It is not customary to talk about mental problems in our society out loud. Madness is something terrible that casts a shadow on the reputation of not only the patient, but also his loved ones.
Psychiatric care in Russia leaves much to be desired, despite the many transformations made in this branch of medicine in recent years. Going to a specialist is considered a weakness of the spirit - a normal person will cope with their problems on their own. Ignorance in matters of psychiatry gives rise to many myths. Seems like madness is far away. It will not overtake a successful person who does not abuse alcohol and drugs.
But the human psyche is not static. Anyone may need mental he alth care at some point. The brain is still not fully understood. Still, mental illness should not be treated with superstitious fear. And even more so, do not neglect information about the rules for providing psychiatric care. What symptoms should you see a doctor for? How will registration affect the fate of the patient?
Psychiatric lawhelp
The basis for hospitalization is the doctor's decision based on the complaints of the patient or his relatives. But that's not all. He is sent to the hospital after a psychiatric examination and in most cases voluntarily. If the patient's actions pose a danger to others or he is absolutely helpless in everyday life, he is forcibly hospitalized. This is stated in the law "On Psychiatric Care", adopted in 1992. By the way, scary tales about Kanatchikov's dacha arose in Soviet times and have a real basis.
A bit of history
In Soviet times, there were no clear instructions in the field of psychiatry. The law "On psychiatric care and guarantees of the rights of citizens in its provision" in Russia was adopted eighty years later than in Europe. It is not surprising that in a totalitarian state the absence of norms and acts was used for political purposes.
USSR has long sunk into oblivion. And the fear of people in white coats remained with everyone experiencing mental ailments. We do not yet have as many communities and associations as abroad, but distrust of doctors is still not justified. A psychiatric diagnosis is not the end. With proper treatment and compliance with all medical prescriptions, this is rather the beginning of a new life.
Out-of-Hospital Psychiatric Care
This system consists of a psycho-neurological dispensary, a psychiatric office, a day hospital. The first link listed is the main one. The dispensary has several advantages overhospital and semi-hospital. The patient undergoes treatment, remaining in the familiar social environment.
Thanks to an out-of-hospital examination, the doctor manages to effectively influence the disease. A neuropsychiatric dispensary is an institution designed to detect diseases at an early stage. Here, systematic monitoring of patients is carried out, specialized medical care is provided.
Future patients are most scared not so much by the treatment as by the documentary side. A person who has received emergency psychiatric care at least once is registered. It seems to be not so easy to get off it, which leaves an imprint on the rest of your life. However, this is one of the misconceptions.
Involuntary medical measures
The law "On Psychiatric Care for Citizens" specifies the procedure for its provision and the rules for hospitalization. If a person does not interfere with others, that is, does not represent an immediate danger, he will not end up in the hospital against his will. True, the comments to the law "On Psychiatric Care and Guarantees for Citizens" do not say what the term "immediate danger" means. A person who harms only himself can also be registered with a psychiatrist. That is, someone, for example, who is suicidal.
In the law on "Psychiatric care and guarantees of citizens for its provision" there is another wording - "significant harm to he alth." It is no less vague than the aforementioned term. When providing psychiatric care, the rights of citizens are oftenare violated - many people think so, because Russian legislation in this area is very vague. But this does not mean that doctors in Russian hospitals only dream of how to “heal” the next patient.
You need to seek medical help on time. Otherwise, the borderline condition will develop into an ailment, from which it is difficult, and sometimes impossible, to get rid of.
Between norm and pathology
So, registration is not a sentence. Despite the fact that modern Russian laws are far from ideal, punitive psychiatry is in the past. This is the first thing to be clear. Secondly, there is a fine line between normality and pathology. According to WHO statistics, about 30% of people in the world have experienced the need for psychiatric care at least once in their lives. In this case, the disease at an early stage is determined by a specialist. But ignorance of the basics of psychiatry leads to the fact that a strange, eccentric person is labeled insane, and someone who suffers from prolonged depression is mistaken for a bum and lazy.
Norm is a relative concept. It is largely due to the customs of society. There is no instrument that measures the risk of developing a mental disorder. Nevertheless, we will give brief information about the symptoms of a borderline state, that is, the harbingers of the disease.
Solitude
Each person is endowed with individual traits. One is constantly in need of attention. The other seeks a calm environment. But a clear inability to communicate withtalks about mental problems to others.
Inadequate reaction to what is happening
As you know, there are four types of temperament. Choleric people react more emotionally to what is happening than phlegmatic people. Meloncholics are prone to feelings, and sanguine people easily find a common language with others. But not every act can be attributed to the features of temperament. If an unsuccessful phrase of the interlocutor infuriates a person and loses control over himself, an inadequate emotional reaction takes place. This is not choleric, but one of the signs of an impending disease. The same can be said about inappropriate indifference and equanimity, which cannot be explained by pronounced phlegm.
Breaking from reality
A rich imagination is not a sign of insanity. But violent fantasies that have no connection with reality are appropriate at an early age. If an adult has imaginary friends or suspects neighbors and colleagues of military espionage, his relatives should consult a specialist, and perhaps refer a loved one to see a psychiatrist.
Inability to build close relationships
Human beings have a need for affection. True, in the 21st century there are more and more people who do not seek to create a family. Loneliness is not a disease. But the complete absence of the need for affection (no matter to whom: to family, colleagues, friends or a dog) indicates a violation of the psychological mechanism.
The principle by which psychiatrists work is: "No complaints - no diagnosis." If a person is allsatisfied, and he does not harm others, he does not need psychiatric help. But if the inability to communicate is reflected in work, relationships with loved ones, leads to loneliness, isolation, alienation from society? Should relatives turn a blind eye to this?
Flaws of Russian psychiatry
Critics of modern medicine often talk about the methods used in medical institutions. They allegedly do harm, and in some cases suppress the will of the patient. Diagnosis and definition of the norm are also criticized. Psychiatrists are ordinary people. They are also subjective and can be wrong. The formation of a negative image of psychiatric care was influenced not only by historical memory, but also by popular culture ("Over the Cuckoo's Nest").
Doctors are also accused of colluding with drug manufacturers. Not unreasonably. Manufacturers of psychotropic drugs, indeed, managed to expand the market in due time. But the increase in the number of patients taking "saving" pills is also due to another factor: many patients prefer medication to change their lifestyle and undergo a course of psychiatry.
Most of the medical institutions in Russia are in a deplorable state. According to the results of studies conducted in 2013, 40% of buildings are in need of major repairs. Due to insufficient funding, little attention is paid to patients.
Patient rights
The safety of people around the patient who shows aggression is more important than his personalfreedom. This argument speaks in favor of forced hospitalization. It is very difficult for (loving) relatives to give consent to this procedure. It is even more difficult to hospitalize a patient diagnosed with depression. But should a person who dreams of ending his life be left alone with his thoughts?
Stigmatization
As already mentioned, misconceptions about psychiatric disorders reign in society. People go to two extremes. Some believe that insanity is expressed in the ability to hear otherworldly voices or talk to fictional characters. Others believe that depression is not a disease, but a mood, a state of mind. At the same time, both of them are sure that a psychiatric diagnosis is a sign of inferiority. Due to these misconceptions, the number of patients who resist registration is growing.
Visit a psychiatrist
When a person breaks his arm, he goes to the traumatologist. The thought does not occur to him: “I am strong, I can handle it myself.” When a person becomes depressed, and it lasts more than three months and is accompanied by symptoms characteristic of this disease, he should make an appointment with a psychiatrist. What happens after visiting this specialist?
A visit to a psychiatrist does not automatically lead to registration. First, a simple consultation. But one conversation with a doctor is not enough to make a diagnosis. Each institution has two types of databases. The first group includes “light” patients, that is, those whose disease does not cause problems.surrounding. In the second - patients with serious diseases, the presence of which is visible to the naked eye.
A patient from the “lung” category will not be included in the IPA database against his own will. First he needs to sign documents. Only special services have access to these bases. But in a psycho-neurological dispensary, you can also agree on paid treatment on the condition of anonymity. In the course of several consultations, the doctor reveals the presence of a personality disorder. Determines how severe the patient's situation is. And only after that offers psychiatric care (outpatient or inpatient).
Community care is as follows: the patient visits a specialist when he needs it and has to stop the course of treatment at any time. This is the so-called advisory group, to which another patient can go if his condition has improved. But there is another form - dispensary. In this case, the patient regularly visits the doctor without fail.
Can I be deregistered
The patient is excluded from the bases of IPA in the event that a stable remission lasts more than three years, that is, there are no symptoms of the disease. This does not mean that when the patient improves, he can stop visiting a psychiatrist, and three years later be removed from the register. All this time, he must visit a specialist from time to time, so that he fixes the signs of remission.
