CCPR/C/127/D/2920/2016
hold an inpatient forensic psychiatric observation in the psychiatric facility in Almaty. On 7
May 2010, the court ordered the author’s inpatient forensic psychiatric examination. In the
report of the examination of 7 July 2010, experts concluded that the author was suffering
from a chronic “mental disease”, identified as chronic delusional disorder, 17 and
recommended compulsory psychiatric treatment. On 5 August 2010, the Balkhash city
court found the author “mentally unfit” to stand trial and ordered her forced psychiatric
hospitalization and treatment. On 2 November 2010, the Karaganda regional court
confirmed this decision on appeal. On 6 September 2011, the Talgar regional court replaced
the order for the author’s compulsory psychiatric treatment with compulsory outpatient
supervision and treatment at her place of residence, Balkhash city. This court decision was
not appealed.
4.4
On 27 September 2011, the author was registered in the psychiatric medical centre
in the city of Balkhash for regular medical observation and treatment. However, only on 12
December 2011 did the author go for the first time to the psychiatric medical centre for a
review. The medical commission, consisting of four doctors, concluded that the state of the
author’s mental health had deteriorated and that compulsory hospitalization was
necessary. 18 The State party submits that the legality of the author’s internment at the
psychiatric facility was reviewed by the Ministry of Health’s Medical and Pharmaceutical
Oversight Committee for the Karaganda Region, 19 and no violations were revealed. On 5
January 2012, the author was released from the psychiatric facility with consequent
outpatient observation and treatment by a local psychiatrist. The author visited the
psychiatrist three times (on 17 and 27 January and 7 February 2012).
4.5
The State party notes that, on 12 October 2012, the Balkhash city court rejected the
author’s complaint against the Deputy Chief Medical Officer regarding her forced
hospitalization from 12 to 29 December 2011. Both appeal and cassation complaints were
also rejected on the grounds that the author’s hospitalization had been lawful and medically
necessary, and that the Deputy Chief Medical Officer had acted according to the law.
4.6
The State party submits that, according to article 124 of the Public Health and
Health-Care Code (Health-Care Code), “dynamic monitoring” may be ordered without the
consent of a person with a “mental disorder”, and includes monitoring of the person’s
mental health by means of regular examinations by a psychiatrist and provision of
necessary medical and social assistance. Taking into account the author’s diagnosis, the
psychiatric medical centre kept a register of her scheduled regular visits to a psychiatrist
and for treatment. However, since 7 February 2012, the author has not complied with those
requirements.
4.7
The State party relates that, after numerous attempts to contact the author by the
psychiatric facility personnel, it was assumed that her state had worsened, so the decision to
bring the author to the psychiatric facility was taken. On 9 August 2013, the author was
brought to the psychiatric facility for examination by personnel of the facility, with the
assistance of two police officers.20 The medical commission took a decision that the author
needed to be hospitalized because she had persecutory delusions and engaged in unceasing
complaint and litigation activities. The State party submits that, according to article 125
(1.1) of the Health-Care Code, forced internment in a psychiatric facility before a court
decision is only possible in relation to people having severe “mental diseases”.21 In such
cases, the psychiatric facility is required to inform a prosecutor within 48 hours from the
moment of a person’s forced internment. The Balkhash city prosecutor’s office was
informed on 9 August 2013; later on, a request for the forced hospitalization of the author
was filed with the Balkhash city court, which approved the request on 20 August 2013. All
the author’s appeals were rejected by the courts. In addition, upon the request of the
17
18
19
20
21
6
The State party claims that according to the International Classification of Diseases chronic
(“persistent”) delusional disorder is a part of the bigger group “schizophrenia”, and is considered to
be a severe psychological disease.
The State party notes that article 94 (providing medical care without consent) of the health code
provides for medical care to be provided without consent, inter alia, when a person suffers from a
severe mental disorder or from a mental disorder and has committed a socially dangerous act.
The review took place from 27 to 30 December 2011.
According to article 127 of the Health-Care Code, the police must assist medical personnel in cases of
forced psychiatric examination and hospitalization.
See Health-Care Code, art. 94 (1.2)–(1.4).