“Excessive use of isolation and constraint deemed a human rights violation. Remedial action sought. ”
In October of 2004, a petition was filed by Ms. Kim (34) with the National Human Rights Commission of Korea against a chairperson of a mental health hospital located in Daejon Metropolitan City. The complaint stated “I would like NHRC to investigate a case where a patient was constrained for more than 3 days. The patient was not allowed to go to the restroom and was forced to wear a diaper. Also, some patients were unjustly hospitalized.”
In response, NHRC recommended the chairperson (1) to comply with the admission and hospitalization procedures of the Regulations on Mental Health, (2) to come up with and conduct improved measures that don’t violate human rights when isolating or constraining a patient, and (3) to implement regular job training and human rights education to hospital employees.
NHRC also recommended the Mayor of Daejon Metropolitan City, a supervisory body, (1) to take administrative actions necessary towards the hospital, including a warning and an order to correct the problem, and (2) to adequately supervise the hospital in the future.
1. Isolation and constraint
The results of the investigation done by NHRC are as follows.
It was found that (1) the hospital constrained several patients including the complainant for more than 40 hours at a time, that (2) the hospital did not thoroughly check the conditions of the patients nor record their observations regularly, that (3) it isolated some patients as many as 41 times for about 20 days and constrained other patients over 8 times, and in particular that (4) the complainant was confirmed to be forced to wear a diaper along the use of restraining techniques. At the time, only two months had passed since the complainant gave birth to a baby.
Therefore, 40 hours of constraint must have been very harsh.
Measures of isolating and constraining a patient are ones that could gravely violate fundamental human rights including personal liberty. Hence, (1) only under the instruction of a psychologist for a therapeutic purpose should isolation or constraint be allowed when a patient is likely to harm oneself or others. (2) Even in that case, the length of time should be limited and the method of isolation and constraint should be implemented upholding human rights to the greatest extent.
NHRC considered that (1) the chairperson isolated and constrained the patient too often and for too long, (2) throughout the process, the chairperson did not check the patient’s health condition or her progress violating personal liberty.
2. Admission and discharge procedures
After examining the records of admissions and discharges at the hospital in question, NHRC found that (1) the hospital never complied with Paragraph 3 of Article 24 of the Psychological Health Law stating that ‘if a patient was recommended to prolong his/her hospitalization, the patient has to be given advance notice. (2) In the case of Ms. Kang, it was confirmed that she was not asked nor notified with regards to prolonging her stay in the hospital. She couldn’t contact her husband, her legal guardian, because his business had gone bankrupt after the financial crisis hit the nation.
Also, Article 21 of the Psychological Health Law provides that the qualification of a guardian of a patient with a psychological disorder is limited to ‘a supporter or guardian in Civil Law’. However, the NHRC confirmed that (1) a former husband, a monk, a friend, an employee at the mental health facility signed admission papers to continue to hospitalize patients and (2) that the chairperson admitted some patients without acquiring the document necessary to identify the relationship with the patients on several occasions.
Therefore, NHRC concluded that the chairperson broke the Law providing admission of the mentally ill at a mental health facility and the procedure of prolonging a stay in the hospital and thereby violated the patient’s basic rights.
In addition, during the investigation process, NHRC discovered that (1) as of the end of April 20, 2005, the number of patients hospitalized amounted to 273, but only 2 psychologists were working there. Therefore, they were each responsible for an average number of 136.5 patients respectively. So, the hospital grossly violated the Implementations Regulations of Psychological Health Law that allows one psychologist to take care of a maximum number of 60 patients. Therefore, the issue should be corrected. As a result, NHRC informed the Mayor of Daejon Metropolitan City of the issue so that the Mayor could take remedial actions in the future independently from the petition.-End-
