Ethical Issues in Prison Psychiatry in România

Abstract

(from the chapter) Historically, involuntary treatment of incompetent patients with mental illness (which can take place in a hospital or in the community) takes into consideration the best interest of the patient and also the best interests of those of the family/carer(s) and the wider community. The involuntary treatment of prisoners, however, is a contentious issue; currently there is no mechanism that permits the involuntary treatment of mentally ill prisoners, unless they deteriorate to such an extent that they require hospitalization. Legislation for the involuntary treatment of a patient under a Community Treatment Order should be extended to prisons as they are part of and belong to the community. There have been some improvements in the quality of care delivered in the mental health services in Romania since the implementation of the Mental Health Law 2002. However, there are significant areas of unmet need and research is needed to evaluate whether prisoners with mental disorders receive appropriate care to the standard mandated by the European Convention on Human Rights. The most important problems facing forensic psychiatry and prison mental health in Romania and other Eastern European countries include insufficient care programs, the lack of multi-disciplinary treatment teams, a lack of psychosocial rehabilitation programs and programs for the re-integration of forensic psychiatric patients back into the community. It is important that we continue to advocate for improved standards of care for forensic patients whilst they are in custody, and upon release into the community, if we are committed to diverting the typical trajectory of such patients away from recidivism and poorer health outcomes in the future. (PsycINFO Database Record (c) 2016 APA, all rights reserved).