Pagalba

Republic of Lithuania Law on Mental Health Care

Ástatymas I-924 1996.06.06 Parliamentary record,1997, Nr. 5
1996.06.06 Iðvertë: Lietuvos Respublikos Seimo kanceliarija Dokumentø skyrius .
1996.06.06 Teisës aktà priëmë: Lietuvos Respublikos Seimas .
Susijæ dokumentai Originalus Microsoft Word 97 formato tekstas
 
republic of lithuania
LAW 
ON 
MENTAL HEALTH CARE 
Chapter I
GENERAL PROVISIONS 
   Article 1. As used in this Law:
   mental disease means a disease diagnosed by a medical doctor and certified by a psychiatrist which, pursuant to the effective classification of diseases, is assigned to mental diseases. A mental disease may not be diagnosed on political, religious, racial grounds;
   patient means a mental patient or any other 
person to whom mental health care is applied;
   mentally ill person means a person ill with a mental disease;

   the patient’s representative (representative) means 
a legal representative (parents, adoptive parents, foster parents, guardians) or 
an appointed representative. The appointed representative shall be chosen by the 
patient. The power of attorney of the appointed representative must be executed 
in accordance with the procedure laid down in Article 49 of the Code of Civil 
Procedure of the Republic of Lithuania;
   mental health facility means a health care 
institution (public or non-public), which is accredited for mental health care. 
If only a certain part (unit) of a medical aid institution has been accredited 
to engage in mental health care, the term shall apply only to the unit. In this 
Law the term is also applicable to psychoneurological facilities;
   medical ethics commission means a commission 
formed in a mental health facility for addressing the issues of medical 
ethics;
   mental health centre means a municipality-owned 
institution accredited by the government to engage in mental health care and to 
provide social assistance to the mentally ill and other persons;
   Municipal Mental Health Commission (hereinafter 
referred to as MMHC) means a specialised commission set up by the municipality 
and authorised by the government to settle the issues related to health care 
conditions of the mentally ill;
   psychiatrist means a medical doctor entitled 
under the statutes of the Republic of Lithuania to practice psychiatry;
   psychotherapist means a person entitled under 
the statutes of the Republic of Lithuania to practice psychotherapy. In the 
event that the psychotherapist provides the mentally ill person with psychiatric 
aid, the requirements of this Law shall be applicable to him;
   psychologist means a person entitled under the 
statutes of the Republic of Lithuania to provide the mentally ill with 
psychological aid. If the psychologist provides the mentally ill with 
psychological aid, the requirements of Chapter Four of this Law shall apply to 
him;
   nursing staff means medical aid institution 
personnel nursing the mentally ill;
   mental health care means specialised health 
care carried out in accordance with the standards approved by the Ministry of 
Health of the Republic of Lithuania. Its purpose is provision of psychiatric aid 
(diagnosis, treatment of mental functions disorders, timely prevention of 
exacerbation of mental diseases), helping a person to rehabilitate and return to 
life in the community;
   hospitalisation means a person’s admission to a 
psychiatric institution as a patient. 
   Article 2. The purpose of the Law on Mental 
Health Care of the Republic of Lithuania is to establish the rights of the 
persons who are provided with mental health care, the procedure and supervision 
of mental health care. 
Chapter II
RIGHTS OF MENTALLY ILL PERSONS AND RESTRICTIONS THEREOF 

   Article 3. Mentally ill persons shall have all 
political, economic, social and cultural rights. There shall be no 
discrimination on the grounds of mental illness. A person with a background of 
mental disease may not be discriminated against by reason thereof.
   A person who discriminates against a mentally 
ill person by reason of the latter’s present or past mental health disorders 
shall be held liable in accordance with the procedure established by the laws of 
the Republic of Lithuania.
   Article 4. Mentally ill persons may be declared 
incompetent only by a court decision. The municipality, taking into 
consideration the requests of an incompetent person, shall appoint a 
representative for the protection of his interests.
   Article 5. The state must provide mentally ill 
persons with conditions for development, help them acquire work skills, change 
their qualifications, rehabilitate and return to life in the community.
   The procedure of establishment and operation of 
institutions for the development of and care for the mentally ill shall be 
regulated by the laws and other legal statutes of the Republic of 
Lithuania.
   The terms and conditions of establishment and 
operation of special schools, kindergartens, special groups (classes) in 
educational institutions shall be laid down by the Ministry of Education and 
Science and by the municipalities. Minors may also be enrolled in the general 
type groups and classes.
   Article 6. Mentally disabled persons shall be 
taken care of by the state. They shall be provided with social assistance in 
compliance with the procedure laid down by the laws of the Republic of 
Lithuania. Health care of mentally disabled persons shall be financed in the 
manner established by the laws of the Republic of Lithuania.
   The municipality shall organise and support the 
nursing and care of the mentally disabled in their families, health care 
institutions, mental health centres and other institutions of care and 
rehabilitation. 
Chapter III
THE RIGHTS OF HOSPITALISED PATIENTS AND RESTRICTIONS THEREOF 
   Article 7. Hospitalised patients shall have the right to:

   1) communicate with other persons (including other 
patients), have freedom of access to telephone, telegraph, postal services and 
other means of communications;
   2) receive, in private, regular visits from 
their representatives, other visitors;
   3) send and receive all kinds of private or 
public statements, letters which may not be read or censored by other 
persons;
   4) purchase and receive the necessary items;
   5) be provided with a possibility to enjoy privacy;
   6) perform religious rites;
   7) read, go in for sports, and enjoy other types of leisure activities;
   8) receive audio-visual information;
   9) study and expand their knowledge;

   10) engage in the activities suited to their social 
and cultural background and aimed at promoting rehabilitation and reintegration 
in the community.
   Conditions for fulfilling the above-mentioned 
requirements shall be provided for in the internal regulations of a mental 
health facility.
   The patients’ rights defined in this Article 
may be restricted on the psychiatrist’s decision only in the event of a real 
threat to the patient himself or to others. The restrictions must be recorded in 
the patient’s clinical record.
   The above-stated rights of patients may be 
restricted in accordance with the procedure specified by the laws of the 
Republic of Lithuania. 
   Article 8. In a mental health facility the 
patient shall realise his rights himself or through his representative.
   The administration of a mental health facility 
must assist the patient in reaching his relatives, representative. 
   Article 9. The labour activity of mentally ill 
persons hospitalised in a mental health facility must be voluntary, having a 
therapeutic and rehabilitative effect and helping them to return to the 
community.
   The requirements of conditions of work and 
length of work period of the mentally ill persons shall be determined by the 
Ministry of Health. Labour activity must recommended and controlled by the 
psychiatrist. It shall be prohibited to force a mentally ill person to 
work.
   Production-rehabilitation sections of mental 
health facilities must be structural subdivisions of said institutions. The 
procedure of their organisation and operation shall be determined by the 
Ministry of Health. 
Chapter IV
THE PATIENTS’ MENTAL HEALTH CARE 

   Article 10. Patients shall have the right to receive 
appropriate, accessible and suitable health care.
   A patient shall have the right to choose a 
psychiatrist, a mental health facility and type and scope of health care or to 
refuse same. The right may be restricted if circumstances specified in Article 
27 of this Law exist as well as in the event of mental health care being 
provided in the cases provided for in Chapters 8 and 9 of this Law. 
   Article 11. Mental health care (out-patient or 
in-patient) shall be provided according to the person’s place of residence at 
the mental health centres, as well as at other mental health facilities, care 
and custody institutions.
   The mental health centre shall be established 
by the municipality. Its activities shall be governed by the regulations 
approved by the Government of the Republic of Lithuania. 
   Article 12. The conditions of the patients’ 
mental health care at the time of their hospitalisation may not be inferior to 
the treatment and nursing conditions of persons ill with other 
diseases. 
   Article 13. The patients’ health care 
conditions shall be determined by the psychiatrist, seeking to ensure that the 
treatment and nursing conditions offer the least restrictive environment.
   The actions of a mentally ill person may be 
subject to restrictions only provided that the circumstances specified in 
Article 27 of this Law are manifest. A recording to the effect must be promptly 
made in the clinical record. 
   Article 14. Patients shall have the right to 
confidentiality with regard to information concerning their health. The 
psychiatrist, other medical doctor, the nursing staff, the administration of a 
health care facility, members of the MMHC must guarantee the above-stated right 
of the ill person in compliance with the laws of the Republic of Lithuania and 
according to the requirements of medical ethics. Information concerning the 
patients’ state of health shall be furnished to other persons in compliance with 
the procedure established by the laws of the Republic of Lithuania. 
   Article 15. The psychiatrist must inform the 
patient of his health disorders and health care being provided. The scope of 
said information shall be determined by the psychiatrist taking into account the 
patient’s condition and in compliance with the requirements of medical 
ethics.
   The patient shall have the right of access to 
extracts from his medical record, except in cases where the information may have 
a detrimental effect on his health. A decision regarding such restrictions shall 
be taken by the psychiatrist who shall make an appropriate recording in the 
patient’s clinical record. Extracts from the clinical record shall be arranged 
in such a manner as not to harm the interests of third persons and, upon the 
patient’s request, shall be furnished within 3 days. In case the patient’s right 
of access to the clinical record in the manner defined in this Law is subjected 
to restrictions, he or his representative may apply to the MMHC regarding the 
patient’s right of access to the clinical record.
   The patient’s representative shall be entitled 
to receive information from the psychiatrist, other medical doctor, the 
administration of the mental health facility regarding the state of health of 
the represented person, methods of prophylaxis, diagnostics and treatment 
applied to him, to be granted access to the clinical records of the incompetent 
person represented by him.
   The representative shall also have the right of 
access to other medical documentation directly concerning the interests of the 
represented person. The attending psychiatrist or the mental health facility 
administration must promptly furnish the representative with such information 
and documents .
   If the patient is a minor, the information must 
be presented to his parents or guardians.
   Article 16. No treatment shall be given to a 
patient without his consent, except when he is an involuntary patient 
hospitalised by reason of circumstances specified in Article 27 of this Law and 
is unable to correctly evaluate his state of health. In such case the 
psychiatrist shall inform the patient and his representative of the prescribed 
involuntary treatment. The information must be recorded in the patient’s 
clinical record. If the patient disagrees with the psychiatrist’s opinion that 
he is unable to correctly evaluate his condition, he or his representative shall 
have the right to apply to the MMHC which shall decide whether or not the 
mentally ill person is able to correctly evaluate his state of health. Should 
the MMHC decide that the patient’s judgement is not impaired, the treatment 
administered without his consent must be stopped and may not be continued 
without his consent.
   In the cases specified in paragraph 1 hereof 
consent for the patient’s involuntary treatment must be obtained in accordance 
with the procedure laid down in Article 28 of this Law. Until the MMHC consent 
is obtained, the patient, upon the decision of two psychiatrists, may be 
subjected to involuntary treatment for not longer than 72 hours. 
   Article 17. A patient who is a minor must be 
given treatment with the consent of one of the parents or the guardian. If one 
of the parents or the guardian refuses treatment prescribed by the psychiatrist 
and this is likely to result in irreparable damage being inflicted on the 
minor’s health, the medical doctor must promptly apply to the MMHC and obtain 
its consent for giving the minor treatment without the consent of one of the 
parents or the guardian.
   Minors shall be hospitalised and given 
treatment separately from adult patients. 
   Article 18. Mentally ill persons may be 
prescribed only the methods of treatment approved in accordance with the 
procedure laid down in the legal statutes of the Republic of Lithuania.
   Methods of treatment which have irreversible 
harmful effect on health may not be applied to incompetent mentally ill 
persons.
   Clinical experimental methods of treatment, 
psychosurgery may be applied with respect to mentally ill persons only for the 
purpose of treatment under the supervision of the medical ethics commission. 
Clinical experimental methods of treatment, psychosurgery may be applied only 
with the written informed consent of the mentally ill person certified by two 
witnesses and the head physician of the mental health facility. Approval of the 
medical ethics commission must also be received. 
   Article 19. If the patient’s life is in real 
danger, urgent medical aid may be given without the consent of the mentally ill 
person. The mentally ill person and his representative shall be informed of the 
medical aid given. 
Chapter V
THE RIGHT OF THE PATIENT OR HIS REPRESENTATIVE TO APPEAL 
TO THE MMHC, THE COURT AGAINST THE CONDITIONS 
OF HEALTH CARE 

   Article 20. The patient or his representative shall 
have the right to appeal to the MMHC against the conditions of health care. In 
the event of disagreements between the patient or his representative and the 
MMHC regarding involuntary hospitalisation and involuntary treatment, the 
dispute shall be settled in court. 
   Article 21. The patient or his representative 
shall have the right to present to the MMHC medical findings regarding the 
health condition, conditions of health care as well as other documents issued by 
a chosen psychiatrist. 
   Article 22. The patient or his representative 
shall have the right to be present and be heard out at the MMHC when the issues 
concerning his involuntary hospitalisation, treatment, etc. are being 
decided.
   The MMHC must state its findings and decisions 
in writing and present same to the patient or his representative within a two 
weeks’ period. 
Chapter VI
HOSPITALISATION OF PATIENTS 

   Article 23. The primary examination and assessment 
of the patient’s mental condition may be performed by the psychiatrist on 
reasonable suspicion of a severe mental illness the symptoms whereof are 
identified in Article 27 of this Law. Primary examination of the person’s mental 
condition shall be conducted in accordance with the procedure established by the 
Ministry of Health.
   A medical doctor, the patient’s representative, 
his close relatives, the police may request his primary examination. 
   Article 24. If a patient applies with a request 
to be hospitalised, he may be hospitalised only provided that:
   1) at least one psychiatrist, upon examining 
the patient, recommends he should be treated as an inpatient at a mental health 
facility;
   2) he has been informed about his rights at a 
mental health facility, the purpose of hospitalisation, the right to leave the 
psychiatric facility and restrictions of the right as specified in Article 27 of 
this Law. 
   Article 25. Patients who are minors may be 
hospitalised only with the consent of one of the parents or his guardian except 
for the circumstances specified in Article 27 of this Law. In case of 
involuntary hospitalisation of a minor by reason of circumstances specified in 
Article 27 of this Law, involuntary hospitalisation and involuntary treatment 
conditions prescribed by this Law shall be applicable to him.
   If the patient who is a minor is under the age 
of 10 years, one of the parents or guardians shall have the right to be admitted 
to hospital with him.
   In the event of hospitalisation of a patient 
who is a minor and over the age of 10 years, one of the parents or guardians, 
should he so request, may stay at the mental health facility together with the 
minor. Decision on the issue shall rest with the psychiatrist who shall have to 
take into account the character of the illness and the minor’s mental condition. 
If the parents or guardians object to the psychiatrist’s decision they may 
appeal against it to the MMHC. The Commission’s decision shall be 
final. 
   Article 26. Patients hospitalised in compliance 
with the requirements of Article 24 of this Law shall have the right to leave 
the mental health facility at any time, provided that there are no circumstances 
specified in Article 27 of this Law.
   Article 27. A person who is ill with a severe 
mental illness and refuses hospitalisation may be admitted involuntarily to the 
custody of the hospital only if there is real danger that by his actions he is 
likely to commit serious harm to:
   1) his health, life;
   2) to the health, life of others. 

   Article 28. When the circumstances specified in 
Article 27 of this Law do exist, the mentally ill person may be involuntarily 
hospitalised and administered treatment in a mental health facility for a period 
not exceeding 72 hours without the consent of the MMHC. If such consent is not 
obtained within 72 hours, involuntary hospitalisation and involuntary treatment 
must be terminated. The administration of the mental health facility must 
forthwith notify the patient’s relatives, representative about the involuntary 
hospitalisation.
   The administration of the mental health 
facility must promptly apply to the MMHC which, upon considering the 
psychiatrist’s recommendations, shall have the right to take a decision 
regarding the extension of the patient’s involuntary hospitalisation and 
involuntary treatment period but for no longer than one month from the 
involuntary admission to the mental health facility. Following the 
psychiatrist’s recommendations the mental health facility administration shall 
have the right to terminate the patient’s involuntary hospitalisation, 
involuntary treatment prior to the expiry of the term.
   Should it be necessary to prolong involuntary 
hospitalisation and involuntary treatment by the expiry one month, the 
administration of the mental health facility must apply to the district court 
regarding the extension of the involuntary hospitalisation and involuntary 
treatment period. The district court may, based on the findings of the mental 
health facility, either prolong or terminate the patient’s involuntary 
hospitalisation and involuntary treatment, but each time for a period not 
exceeding 6 months. On the recommendation of the attending psychiatrist, the 
administration of the mental health facility shall have the right to terminate 
the patient’s involuntary hospitalisation and involuntary treatment prior to the 
expiry of the prescribed time period. 
   Article 29. Where the circumstances specified 
in Article 27 exist, mentally ill persons shall be taken for involuntary 
hospitalisation by the police at the request of the mentally ill person’s 
representative, on doctor’s instructions or by the order of the district court 
judge. A medical doctor must be present during involuntary hospitalisation of 
mentally ill persons. 
   Article 30. A mentally ill person who is being 
involuntarily admitted to a mental health facility as a patient must acknowledge 
by his signature that he has been informed by the mental health facility 
administration about his involuntary hospitalisation and his rights at the 
mental health facility. If the mentally ill person refuses or is unable to put 
his signature, the fact of his having been informed about his involuntary 
hospitalisation shall be testified in writing by two witnesses who may be mental 
health facility staff members but not psychiatrists. 
   Article 31. A person’s hospitalisation in 
violation of the requirements of this Law shall be illegal. Persons through 
whose fault a person was illegally hospitalised shall be held liable in the 
manner established by the laws of the Republic of Lithuania.
Chapter VII
PROCEDURE FOR CONDUCTING FORENSIC PSYCHIATRIC 
EXAMINATION 

   Article 32. Grounds of forensic psychiatric 
examination and procedure for prescribing the examination shall be regulated by 
the Codes of Criminal Procedure and Civil Procedure of the Republic of 
Lithuania. 
   Article 33. Inpatient forensic psychiatric 
examination shall be conducted only at mental health facilities. During the 
examination period mental health care shall be provided in compliance with the 
requirements of this Law. During the period of examination the patients shall 
have all the rights determined by this Law except for the right to choose a 
mental health facility, conditions of health care. The patients’ rights 
established in paragraphs 1, 2, and 3 of Article 7 of this Law may be restricted 
on the decision of the official who prescribed the inpatient forensic 
psychiatric examination. 
Chapter VIII
MENTAL HEALTH CARE PROVIDED TO PERSONS SENTENCED 
TO A TERM OF IMPRISONMENT WHO BECOME MENTALLY ILL 

   Article 34. Persons sentenced to a term of 
imprisonment who become mentally ill shall be provided with mental health care 
during their term in prison in compliance with the requirements of Chapter 4 of 
this Law at mental health facilities located in places of 
imprisonment. 
   Article 35. The rights of mentally ill persons 
who undergo treatment in places of imprisonment may be subject to restrictions 
according to the requirements of this Law and other laws of the Republic of 
Lithuania like those of other persons sentenced to a term of 
imprisonment. 
Chapter IX
MENTAL HEALTH CARE PROVIDED TO MENTALLY ILL PERSONS 
WHO HAVE COMMITTED AN ACT DANGEROUS TO THE PUBLIC (A CRIME) 

   Article 36. The issue concerning involuntary 
hospitalisation and involuntary treatment of mentally ill persons who have 
committed an act dangerous to the public and have been recognised as being of 
diminished responsibility shall be decided by court in accordance with Article 
27 of this Law and the Criminal Code of the Republic of Lithuania. 
   Article 37. On the recommendation of a mental 
health facility and having decided, based on the findings of the mental health 
facility, that a person must undergo treatment after being involuntarily 
hospitalised, the court must indicate the mental health facility to which the 
person must be admitted involuntarily as a patient and determine the length of 
involuntary hospitalisation period as well as determining the conditions of 
health care.
   After the lapse of 6 months or earlier, if 
necessary, the court must consider, based on the findings of the mental health 
facility, and upon the recommendation of the mental health facility the issue of 
involuntary hospitalisation and involuntary treatment, and prolong 
hospitalisation and the above treatment, each time, however, for a period not 
exceeding 6 months, or must terminate same. 
   Article 38. The requirements of this Law, 
except for the right to choose a mental health facility and health care 
conditions, shall apply to the mentally ill persons involuntarily hospitalised 
pursuant to a court order. 
Chapter X
MUNICIPAL MENTAL HEALTH COMMISSION 

   Article 39. The MMHC shall be established on the 
municipality’s decision for a 3-year period in the locality which has an 
inpatient mental health facility for the purpose of addressing mental health 
care issues set forth in this Law, such as: involuntary hospitalisation, 
involuntary treatment, disputes arising between the patient, his representative 
and medical personnel relative to health care, as well as other issues 
identified in this Law and the MMHC regulations. 
   Article 40. The formation of the MMHC, its 
operations and financing shall be determined by this Law and the regulations 
approved by the Government of the Republic of Lithuania. 
   Article 41. The MMHC shall consist of not less 
than 3 permanent members and 3 deputy members. In case a permanent member is 
unable to take part in the MMHC meeting, his deputy member shall be invited to 
the meeting. The chairman of the Commission and his deputy member shall be 
appointed by the municipality board from among the persons trained in law.
   The MMHC shall decide issues by majority vote. 
Its decision shall be valid if at least 3 members attended the meeting and cast 
their votes. Should the meeting be attended by deputy members, a recording to 
the effect must be made in the minutes of the meeting. 
   Article 42. The MMHC shall within a 10-day 
period consider written complaints, statements and requests of the patients, 
their representatives, organisations and officers protecting the patients’ 
rights.
   If the MMHC is applied to by a mental health 
facility administration, the MMHC shall resolve the issue concerning involuntary 
hospitalisation of a mentally ill person within the time period laid down in 
Article 28 of this Law. 
   Article 43. The MMHC must invite to its 
meetings competent specialists, other persons or officers provided that the 
character of the issue under consideration necessitates this. The MMHC shall 
have the right to request the filing of necessary documents (including the 
clinical record).
   Representatives of the mental health facility 
administration, psychiatrists must attend the MMHC meeting, present the 
necessary documents, give explanations when the issue concerning the treatment 
of their patients is being decided. In such case the MMHC must deliver a written 
invitation.
   Article 44. When resolving issues concerning 
the patient’s person and his health care, the MMHC members must comply with the 
requirements of medical ethics and confidentiality of a person’s medical secret. 
Members of the MMHC who violate the above requirements shall be held liable in 
accordance with the procedure established by laws of the Republic of 
Lithuania. 
   Article 45. The activities of the MMHC shall be 
controlled by the municipality and the Ministry of Health.
   Complaints against the activities of the MMHC 
shall be considered by the municipality and the Ministry of Health. 
Chapter XI
RESPONSIBILITY FOR VIOLATIONS OF THE LAW 
ON MENTAL HEALTH CARE 

   Article 46. Persons who violate the requirements of 
this Law shall be held liable in accordance with the procedure established by 
the laws of the Republic of Lithuania. 
   Article 47. A person who violates the 
requirements of Article 14 of this Law as well as the patient’s representative 
who releases information about mental health disorders of the person he 
represents without the consent of the represented person, except when the person 
is a minor, shall remedy the moral damage in accordance with the procedure laid 
down in Article 140 of the Law on the Health System of the Republic of 
Lithuania.  
Chapter XII 
FINAL PROVISIONS 

   Article 48. The Law on Mental Health Care shall come 
into effect as of 1 January 1996. 
   I promulgate this Law passed by the Seimas of the Republic of Lithuania. 
 
   Algirdas Brazauskas
   President of the Republic 
Vilnius
6 June 1995 
No. I-924




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