Communicated on 16 January 2014
FOURTH SECTION
Application no. 6752/13
O.G. (II)
against Latvia
lodged on 21 January 2013
STATEMENT OF FACTS
The applicant is a Latvian national, who was born in 1965 and lives in Riga. The President granted the applicant’s request for his identity not to be disclosed to the public (Rule 47 § 3).
A. The circumstances of the case
The facts of the case, as submitted by the applicant, may be summarised as follows.
On 9 August 2012 the applicant was detained by the police and brought to a psychiatric hospital in Riga. According to the applicant, he was then strapped down and injected with unknown drugs.
On the following day the applicant and his medical file were examined by a panel consisting of three doctors in order to establish whether there were grounds to provide involuntary psychiatric treatment.
As regards the circumstances in which the applicant had been detained, the report of the panel states that he had been detained in public transportation due to aggressive behaviour towards ticket controllers. When brought to a police station the applicant had behaved aggressively, had tried to attack police officers, had uttered threats and had told that he had robbed the president. The report also refers to the fact that the applicant had a prior history of being treated in a psychiatric hospital.
As to the applicant’s behaviour in the reception area of the hospital the report states the following:
“[the applicant] behaved in an expressive way, was under a state of psychomotor agitation, aggressive[,] was answering questions with counter‑questions not relating to the substance, while making strange movements with the head and trying to affect the surrounding people with his eyes[. The applicant] occasionally listened to what was happening around him, was smiling without any reason and was under the spell of his own psychotic experiences”.
Concerning the applicant’s behaviour during the interview with the panel of doctors, the report states the following:
“No symptoms of unclear consciousness. Not accessible for a productive contact. Answers questions with counter-questions. Behaves in an expressive, defiant way. Suspicious. Asks what drugs have been given, who has allowed to give [him] drugs without his agreement. Does not explain his actions [in the police station and against the ticket controllers]. Denies having said that he has robbed the president. Says that “everything will be alright”. Refuses to [give consent to being treated in the psychiatric hospital]. Thinking is confused, inconsistent. Gives an impression that [he] is listening to what is happening around him. Patient is entirely under the spell of his own psychotic experiences. Complete lack of criticism [sic] towards the necessity of being treated, concerning his illness and actions.”
The report went on to diagnose the applicant in the following manner:
“Diagnosis: F20.00 Paranoid schizophrenia – continuous course, acute phase. Hallucinatory-paranoid syndrome. ”
The concluding part of the report stated that an involuntary in-patient treatment in a psychiatric hospital had to be continued on the basis of section 68(1) of the Medical Treatment Law. The report noted that the applicant had expressed a wish to participate in the court hearing concerning his compulsory treatment.
The hearing of the Riga City Ziemeļu District Court took place on 13 August 2012 and was attended by the applicant, a sworn attorney E.T. and a representative of the hospital. During the hearing the representative of the hospital maintained the proposal to order the applicant’s involuntary in-patient psychiatric treatment, referring to, among other things, the fact that the patient was “angry”, that he did not want to talk to doctors, had stated that he had killed the president, was aggressive. She also referred to the applicant’s prior history of psychiatric treatment. In response to the applicant’s question the representative of the hospital explained to him that he had been brought to the hospital because he had “talked nonsense”. The applicant admitted that there had been a conflict in the public transportation but denied having said that he had killed or robbed the president. He explained that he knew himself how and when he should get medical treatment, and that he had been receiving out-patient medical treatment.
The court adopted a decision on 13 August 2012. It referred to the history of the applicant’s psychiatric treatment, noting that he was regularly visiting a psychiatrist on an out-patient basis but that he was taking the prescribed medications whenever he chose to. Subsequently the decision reproduced the report of the panel of doctors which had examined the applicant, summarised the oral submissions of the participants of the hearing and came to the conclusion to endorse the recommendation of the panel that the applicant had to be hospitalised. In establishing that the applicant posed danger to others, the court referred to the record of the applicant’s detention that had been drawn up by the police on 9 August 2012. That report noted that the applicant had uttered threats, had reported that he had stolen from the President of Latvia, had robbed several houses, and so on.
The court went on to note the following:
“An analysis of the materials in the application [for the applicant’s involuntary treatment] confirmed that it has been found that [the applicant] suffers from a psychiatric disorder, due to which he has been repeatedly treated in [a psychiatric hospital]. The symptoms of a psychiatric disorder are characterised by aggressive and conflict-tended behaviour, due to which the court has no reasons to doubt the circumstances of the patient’s behaviour [and] the reasons and circumstances of his placement in the [hospital], as described in the decision of the panel and materials appended to it.
Such behaviour of the patient creates real danger to the life and health of the patient himself as well as to that of other persons”.
The court agreed with the medical panel’s conclusion that an improvement of the applicant’s health was only possible if he received an in-patient treatment. The court noted that there was no evidence apart from the applicant’s own statement that he was taking the prescribed medications. The court further considered that the applicant had remained sceptical about the suggestion that he was suffering from a mental disease. In the light of these considerations the court came to the conclusion that ordering involuntary treatment was in the best interests of the applicant. The court ordered that the applicant receive in-patient treatment for two months.
The applicant appealed and his appeal was examined in written proceedings by the president of the Ziemeļu District Court on 30 August 2012. In his appeal the applicant had indicated that he disagreed with the interference by the psychiatric hospital in his personal life and that he did not understand in the context of what proceedings he had been detained. The president of the court considered that the applicant’s appeal did not contain any grounds that would put in question the legitimacy of the impugned decision.
The applicant was released from the hospital on 14 September 2012.
B. Relevant domestic law
Section 67(1) of the Medical Treatment Law provides that psychiatric assistance should be provided on a voluntary basis. In-patient assistance is to be provided in a psychiatric establishment only where, owing to the state of health of the patient, such assistance cannot be provided on an out-patient basis or at the patient’s place of residence.
Section 68(1) provides an exhaustive list of situations in which involuntary psychiatric treatment may be administered. The first subparagraph authorizes involuntary treatment in cases if the patient
“has threatened or is threatening, has attempted or is attempting to inflict bodily injuries on himself or on another person or has been or is violent towards other persons and if a medical specialist concludes that the patient has a mental health disorder, which might result in serious bodily injury to the patient himself or to another person”.
The second subparagraph of section 68(1) allows involuntary treatment in cases where the patient displays an inability to take care of himself and if a medical specialist concludes that the patient has a mental health disorder which might result in irreversible and serious deterioration of the patient’s health condition.
Section 68(3) provides that in case involuntary hospitalisation of a patient is necessary, a panel of psychiatrists examines the patient within 72 hours and adopts a decision in that regard. Pursuant to section 68(5) such decision is sent to the competent district court within 24 hours. The district court then examines the decision of the panel and decides whether to approve the patient’s involuntary hospitalisation for a period of up to two months.
Section 69 of the Medical Treatment Law provides as follows:
“(1) If a person disrupts public order due to a mental disorder or a mental disease, that person shall be detained, transported to a psychiatrist and supervised there by the police in accordance with the Law on Police.
(2) The police shall submit to the psychiatrist a written report concerning the antisocial nature of the [patient’s] behaviour”.
COMPLAINTS
The applicant complains under Article 5 § 1 of the Convention that he was unlawfully deprived of liberty from 9 August to 14 September 2012. In particular he complains that on 9 August 2012 and prior to his examination by the panel of doctors he could not have been considered “a patient” of the psychiatric hospital.
QUESTION TO THE PARTIES
Was the applicant deprived of his liberty in breach of Article 5 § 1 of the Convention? In particular, did the deprivation of his liberty correspond to paragraph (e) of this provision?
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