psychiatrist (in a dispensary or other medical institution providing outpatient psychiatric care) and providing a mentally ill person with the necessary medical and social assistance (Part 3 of Article 26 of the Law of 1992). Such observation and treatment by a psychiatrist is established regardless of the patient’s consent and is carried out compulsorily (Part 4 of Article 19 of the 1992 Law). Unlike ordinary dispensary observation, compulsory observation and treatment is canceled only by a court decision, and in necessary cases can be changed by the court to another measure - compulsory treatment in a psychiatric hospital. The basis for replacing outpatient treatment with inpatient treatment is the representation of a commission of psychiatrists about the deterioration of the person’s mental state and the impossibility of carrying out compulsory treatment without placement in a hospital.

Outpatient compulsory observation and treatment by a psychiatrist in some cases can be used as a primary measure of compulsory treatment, in other cases this measure can act as the last stage of compulsory treatment after compulsory treatment in a psychiatric hospital.

As a primary measure, compulsory outpatient observation and treatment by a psychiatrist can be used in relation to persons who have committed socially dangerous acts in a state of short-term mental disorder caused by pathological intoxication, alcohol, intoxication, exogenous or postpartum psychosis.

As the last stage of compulsory treatment, experts propose the use of outpatient observation and treatment by a psychiatrist for persons who have committed socially dangerous acts in a state of chronic mental disorder or dementia, after undergoing compulsory treatment in a psychiatric hospital due to the fact that these persons need medical supervision and supportive treatment regimen.

The introduction into the Criminal Code of such compulsory medical measures as outpatient observation and treatment by a psychiatrist is aimed at reducing the number of people subjected to compulsory treatment in psychiatric hospitals and preserving their social adaptation during outpatient treatment by a psychiatrist in the patient’s usual living conditions.