Long-term deprivation of liberty disablement judgment. Notifications of involuntary commitment to the Duty Court, examined at the Unit for Acute Illness, Virgen de la Montaña (Cáceres), did not state the exact time and date of each committal. This was also lacking at Balcó de la Safor (Valencia). Authorised committals on insufficient grounds 153. Both at this facility and at the unit for acute illnesses, Puerto Real Hospital (Cádiz), we found judicial committal orders with insufficient grounds to justify the committal, either because it was merely indicated that the medical examiner had “decided in favour of the committal” or a probable diagnosis only was provided (bipolar disorder, psychotic disorder with dissociation episodes, delirious disorders). In the Ombudsman’s opinion, to ensure that patient rights are guaranteed, in addition to a doctor’s opinion, it would be appropriate to have confirmation that the patient is unable to provide valid consent, justifying the specific reasons requiring each committal to psychiatric hospitalisation (as an example, without limitation, danger for the patient or for third parties, therapeutic reasons preventing a follow-up on treatment if the patient is released, discontinuation of earlier treatment when free, lack of suitable alternatives, etc.). Voluntary committal document Court-appointed lawyer Guardianship §324 AR 2014 154. At the Units for Acute Illnesses of the Puerto Real (Cádiz) and Virgen de la Montaña (Cáceres) Hospitals, patients who are voluntarily committed do not sign any document. Although this is standard practice in mental health hospitals in Spain, the patient’s signature would constitute an example of good practice, insofar as doubts would be cleared on the legality of the commitment. Consequently, a protocol should be put in place requiring that all patients sign a voluntary committal document. 155. Just one of the facilities offered a report visited (unit for acute illnesses, Puerto Real Hospital, Cádiz) to each patient, stating in the court applications for involuntary committals or changes from voluntary to involuntary committals, the possibility of being assisted by a court-appointed lawyer. 156. Many of the inmates interviewed at the Balcó de la Safor Therapeutic Centre (Valencia) claimed to not personally know their guardian or, even, did not know who their guardian was. They also claimed unawareness of how their guardian was managing their money. The effective guardianship of incapacitated persons has a direct impact on how their rights are upheld and guaranteed, which is why all public or private guardian entities should be 101

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