Il Trattamento Sanitario Obbligatorio spiegato da uno Psichiatra

Summary

The video discusses the controversial topic of mandatory health treatment, focusing on its legal framework and ethical considerations. It clarifies misconceptions about involuntary psychiatric treatment, explaining the conditions under which it can be lawfully applied in Italy, as per the Law 180/1978 and Law 833/1978. The video emphasizes that such treatment is a last resort, only used when a person presents with acute mental health issues and refuses voluntary treatment, posing a risk that necessitates urgent intervention. It also outlines the rights of the individual undergoing treatment, including the right to communication, legal assistance, and being informed about the nature of their treatment. The video concludes by mentioning the possibility of less drastic alternatives like the obligatory health check, known as ASO.

Takeaways

• 📢 The video aims to clarify the controversial topic of mandatory health treatment in the context of mental health.
• 😷 Mandatory health treatment, also known as TSO (Trattamento Sanitario Obbligatorio), is a legal measure that compels a person to undergo medical treatment against their will.
• 🏥 TSO is primarily used in the psychiatric field and is a measure rarely and often inappropriately applied outside of clear psychiatric pathology.
• 🔍 TSO can only be enacted when three conditions are met: urgent psychiatric intervention is needed, the person refuses voluntary treatment, and no other timely and suitable measures outside the hospital environment are available.
• ⚖️ The law 180/1978, also known as the Basaglia Law, and law 833/1978 regulate TSO, with the latter specifying the conditions and procedures.
• 🏛️ The mayor, as the chief health authority of the municipality, orders TSO upon agreement by two doctors, one of whom must be a psychiatrist from the national health service.
• 🕒 TSO is initially valid for 7 days and can be renewed if the conditions persist.
• 🚨 Law enforcement may be involved in the application of TSO, and at least one doctor should be present during the procedure.
• 📝 Patients under TSO retain most of their rights, including communication and visitation rights, and the right to be fully informed about their treatment.
• 🤝 TSO should not be used lightly by medical professionals as the ultimate goal is to establish a strong therapeutic alliance with the patient.
• 📞 Individuals can appeal TSO decisions, and legal representation is possible to contest the measure.
• 🤔 Alternatives to TSO, such as the less drastic ASO (Accertamento Sanitario Obbligatorio), are often considered as preliminary steps to establish a medical patient relationship.

Q & A

What is the main topic of the video?

The main topic of the video is the compulsory health treatment, also known as the 'trattamento sanitario obbligatorio' (TSO), in the context of psychiatry.

Why is the topic of compulsory health treatment controversial?

The topic is controversial due to the spread of misinformation and the lack of accurate knowledge about when and how compulsory health treatment is applied, as well as concerns about individual rights and the potential for misuse.

What are the three conditions required for a TSO to be implemented?

The three conditions are: 1) The presence of mental alterations requiring urgent therapeutic interventions, 2) The person's unwillingness to voluntarily undergo treatment, and 3) The absence of conditions that would allow for timely and appropriate extraordinary measures outside the hospital environment.

Where can a TSO be enforced?

A TSO can be enforced at the psychiatric diagnosis and treatment service (SPDC) in the area where the person resides or where the measure is being implemented.

Who has the authority to order a TSO?

The mayor, as the highest health authority of the municipality of the person's residence or the municipality where the measure is being implemented, orders the TSO with a provision when two doctors agree that the person meets the three conditions described.

What are the rights of a patient undergoing compulsory health treatment?

The patient retains all their rights except for the right to refuse treatment. They have the right to communicate with anyone they wish, to be visited by family, and to contact a lawyer. They also have the right to be fully informed about the nature of the therapies they are undergoing, including the risks and benefits.

What is the role of the police or other law enforcement in the implementation of a TSO?

The police or other law enforcement may be involved to assist in the application of a TSO, especially in cases of immediate urgency or when the person's behavior poses a risk. However, the use of physical restraint should be exceptional and only for the shortest necessary time.

Is it possible to oppose a TSO?

Yes, an individual or anyone concerned about the person can appeal a TSO. The mayor is obliged to respond within ten days, and if the appeal is negative, the case can be taken to the criminal judge or the court directly for a review.

What is an alternative to a TSO?

An alternative to a TSO is the 'Accertamento Sanitario Obbligatorio' (ASO), which is often less drastic and can serve as a preliminary measure to establish a therapeutic relationship with the patient.

How is the TSO physically implemented?

The TSO is implemented with the involvement of law enforcement, and at least one doctor must be present. It can involve verbal techniques or the use of psychopharmacological treatments to address any immediate behavioral emergencies.

What is the ultimate goal of compulsory health treatment?

The ultimate goal is to help the person in need, with the aim of establishing a strong therapeutic alliance rather than simply enforcing a legal obligation. The focus should be on effective patient-doctor relationships and treatment.