PSYCHIATRIC DEPARTMENT 1st' FACULTY OF MEDICINE CHARLES UNIVERSITY

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PSYCHIATRIC DEPARTMENT1st. FACULTY OF
MEDICINECHARLES UNIVERSITY

• PSYCHIATRIC CARE IN THE CZECH REPUBLICK - human
  rights, coercion and institutions
• Prof. Jirí Raboch, M.D.

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CZECH REPUBLIC
Prague
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CZECH PSYCHIATRIC ASSOCIATION SINCE 1919 1 082
MEMBERS
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BEGINNIGS OF PSYCHIATRY HABSBURG MONARCHY

• 1790 FIRST
• PSYCHIATRIC
• WARDS AT
• THE GENERAL
• (UNIVERSITY)
• HOSPITAL IN
• CENTRAL PRAGUE

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PRAGUE PSYCHIATRIC HOSPITAL 1919www.plbohnice.cz
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MAIN TRENDS AFTER VELVET REVOLUTION 1989

• SOME CHANGES OF THE STRUCTURE OF THE MENTAL
  HEALTH CARE SYSTEM
• DECENTRALISATION AND PRIVATISATION OF OUT-PATIENT
  CARE, REDUCTION OF BEDS IN PSYCHIATRIC HOSPITALS
• NEW PSYCHOACTIVE DRUGS AND OTHER TREATMENTS,
  INCREASING EXPENDITURES
• INSURANCE COMPANIES, ECONOMIC PROBLEMS
• INCREASED INTEREST OF PHYSICIANS IN PSYCHIATRY x
  STIGMA

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PRIVATISATION OF PSYCHIATRIC OUT-PATIENT
DEPARTMENTS
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BEDS IN PSYCHIATRY1998 ()
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NEW PSYCHIATRISTS
YEARS
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NUMBER OF PSYCHIATRISTS
ÚZIS 2007
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NUMBER OF FIRST OUT-PATIENT CONSULTATIONS/YEAR
ÚZIS 2007
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NUMBER OF PSYCHIATRISTS/100 000 OUT-PATIENT
CARE 2007
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NUMBER OF PSYCHIATRIC BEDS/100 000
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NUMBER OF BEDS IN PSYCHIATRIC HOSPITALS, 2007
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COMMUNITY CARE (DAY CARE CENTRES, CRISIS
INTERVENTION CENTRES, HELP LINES, SHELTERED
HOUSES,)

• NO CENTRAL STATISTICS AVAILABLE
• EDEN European Day hospital EvaluatioN

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NUMBER OF NEWLY SET UP DAY CARE CENTRES
(1965)
Raboch et al., 2003
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DAY CARE CENTRES IN CR 2001
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DIAGNOSTIC STRUCTURE

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DRUGS CONSUMPTIONDDD/1 000 INHABITANTS/DAY
DDD/1000 INHABITANTS/DAY
Suchopár and Raboch, 2006
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HUMAN RIGHTS IN CZECH MEDICINE/PSYCHIATRY

• HEALTH CARE ACT (20/1966)
• MEASURES WITHOUT CONSENT INCLUDING ADMISSION TO A
  MEDICAL ESTABLISHMENT IF A PERSON WITH SIGNS OF
  A MENTAL DISORDER OR INTOXICATION THREATENS
  HIM/HERSELF OR HIS/HER SURROUNDINGS

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DETENTION

• INSTITUTIONS MUST WITHIN 24 HOURS NOTIFY THE
  APPROPRIATE COURT
• COURT APPOINT A GUARDIAN
• COURT IS OBLIGED TO DECIDE THE CASE WITHIN 7 DAYS
• LONGER HOSPITALISATION MUST BE REEVALUATED WITHIN
  3 MONTHS

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OF DETENTIONS IN PSYCHIATRIC INSTITUTIONS IN
CZECH REPUBLIC 2004

PH Psychiatric Hospital, PD Psychiatric
Department in general hospital
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INVOLUTARY ADMISSIONSPsychiatric Hospital Praha
Bohnice
No. admissions
year
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Psychiatric beds and staffingInternational
comparision
Vevera et al. 2008
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USE OF COERCIVE MEASURES

• ADMINISTRATIVE MEASURE OF MINISTRY OF HEALTH
  (1.1.2005)
• PRACTICE GUIDELINIS OF THE CZECH PSYCHIATRIC
  ASSOCIATION (2006)
• INTERNAL MEASURES OF EVERY INSTITUTION

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TECHNICAL AND PERSONAL EQUIPMENT IN EUNOMIA
CENTRES
n.s.
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STIGMA OF PSYCHIATRYCR 1999, representative
sample of 1248 respondents
Raboch et al., 2000
1 - best, 5 - worst
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SATISFACTION WITH TREATMENT - EDEN (CAT 0 10)
Raboch et al., 2004
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THANK YOU FOR YOUR ATTENTION!ENJOY YOUR STAY IN
PRAHA!
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