About PI Rokiškis Psychiatric Hospital
The main hospital activities:
- Organization and provision of health care services (under license);
- For involuntary patients:
- Guaranteeing security and surveillance;
- Behaviour analysis, control and correction;
- Assessment and prediction of the recurrent of crime risks;
- Organization of occupations and daily activities;
- Submission of assessment reports to the Court;
- Planning individual guidances and psycho-social rehabilitation of patients discharged from the hospital;
- Social and legal services;
- Training of specialists, providing or organization of methodological, informational and consultancy support to professionals;
- Preparation of projects and participation in the projects of other institutions;
- Co-operation with domestic and foreign medical, forensic psychiatry, psycho-social, and vocational rehabilitation institutions;
- Other legitimate activities to meet the institution’s objectives.
At PI Rokiškis Psychiatric Hospital, psycho-social rehabilitation services are provided by the multidisciplinary team of professionals.
An introduction from the director of Rokiškis Psychiatric hospital A. Liausedas:
Citizens who committed crimes and by the court decision have to pass the treatment in the mental hospital are involved in the process of the re-socialization that begins its development on the national level after the restoration of Lithuania’s independence.
The purpose of our hospital is to protect the society from the possible aggression, as well as to educate the patients to live with their illnesses and adapt to the surroundings. Our clients are the persons who suffer from the mental diseases. This is a vulnerable part of the society, as the understanding, tolerance, willing to help and attitude to them very essentially reflects the maturity of our society. People with whom we daily work are very different and have the various singularities, in addition, they have different illnesses; but separately from the variety of the clinical records they have the healthy part of their personalities. Especially this part of personality is the primary matter of our work. For that reason we believe that the best way is to educate the patients to use the healthy part of their personality, because they will be able to control themselves and that moment brings the positive feelings that will be reflected in the surroundings and society safety.
The social integration of forensic psychiatric patients is a consequent process where the rehabilitation is the part of this process. The medical and security technologies for this patients’ group are already known in the world; therefore, thought the process of adaptation and permanent development we create the optimal solutions.
The process of re-integration and rehabilitation of forensic psychiatric patients is very time consuming/heavy mission. Therefore, in line with other national institutions we use the modern foreign experience from the relevant medical field, as the system and methodology of patients’ re-socialization are effective and based on the longitudinal theoretical and practical experiences. This experience shows that many patients from the sector of forensic psychiatry have the real possibility to live the full-value life. The beginning of this life has to be started in the meaningful environment that will be a source and means for the development of already existed and just acquired social skills.
The process of the treatment and rehabilitation of patients how were declared irresponsible by the court decision in Lithuania
Until the restoration of Lithuania’s independence, all citizens who committed dangerous acts against society and who were declared irresponsible were treated in the special psychiatric hospital in Chernyakhovsk, Russia. A decree of the Lithuanian Government (December 17, 1991, No. 566) “About the establishment of the special psychiatric department” determined that such patients should be treated in Lithuania. The treatment functions of such patients were delegated to the psychiatric hospital of Rokiškis. In order to observe the government requirements the special psychiatric departments with the different observation regimes/conditions were established in Rokiškis psychiatric hospital. Therein the patients from severe and reinforced observation regimes passed the treatment in the hospital for the patients who committed crimes; but the patients with the regime of the general observation were treated in the mental hospitals according to the individual living place.
As a result, the mentioned type of the hospital placement limited the formulation of the individual treatment program, as well as the lack of the material and intellectual (trained staff) resources for the re-socialization and re-integration of patients into the community. On the other hand, the forensic patients were treated in the general psychiatric department of Rokiškis psychiatric hospital where were impossible to organize a special security observation that caused a violence of ethical requirements and psychiatric patients’ rights. Therefore, many problems emerged with the discipline and elimination of escapes’ occasions and prevention of the conflict situations between the patients.
In 1993, the number of patients significantly increased in Rokiškis psychiatric hospital that caused a situation when the hospital was not able to observe the requirements for the compulsory treatment. In 1997, the International commission of experts (prison and medical service) visited the hospital and recommended to reorganize the department for compulsory treatment patients.
On October 16, 2001, the conference was organized with the purpose to improve the formed situation. The following institutions participated on the current meeting: the Ministry of Health, State patients fund, Ministry of Interior, Ministry of Finance, Administration of the Panevezys district, Department of Health Service (under the Ministry of Interior), State Service of Psychiatric Health, and State Service of Forensic Psychiatry. The conference participants declared that the finance of the compulsory treatment in the mental health care system is not sufficient and that moment cannot guarantee the enough security for the society. The organizational problems of compulsory treatment were analyzed by the Committees of the Seimas: the Committee on National Security and Defense, Committee on Finance, and Committee on Health Affairs. The order of the treatment, patients’ security questions and requirements to the observations were discussed in the work group between the Ministries on Interior and Health.
In 2002, the decision was made to concentrate all patients who passed the compulsory treatment on the territory of the Lithuanian Republic in Rokiškis psychiatric hospital only. In order to realize this purpose the investment project was developed. The realization of this project will allow establishing of 270 places (beds) for the modern compulsory treatment. In the same year, the Geneva Initiative on Psychiatry started another project “Reorganizing forensic psychiatric services in Lithuania” in the society. The overall goals of this project were to educate the staff to work with forensic psychiatric patients, as well as to observe the staff trainings and patients’ conditions. The organization of basics of the occupational therapy, rehabilitation and creation of the methodology for the individual treatment plans were scheduled in the context of the same project.
With the entrance of the Lithuanian Republic into the European Union all mentioned above processes that were related with the treatment, rehabilitation, and re-socialization of the mentally disordered patients who committed crimes, significantly accelerated. In order to improve the national security, psychiatric patients’ rights, irresponsible patients’ treatment, care, rehabilitation and re-integration into the community were based on the recommendations of the European experts.
In International rules and normative acts of the Lithuanian Republic are noticed that citizens who committed crimes and suffer from the mental disorders have the rights for the same treatment conditions and quality as the ordinary patients in the treatment institutions. The adequate treatment that does not differ from the treatment quality of other patients has to be offered to the psychiatric patients, as well as the psychiatric patients have to be protected from the unhealthy/dangerous treatment methods, violence, and exploitation. The rights of the psychiatric patients are specifically specialized. Their treatment is associated with the Human Rights Acts, lows, and international documents. For that reason, Rokiškis psychiatric hospital is the only institution that practices the compulsory treatment for the psychiatric patients and qualitatively integrated in the Lithuanian system of the forensic psychiatry.
The psychiatric hospital of Rokiškis that practices the treatment, regulatory and re- socialization system for forensic psychiatric patients has cooperated with Dutch colleagues for some years. In the frame of the exchange project that was sponsored by the Dutch Kingdom, the hospital staff received the possibilities to get experiences of well developed systems of the forensic psychiatry in foreign countries. During the cooperation period the acquired methodological experiences and suggested recommendations were implemented by the hospital staff on the practical field of Rokiškis psychiatric hospital. The results of this implementation revealed in the modern organization of the patients’ treatment, security, social skills training and social integration skills.
The system for the integration of forensic psychiatric patients into the labor market asked for the improvements of the re-socialization processes for citizens with the mental disorders. For the perspectives of the patients’ and society safety, it is very important to predict the further patients’ behavior after the compulsory treatment, when they will be integrated into the community.
Leading by International rules in force and the legislation of the Lithuanian Republic the administration/staff of Rokiškis psychiatric hospital tries to introduce the principles of equal rights for all patients and build the effective system of treatment for the citizens who committed crimes and who were declared irresponsible. Equally, the hospital tries to find the effective mechanisms for the reintegration of the forensic psychiatric patients into the society.
The psychiatric hospital of Rokiškis does not limit its activities by the development of the treatment methods; moreover, it wants to shape a special system of occupations, social help and psychosocial rehabilitation for the mentally disabled persons.