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“Evaluation of Psychiatric Detention Criteria without Face-to-face Patient Interview is a Violation of Human Rights,”Says NHRCK
-Patients should be given an opportunity to state their opinions and respond to questions about involuntary admission in a face-to-face interview-
The National Human Rights Commission of Korea (Chairperson Young-ae Choi) concludes that it is a violation of personal liberty, which is protected under Article 12 of the Constitution, if a psychiatric hospital fails to conduct a face-to-face interview requested by a patient who was involuntarily admitted to the hospital in the assessment of their detention criteria even if it has obtained a written statement from the patient. It recommended the respondent institution interview patients face-to-face upon their request, enhance the guidelines for psychiatric detention assessment and provide training for researchers.
As involuntary admission by legal guardians defined in Article 24 Paragraph 1 of the former Mental Health Act was ruled unconstitutional by the Constitutional Court in September 2016, psychiatric detention assessment, along with the requirement for the secondary diagnosis by psychiatrists from a different institution, has been introduced as part of a stricter hospitalization process under the Mental Health Promotion and Welfare Act. The psychiatric detention review board, an independent institution, makes a decision as to the suitability of detention and extension of inpatient stays by conducting a review of hospital admission reports and supporting documents and a face-to-face patient interview within one month of the initial admission. Once a decision is made to extend the period of hospitalization, the patient is required to remain in hospital until the next assessment.
The complainant was hospitalized involuntarily into the respondent institution by a legal guardian from November 6 2019 through January 2 2020. During the period of hospitalization, the complainant was notified by the hospital administrator of the results of the psychiatric detention assessment that order the patient to stay in hospital for an additional period of time. The complainant filed a petition with the Commission over the validity of such decision, claiming that no face-to-face interview has been conducted to lead to the decision.
It has been confirmed that the complainant applied for a face-to-face interview for the evaluation of the detention criteria. An researcher actually visited for an interview on November 15 2019, but was unable to conduct one as the complainant, who had been in an agitated and unstable state, was given sedatives in an isolated room. The research was resumed on November 28 2019 through attempts to call family members, request and review of written statements from the complainant and phone calls with hospital staff and the police officer who responded to an initial call for help and the decision to extend hospitalization was notified to the complainant.
In light of the fact that the psychiatric detention assessment system was introduced to determine the legality and fairness of involuntary hospitalization by a legal guardian (Article 24 Paragraph 1 of the former Mental Health Act, ruled unconstitutional by the Constitutional Court), the NHRCK Committee on Remedies for Discrimination notes that a face-to-face interview is a procedural right given to physically restrained patients to answer questions and state their opinions regarding involuntary hospitalization and that the review board should have made every possible effort to guarantee patients’ right to have a face-to-face interview.
It may have been difficult to have an interview with the complainant who had been given sedatives, but the researcher should have made an additional attempt to meet the patient in person during the review period. The research continued with a written statement from the patient and phone interviews with other persons concerned. However, the complainant was not in a constant state of being unable to have an interview. Moreover, the written statement, prepared by a hospital staff member during the period of inpatient care, is deemed insufficient to convey the opinion of the patient and cannot replace the face-to-face interview where the patient can directly communicate their views to the researcher.
The Committee on Remedies for Discrimination further recommends that a patient who was involuntarily admitted to a psychiatric hospital be allowed to be present and state their views at the meeting of the review board to ensure the effectiveness of the psychiatric detention review board as a practical screening mechanism.