It is not customary to speak out loud about mental problems in our society. Madness is something terrible, casting a shadow on the reputation of not only the patient, but also of 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. A visit to a specialist is considered a weakness of spirit - a normal person will cope with his problems on his own. Ignorance of psychiatry raises many myths. Madness seems to be 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 psychiatric help at some point. The brain is still not fully understood. Yet mental illness does not need to be treated with superstitious fear. And even more so, do not neglect information about the rules for the provision of psychiatric care. What symptoms should I see a doctor for? How will registration be reflected in the fate of a patient?
Psychiatric Care Act
The basis for hospitalization is a doctor’s decision based on complaints from the patient or his relatives. But that's not all. He is sent to a 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 will be hospitalized forcibly. This is stated in the law "On Psychiatric Care", adopted in 1992. By the way, the terrible stories about the Kanatchikovo 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" was adopted in Russia 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.
The USSR has long sunk into oblivion. But the fear of people in white coats for all those experiencing mental ailments remained. We do not yet have as many communities and associations as abroad, but distrust of doctors is still not justified. The diagnosis made by a psychiatrist is not the end. With proper treatment and compliance with all medical prescriptions, this is more likely the beginning of a new life.
Community-based psychiatric care
This system consists of a neuropsychiatric dispensary, a psychiatric office, a day hospital. The first link of these is the main one. The dispensary has several advantages over stationary and semi-stationary. The patient is undergoing treatment, remaining in the familiar social environment.
Thanks to a community-acquired examination, the doctor manages to effectively influence the ailment. 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 afraid of not so much treatment as the documentary side. A person who has been given emergency psychiatric care at least once is registered. It seems to be not so simple to withdraw from it that it leaves its mark on the rest of 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 pose an immediate danger, he will not be in the hospital against his will. True, the comments to the law “On Psychiatric Care and Guarantees of Citizens” do not say what the term “immediate danger” means. A person who causes harm only to himself can also be registered with a psychiatrist. That is, one, for example, who is prone to suicide.
The law on "Psychiatric care and guarantees of citizens for its provision" has another wording - "substantial harm to health." It is no less vague than the aforementioned term. In the provision of psychiatric care, citizens' rights are often 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 about how to “heal” another patient.
You need to seek medical help on time. Otherwise, the borderline state will develop into an ailment, which is difficult to get rid of, and sometimes impossible.
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 understood. The second is a fine line between norm and pathology. According to WHO statistics, in the world about 30% of people at least once in their life felt the need for psychiatric care. In this case, the disease is determined at an early stage by a specialist. But ignorance of the basics of psychiatry leads to the fact that a strange, eccentric person is labeled insanity, and those who suffer from prolonged depression are mistaken for a loafer and a lazy person.
Norm is a concept relatively. It is largely due to the customs of society. A device that measures the risk of developing a mental disorder does not exist. Nevertheless, we give a brief information about the symptoms of the borderline state, that is, the precursors of the disease.
Alienation from society
Each person is endowed with individual traits. One is constantly in need of attention. Another seeks a calm environment. But the apparent inability to communicate with others speaks of mental problems.
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 worry, and sanguine people easily find a common language with others. But not every action can be attributed to the features of temperament. If the unsuccessful phrase of the interlocutor infuriates the person and the loss of control over himself - there is an inadequate emotional reaction. This is not choleric, but one of the signs of an impending disease. The same can be said of inappropriate indifference and equanimity, which cannot be explained by pronounced phlegmatism.
Break with 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 makes imaginary friends or suspects neighbors and colleagues of military espionage, his relatives should consult with a specialist, and possibly send a loved one to an appointment with a psychiatrist.
Inability to build close relationships
Man has a need for affection. True, in the XXI century, more and more people appear who are not striving to create a family. Loneliness is not a disease. But the complete lack of need for attachment (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 happy with everything, 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, estrangement from society? Is it worth it to close your eyes to this?
Disadvantages of Russian Psychiatry
Critics of modern medicine often talk about the methods used in medical institutions. They supposedly bring harm, and in some cases suppress the will of the patient. Diagnosis and determination of the norm are also criticized. Psychiatrists are ordinary people. They, too, are not without subjectivity and may be wrong. The formation of a negative idea of psychiatric care was influenced not only by historical memory, but also by popular culture (“Above the Cuckoo's Nest”).
Doctors are also accused of conspiring with drug manufacturers. Not without reason. Manufacturers of psychotropic drugs, in fact, managed at one time to expand the market. But the increase in the number of patients taking “rescue” pills is also due to another factor: many patients prefer medication to changing their lifestyle and taking a course of psychiatry.
Most medical facilities in Russia are in poor condition. According to research conducted in 2013, 40% of buildings need major repairs. Due to insufficient funding, little attention is paid to patients.
Patient Rights
The safety of the people around the patient, showing aggression, is more important than his personal freedom. This argument is 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 with a diagnosis of depression. But is it worth a person who dreams of ending his life, left alone with his thoughts?
Stigmatization
As already mentioned, misconceptions about psychiatric disorders reign in society. People go to two extremes. Some people think that insanity is expressed in the ability to hear otherworldly voices or talk with fictional characters. Others believe: 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. By virtue of these misconceptions, the number of patients resisting registration is growing.
Psychiatrist visit
When a person breaks his arm, he goes to a traumatologist. It does not occur to him the thought: "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 must make an appointment with a psychiatrist. What will happen after visiting this specialist?
A visit to a psychiatrist does not automatically lead to registration. First, a regular consultation. But a conversation with a doctor is not enough to make a diagnosis. Each institution has two types of databases. The first is introduced by the “lungs” of patients, that is, those whose disease does not cause problems for others. In the second - patients with severe diseases, the presence of which is visible to the naked eye.
A patient from the “lungs” category will not fall into the PND database against his own will. First, he needs to sign the documents. Access to these bases is only for special services. But in a neuropsychiatric dispensary, you can agree on paid treatment on condition of anonymity. During several consultations, the doctor reveals the presence of personality disorder. Determines how difficult the patient's situation is. And only after that offers psychiatric care (outpatient or inpatient).
Community-based care is as follows: the patient visits a specialist when he feels the need and has to stop treatment at any time. This is the so-called advisory group, which another patient can join in case his condition has improved. But there is another form - dispensary. In this case, the patient regularly visits the doctor without fail.
Is it possible to deregister
The patient is excluded from the PND database 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 with improvement, the patient can stop visiting the psychiatrist, and after three years to be deregistered. All this time, he should visit the specialist from time to time, so that he fixes signs of remission.