CRISIS SITUATIONS AND THE USE OF COERCION IN PSYCHIATRY

Abstract

The article deals with phenomena of aggression and violence in humans with special attention to mental illnesses. Crisis and violent behaviour do not occur only in psychiatry. It can happen in any context or circumstance, and any person could either fall victim or be the perpetrator. Knowledge of multicausality and complexity as well as of individual environmental and situational factors that can lead to violent behaviour has little power of prediction. Statistical indicators can conceal false positive and false negative results, whereby the error of assessment can dramatically increase the risk of some behaviour or lead to an unjustified suspension of human rights of freedom.
The use of coercion in psychiatry is necessary only in exceptional situations where dangerous behaviour directly threatens the life and health of the person or the environment or property.
Positive legislation, in particular the Law on the Protection of Persons with Mental Disabilities (Narodne novine 76/2014) and the Ordinance on the Types and Methods of Enforcement of Coercion to a Person with Serious Mental Disorders (Narodne novine 16/2015) further protects the rights of the mentally ill and prescribes the type and mode of coercion as well as procedures for handling. Professional psychiatric societies have provided additional guidelines and treatment strategies.
The paper emphasizes the need for better conditions, infrastructure and human resources, with continuous improvement and evaluation of the quality of work in psychiatry. In conclusion, the standards and ethical issues of society and a broad spectrum of activities are being discussed, from destigmatization, through better access to services to standards of living and social inclusion, which can indirectly lead to a significant reduction of violence in society.