Commentary on Article 95. Compulsory Treatment in a Psychiatric Inpatient Facility of the Criminal Code of the Republic of Kazakhstan
Compulsory treatment in a psychiatric inpatient facility may be ordered where the grounds provided for in Article 91 of this Code exist, if the nature of the person's mental disorder requires such conditions of treatment, care, confinement and supervision as can be provided only in a psychiatric inpatient facility.
Compulsory treatment in a general-type psychiatric inpatient facility may be ordered for a person who, due to their mental condition and the nature of the socially dangerous act committed, requires inpatient treatment and supervision but does not require intensive supervision.
Compulsory treatment in a specialized-type psychiatric inpatient facility may be ordered for a person who, due to their mental condition and the nature of the socially dangerous act committed, requires constant supervision.
Compulsory treatment in a specialized-type psychiatric inpatient facility with intensive supervision may be ordered for a person who, due to their mental condition and the nature of the socially dangerous act committed, poses a particular danger to themselves or other persons and requires constant and intensive supervision.
Compulsory treatment in a psychiatric inpatient facility may be ordered where the grounds provided for in Article 91 of the Criminal Code exist, if the nature of the person's mental disorder requires such conditions of treatment, care, confinement and supervision as can be provided only in a psychiatric inpatient facility (Part 1 of Article 95 of the Criminal Code).
Compulsory measures involving the placement of a person in a psychiatric inpatient facility restrict human rights and freedoms to a greater extent than compulsory outpatient supervision and treatment by a psychiatrist, because the application of these measures entails isolation from other people, which results in significant restrictions on human rights and freedoms.
Compulsory treatment in a general-type psychiatric inpatient facility may be ordered for a person who, due to their mental condition and the nature of the criminal offence committed, requires inpatient treatment and supervision but does not require intensive supervision (Part 2 of Article 95 of the Criminal Code).
The following grounds are required for placement in a general-type psychiatric inpatient facility:
the dangerousness of the person subject to hospitalization, both to themselves and to others;
the existence of concerns about a possible significant deterioration in the person's mental condition if they are not placed in a psychiatric inpatient facility. Such concerns must be substantiated by the results of the psychiatric examination conducted.
A general-type psychiatric inpatient facility is a medical and preventive institution that carries out the examination, treatment and social and occupational rehabilitation of persons suffering from mental disorders. Such facilities are under the jurisdiction of the regional state healthcare authority. The conditions of confinement in general-type psychiatric inpatient facilities, i.e. hospitals, are relatively unrestricted, which makes it possible to carry out treatment effectively. However, the mental condition of such patients must not require intensive supervision. The clinical and social criteria for referral to a general-type psychiatric inpatient facility are set out in greater detail in departmental regulatory acts of the healthcare authorities. Thus, persons whose committed acts and mental condition make compulsory hospital confinement and treatment necessary and sufficient are placed in general-type inpatient facilities.
Compulsory treatment in a specialized-type psychiatric inpatient facility may be ordered for a person who, due to their mental condition and the nature of the socially dangerous act committed, requires constant supervision (Part 3 of Article 95 of the Criminal Code). Persons with various mental disorders who have committed dangerous acts classified as serious offences (but not involving an encroachment on the lives of citizens), are prone to committing repeated socially dangerous acts, and have demonstrated such characteristics of their condition and behaviour as indicate the need for their confinement under conditions of constant supervision are referred to such facilities. Constant supervision is ensured by additional medical personnel and employees of the security service established in hospitals.
The specialized nature of a psychiatric inpatient facility means that the medical institution has a special regime for the confinement of patients. The clinical and social characteristics of patients held in these departments determine the specific organization of the institution's work. Firstly, this concerns enhanced control and supervision measures: security alarms, isolated walking yards, inspection of parcels, etc.; secondly, it is associated with the implementation of an extensive range of treatment and rehabilitation measures, occupational therapy, etc.
Compulsory treatment in a specialized-type psychiatric inpatient facility with intensive supervision may be ordered for a person who, due to their mental condition and the nature of the socially dangerous act committed, poses a particular danger to themselves and other persons and requires constant and intensive supervision (Part 4 of Article 95 of the Criminal Code). Thus, this most stringent measure of compulsory treatment is applied in cases where a person's mental state makes it possible for them to commit acts dangerous both to themselves (suicide attempts, self-mutilation) and to others (assault, causing bodily harm, attempted murder, arson, etc.). In addition, the nature of the crime committed by the person also serves as an indicator of such a possibility (murder, banditry, robbery, intentional infliction of grievous bodily harm, rape, etc.). Such persons are characterized by the persistence of their mental disorder and its frequent relapses, pronounced aggressive behaviour, sudden outbursts of anger, etc. These persons require compulsory treatment, but under conditions in which enhanced and strict supervision is maintained over them. The conditions of their confinement in the inpatient facility exclude the possibility of committing acts that may cause substantial harm to the person themselves, medical and service personnel, as well as any other persons, or pose a real threat of causing such harm. Psychiatric inpatient facilities with intensive supervision create maximally safe conditions for the confinement of patients; such facilities have not only external security but also supervision over patients' behaviour inside the department.
Security in specialized-type inpatient facilities is provided by non-military supervisory personnel of the internal affairs bodies. Together with the medical personnel, they also carry out the admission of persons with mental disorders and supervise them during walks, visits, etc.
Minors under the age of 16 are not referred to psychiatric inpatient facilities with intensive supervision.
In psychiatric inpatient facilities, it is sometimes necessary to apply physical restraint and isolation measures to individual patients when, in the opinion of a psychiatrist, socially dangerous actions by the hospitalized person cannot be prevented by other methods. The forms and duration of the application of physical restraint and isolation measures are recorded in the medical documentation (Article 175 of the Code of the Republic of Kazakhstan “On Public Health and the Healthcare System”). The use of physical coercion against patients in a psychiatric inpatient facility without sufficient grounds, as well as the unlawful issuance of orders for its use, entails criminal liability.
A person guilty of placing an individual in a psychiatric inpatient facility without sufficient grounds shall be subject to disciplinary or criminal liability (Article 127 of the Criminal Code, “Unlawful Placement in a Psychiatric Inpatient Facility”).
Commentary of 2021 on the Criminal Code of the Republic of Kazakhstan by Isidor Shamilovich Borchashvili, Honoured Figure of Kazakhstan, Doctor of Law, Professor, Academician of the Kazakhstan National Academy of Natural Sciences, Member of the Scientific Advisory Councils under the Constitutional Council of the Republic of Kazakhstan and the Supreme Court of the Republic of Kazakhstan, Member of the Working Group on the Reform of the Law Enforcement System under the Security Council of the Republic of Kazakhstan, Honoured Employee of the Ministry of Internal Affairs of the Republic of Kazakhstan.
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