Civil rights of patients

Civil rights of patients 

The civil rights of mental patients are not much different from other patients. There have been several clinical, public and legal movements that led to framing of civil rights of patients. There are reports of violation of those rights, due to ignorance of the public, family and care givers. Even in public hospitals due to not having enough resources those rights are violated. 

Treatment in a least restricted alternative environment 

The principle is that patients should be receiving treatment is a least restrictive environment such as an out patient at home, or in a respite facility. Committing to hospital should be avoided as much as possible.

To assess the situation meaning to commit to involuntary treatment is a tricky one. It depends on the information provided by the family, care givers, by people around, any safety issues related to self and others, and at times impression of the psychiatrist applying for the treatment orders to court.

Families may oppose the involuntary treatment order or admission to hospital, and court may decide contrary to the psychiatrist’s opinion.  Patients who are put into seclusion, should be as minimum period as possible, needed to be reviewed periodically.  

Visitation rights 

Patients have the right to meet visitors during the specific visiting hours. At other times such visitors as patient’s lawyers, clergy or spiritual leader, or private physician may be allowed. If patient’s visitation right is cancelled then it should be documented in the patient’s file. So patient’s need comes first.  

If any visitor brings any drug or any harmful substance, then that visitor may be denied to meet the patient. This is done to help the recovery of the patient and to prevent any drug abuse among other patients in the facility.

Communication right 

Patients must have unrestricted access to the communication systems such as telephone or mails. Some hospitals supply materials such as papers, envelopes, and stamps for patient’s use.  

Some patients who are making threatening phone calls to somebody or making unnecessary calls to police etc, should be restricted. This applies to mails also. But some hospitals restrict the use of mobile phones in hospitals by patients as their policy. 

Rights for privacy 

Patients have the rights for privacy such as they can have private shower, or have locker to keep their belongings and have adequate floor space for them. In some poor resourced hospitals overcrowding has been a major issue.  

If a patient abuses privacy by importing drugs or alcohol to his or her room then the privacy right can be cancelled. This is for the benefit of the patient and other patients. They have the right to wear their own clothes and carry money. 

Economic rights 

Patients have right to manage their finances except if they are not declared incompetent to mange. They have the right to get paid when they work. This may cause a problem when a patient not paid for working in a rehabilitation facility or do chores in a hospital such as preparing food for others or doing gardening etc. Because of this valuable rehabilitation facilities or work training centres for patients may get closed down due to lack of money to pay some wages to patients.  

Seclusion and restraint of patients 

This is common in acute psychiatric units in any mental hospitals. It should be clearly documented about the reason for seclusion and restraint. Physical restraint is not commonly used but isolation of patient in a less restrictive environment is important in preventing self harm or harm to others.

During the period of isolation there should be close watch by health professional and it must not be more than what is required.  

In some cultures and in some developing countries acutely mentally ill patients are physically restrained for many days even months to years, without giving any psychiatric help. This is perhaps due to poor understanding of mental health issues, poor or no resources available being living in a remote area, poor economic condition of the family thus not having any access of professional help.