Part II As noted by Piotr Gałecki and King Bobińska292, action targeted against life or health means a violent and drastic action posing a risk to the health or life of the person taking the action or to the health or lives of other people. It may consist in a suicide attempt, self-aggressive acts including self-injury, or aggression towards other people. Action targeted against public security means any behaviour that poses a  threat to public security, not necessarily consisting in aggressive behaviour (e.g. arson, i.e. setting fire). A situation when a  person violently destroys or damages objects in his/her vicinity is usually a manner of strong emotional expression combined with aggressive behaviour. The aggression is targeted against objects in the person’s vicinity. Such behaviour entails strong disorientation, unpredictability and inability to manage one’s own actions, which generates a direct threat to the safety of those in the vicinity. The act of disturbing or disabling the operation of the healthcare institution providing psychiatric health care is a very imprecise term that can lead to abuse of direct coercion, particularly against patients who are difficult to deal with and unwilling to comply with the personnel’s instructions. It should be emphasized, however, that such behaviour may be a reason only for holding the patient down, or compulsory administration of a medicinal product. According to Article 2(18) of the AMHP, decision on when and how to use direct coercion is taken by a physician who is also responsible for supervising such measures. If it is not possible to have the decision taken immediately by a physician, it has to be taken and supervised by a nurse who should immediately notify the physician. Prior to the use of direct coercion, the patient has to be informed of the possibility of its use which has to be indicated in the medical documentation. Any justified use of direct coercion by a  nurse has to be approved by a  physician, or otherwise discontinued. When using direct coercion, the method least discomforting for the patient should be applied, and if the patient subjects himself/herself to the medical procedure and cooperates in the treatment, the coercion should be immediately discontinued293. During the visits to psychiatric care facilities, the NMPT representatives identified the practice of using direct coercion at patient’s request. Personnel members who applied direct coercion to patients explained that the patients Cf. P. Gałecki, K. Bobińska, Ustawa o ochronie zdrowia psychicznego Komentarz [teh Act on Mental Health Protection. A commentary], Warsaw, 2016, p. 125. 293 Ibidem, p. 128. 292 103