Armenia’s outdated mental health laws

From The Guardian, 12 October 2015 (abridged)

in Yerevan

It started as a family row over property. Julietta Amarikian and her brother were arguing about a flat they had jointly inherited from their parents. She wanted to sell and share the proceeds; he wanted her to move out so he could live there with his wife.

The conflict escalated and Amarikian says her brother, unable to get his way, threatened to have her committed to a psychiatric institution if she would not cooperate.

She did not take him seriously at first but when police and medics in white gowns arrived at her door a few days later, she realised he had not been joking.

The 54-year-old says she was taken by force to a Yerevan mental health clinic where she was held for a month against her will. “They locked me up and left me,” she says. “No one even examined me. I was terrified. I thought it was the end of me.

“I have never had problems with my mental health,” she adds. “I only had problems with my brother.”

Human rights workers say that Amarikian’s experience is not unique in Armenia, where it is all too easy to have someone declared mentally incompetent in a hangover from Soviet times when institutionalisation was sometimes used to silence troublemakers.

Under Armenian law, one phone call to the police or a psychiatric institution claiming that someone is a risk to themselves or others is enough to have them hospitalised. If the person refuses to be admitted, the hospital can apply to a court for a mandatory treatment order – without the patient being represented.

An examination by a “psychiatric commission” is required within 72 hours of the order, but staff from the same hospital usually make up the panel. There is no requirement to periodically review the decision and the law does not set limits on the duration of treatment.

Not only is the law open to abuse, human rights workers claim there are perverse incentives for institutions to admit people unnecessarily.

Hospitals are paid 6,000 drams (about €11) a day for each inpatient – a significant amount in a country where the official state pension is 16,000 drams a month.

According to the data provided by the Armenian judicial department, 1,367 people were ruled mentally incompetent between 2008 and 2014. Of these, 247 were committed to psychiatric institutions against their will.

The Armenian state deputy ombudsman, Tatevik Khachatrian, believes the legislation requires complete revision.

“We presented the government with suggestions, such as creating an independent body at psychiatric hospitals and amending the law to offer adequate protection, but we haven’t had a response from them,” said Sakunts.

Hospitals deny abusing the law, saying forced admissions are sometimes necessary. “A healthy person cannot appear in a mental hospital; that is impossible,” said Arega Hakobyan, the head of a clinic in Yerevan. “It is up to doctors, and not to human rights activists, to decide whether a person is sick or healthy.”

But the government seems prepared to admit that this is a concern. “If a problem is being discussed, it means the problem does exist,” said the health ministry’s chief psychiatrist Samvel Torosyan. “The more we develop the legislation to make it more accessible and clear, the more the patients will benefit; increased transparency will result in greater trust.”

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Courtesy of Guardian News & Media Ltd



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