Volume 23, Number 1 (Spring 2017)                   IJPCP 2017, 23(1): 50-67 | Back to browse issues page




DOI: 10.18869/nirp.ijpcp.23.1.50

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Nasr Esfahani M, Attari Moghadam J. Development of the Draft of Law (Mental Health Act). IJPCP. 2017; 23 (1) :50-67
URL: http://ijpcp.iums.ac.ir/article-1-2507-en.html

Psychiatrist, Associate Professor Rasool Akram Hospital, Iran University of Medical Sciences,Mental Health Research Center, School of Behavioral Sciences and Mental Health (Tehran Institute of Psychiatry), Iran University of Medical Sciencesiums , Email: mehdinassr@gmail.com
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Extended Abstract
1. Introduction
In many parts of the world, people afflicted with psychiatric disorders belong to the community of socially vulnerable people. In addition to the obvious suffering caused by mental disorders, these people face burnout resulting from the stigma associated with mental disorder and separation from society. Unfortunately, they are neglected and suffer from sexual-physical and psychological abuse. In addition, they deal with the prospect of losing their jobs and obtaining access to services.
With regard to patients with mental frailties, Iran has accorded them with more dignity in comparison with the rest of the world. Mental health laws in countries have been developed to protect the human and civil rights of people with mental disorders. In Iran, although there are laws sporadically in the collection of existing laws, there is no separate mental health legislation. The aim of this project was to develop a draft of mental health law in Iran.
2. Method
The draft law on mental health has been developed over three phases. In the first phase, people responsible for drafting reviewed the resources about domestic and foreign codified law and selected, among other countries, the most comprehensive mental health legislation as an example and guide. Thereafter, various subjects were mentioned in group meetings with respect to various aspects of the debate and finally, keeping cultural aspects in mind, the initial draft was prepared. The draft was sent to a large number of mental health professionals, government agencies, and non-governmental organizations, and their views were collected and classified. Then, the areas of conflict were discussed in a national workshop attended by experts and stakeholders. Their views were summarized, and the final draft was edited. In the second stage, the written material of the draft became law in Ethics and History of Medicine Research Center in the presence of some lawyers. Like the first stage, the comments of legal experts, a large number of academic centers, governmental and nongovernmental organizations were collected. For a final decision, inconsistent comments were mentioned in the country second workshop and the last reforms applied and the draft was finalized on 10 chapters and 112 articles. In the third stage, acting upon the suggestion from the legal office of the Ministry of Health and Medical Education, the text prepared was revised and the draft summarized across six chapters and 50 articles.
3. Results
Finally, after 27 sessions of 4 hours duration each, the draft of the Mental Health Law was codified with an article as an introduction and six chapters comprising a total of 50 articles. Draft chapters included the first chapter, titled Definitions, which had 1 article and 18 clauses. The second chapter titled Involuntary Hospitalization and Treatment had 11 articles while the third chapter titled Specific Methods of Treatment had 7 articles. The fourth chapter titled Punitive Patient had six articles, and the fifth chapter titled Special Groups had 4 articles. The sixth chapter titled Other Provisions had 20 articles. In the end, the fifth edition of the draft law was developed.
In the first chapter, all terms used were defined in the draft law including severe mental disorder, psychological crisis, compulsory community treatment, serious injury, severe mental disorder and involuntary hospitalization. The second chapter is devoted to involuntary hospitalization and treatment. The third chapter concerns specific methods of treatment. In this chapter, legal provisions related to compulsory community treatment, therapy, restrain, isolation or detention were provided. The fourth chapter is related to criminal cases. In addition to taking into account the expert aspects of subject matter, in the provisions of this chapter the rights of these patients have also been considered. The fifth chapter is about the special groups. According to the law, these groups are referred to as certain groups of people under 18 and over 65 years of age as well as those who, for any reason, are unable to manage their financial affairs. Chapter six is about the development of insurance services, establishing judicial hospitals and penalties for violators of the law. From the beginning till the development of the fifth edition, this plan consumed 18,000 man-hours.
4. Discussion and Conclusion
Finally, after intensive work group with experts in the field of Medicine, Psychology, Law, conducting two large surveys with the help of experts, and organizing two workshops in the country, the draft pertaining to the Mental Health Law was developed. The various chapters of the draft, especially the ones which deal with the loss of patients' rights such as Involuntary Hospitalization, Compulsory Treatment, Punitive Patients or Special Patient Groups, were developed in such a way that patients' rights be respected as much as possible. In this respect, the content of this draft is similar to a lot of mental health laws existing in developed countries [18-22].
In addition to the presence of a system of independent assessment within the draft, at all stages of involuntary hospitalization and treatment, the right of a person to protest was considered as was the way in which the protests were to be handled. The methods, mentioned in this draft, used for involuntary hospitalization are to a certain extent similar to the ones used in other countries [26]. Despite the similarities, there are differences as well. In this draft, the aspects of cultural and social structures were considered. For example, the drafters tried to develop a document which would not only be applicable to the existing organizational structures but also aid in the development of such structures. The draft was, however, less comprehensive in comparison with the mental health regulations of some developed countries [18, 20].
Although it cannot be claimed that the draft developed is devoid of any shortcomings, but it is, with no doubt, one draft law that has been developed and prepared in conjunction with the greatest number of experts in the legislation and codification history of Iran. The major constraint that arose in the development of this draft was the lack of comments from patients and their families which originally should be administered to them after the adoption of the law. The prepared draft cannot be invoked in any way and must be approved by the Parliament.
Acknowledgments 
Office of the Mental-Social Health, and Addiction at the Ministry of Health and Medical Education, and School of Behavioral Sciences and Mental Health (Tehran Institute of Psychiatry), Iran University of Medical Sciences, Tehran, Iran, have financially supported the present paper.
Conflict of Interests 
The authors declared no conflicts of interest.
Type of Study: Original Research | Subject: General
Received: 2016/08/2 | Accepted: 2016/12/20

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