site.btaNational Ombudsman Sends Position to Parliament on Draft Amendments to Health Act about People with Mental Health Disorder

National Ombudsman Velislava Delcheva sent to the National Assembly a position on draft amendments to the Health Act concerning the rights of people with a mental health disorder. Her opinion was requested by Parliament's Labour and Social Policy Committee and Health Committee, the press centre of the National Ombudsman said on Tuesday. 

According to Delcheva, the Ministry of Health should revise Regulation No. 1 of June 28, 2005 on the procedure for the application of temporary physical restraint measures in patients with established mental disorders. She also recommends the drafting of a protocol for the application of the coercive measures of 'immobilisation” and “isolation”, which should clearly indicate for how long and how often patients may be isolated and immobilised for a period of 24 hours, and should specify the grounds on which these measures are applied.

Delcheva notes that Ordinance No. 1 contravenes the UN Convention Against Torture and Other Cruel, Inhuman or Degrading Treatment or Punishment and the Council of Europe Convention for the Prevention of Torture and Inhuman or Degrading Treatment or Punishment. It is inhuman and degrading treatment or humiliation for a patient to be tied up for hours on the same day and isolated, as was uncovered during the inspection at the Lovech State Hospital."

Ordinance No. 1 does not state clearly whether once a measure of immobilisation (tying up) has been ordered for two hours, five minutes after that period the patient can be tied up again an unlimited number of times.

Another significant problem identified by the Ombudsman is the lack of a legal defence mechanism and other systemic deficits.

The opinion stresses that over the years, the Ombudsman has identified numerous systemic problems relating to the rights of patients with mental health disorders, one of the most significant being the application of extreme coercive measures without a system of control. "Tragic incidents continue to occur, and one of the Ombudsman's most important recommendations for legislative change, which is not included in the current bill, is the creation of a single information system in which every ‘immobilisation’ and ‘isolation’ from all psychiatric hospitals in the country must be recorded in real time. This system should link all psychiatric hospitals to the Ministry of Health, and the Ministry should make publicly available, on a monthly basis, data on coercive measures applied in psychiatric hospitals in the country," the position reads.