Complementary Model of Long-Term Care in Poland as a Result of the Political Transformation, Law Reform and Service Changes in Forensic Psychiatry

There have been far-reaching systemic changes in forensic psychiatry in Poland within the last 25 years related to the introduction of new regulations and the necessity to adapt to the standards of Western Europe and the European Union. Of particular importance was the adoption of the Mental Health Care Act that regulated legal issues related to examination, treatment, hospitalisation, rehabilitation and other aspects of mental healthcare by the parliament in 1994. Changes in law introduced in subsequent years in the form of criminal legislation amendments (Penal Code, Criminal Procedures Code, Executive Penal Code) implemented better judicial control over the execution of protective measures, i.e. court-ordered admissions of insane offenders to a psychiatric hospital. Amendments to the law established a new body, namely, the National Psychiatric Committee for Protective Measures in Psychiatry. The Ministry of Justice and the Penitentiary Court supervise the execution of the legitimate purpose of use of this measure, timeliness of opinions, social and health conditions as well as protections against escape. Supervision over the course of long-term psychiatric care of insane offenders is also executed by the offices of the Patient Ombudsman and—through the National Prevention Mechanism—the Polish Ombudsman. In 2013 a new therapeutic and protective measure to be used for sexual offenders with mental disorders was introduced which takes the form of commitment to a new institution—the National Centre for Prevention of Dissocial Behaviours. Other amended regulations concern involuntary psychiatric observations in a hospital setting.