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English Language Page 2.1.1. Civil commitment Article 48 of the Law on the Protection of Health provides that “the persons who suffer from mental illness and who on the basis of their condition are a danger to their life or the lives of the citizens or to the material goods, will be committed for hospital treatment to a respective health organization.” This provision is somewhat strange as on the one hand, it establishes a very high standard with regard to personal danger (threat to life), but a very low standard with regard to danger to property (any threat to any material goods). According to the Non-Litigation Procedure Act a person who is committed involuntarily to a health organization for treatment could be restricted in his/her contacts with the outside world. This law makes a distinction between placement in the hospital, which leads to actual detention and placement, which suggests an open regime of treatment (Article 59). No matter whether a person is brought involuntarily in the hospital or comes voluntarily but the treatment suggests actual detention, if the medical staff in the hospital are of the opinion that this person should be placed and treated in the hospital then they are obliged to report to the district court within 48 hours after the admission. The report should contain information about the person’s mental health condition, the facts that prove that condition and the names of the person who brought the patient to the hospital. The decision for the involuntary hospitalization is taken by the court. No such notification is due if the person is committed under the penal procedure or if he/she is incapacitated (Article 60). The district court should open ex officio a procedure after receiving the report from the hospital. Then the court should immediately order an examination, check all referent facts for the placement in the hospital and hear the patient. The practice shows that more often the court would go to the hospital and talk to the patients there. The court is obliged to make a decision up to three days after the hearing. The decision should determine the duration of the placement and treatment. The latter cannot be longer than one year (Article 67). Together with the placement the court can decide to deprive the person placed of his/her legal capacity. The decision of the court could be appealed before the Regional court by the person placed in the psychiatric hospital or by the guardian and the relatives. If the hospital decides that upon the expiration of the court-ordered term for treatment, it should file a request for the continuation of the treatment to the district court 30 days before the term expires. The court takes a decision for prolongation after it receives the results of the medical examination and after it hears the patient. The law does not regulate the participation of a lawyer, the rules of evidence and the procedure of the hearing before the district court and before the court of appeal. Thus, it falls short of the due process guarantees and allows for arbitrariness and abuse. 2.1.2. Criminal commitment A person may be committed for compulsory treatment in a health organization in Macedonia if he/she is found insane and cannot stand trial. The commitment, called in Macedonia a “security measure”, is regulated by the Penal Procedure Code. It takes place on the basis of a court order in the context of the criminal procedure and after a medical examination. Chapter 19 of the Law on the Execution of Sanctions (Article 236 – 243) regulates the execution of the security measure known as “mandatory psychiatric treatment and placement in a health institution”. Following such placement, the health institution is obliged to provide annual reports to the competent court about the current state of health of the person concerned. In the event that the institution concludes that there is no further need for such a measure, it must propose to the court that the patient concerned either be released or transferred to prison to serve the remainder of any sentence imposed. |
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