The Constitutional Court addressed when involuntary hospitalization is admissible

Involuntary hospitalisation as an interference with fundamental rights

The admission of a person to a health care facility without his or her consent constitutes a direct interference with the right to personal liberty, which is protected by both the Charter of Fundamental Rights and Freedoms and the Convention for the Protection of Human Rights and Fundamental Freedoms. For this reason, the law allows for involuntary hospitalisation only in exceptional and precisely defined cases.

According to the Health Services Act, a person may be hospitalized without his or her consent, in particular if:

• he/she suffers from a mental disorder and poses an immediate and serious threat to himself/herself or his/her surroundings,
• or his/her condition is such that without hospitalisation there is a risk of serious deterioration of his/her health,
  and at the same time the necessary care cannot be achieved by less severe means.

In addition, any such admission must be reviewed by the court without delay in so-called detention proceedings.

What was the case

In the present case, the complainant was admitted to a psychiatric institution without her consent and hospitalised for six days. The courts at all levels – the district, regional and Supreme Courts – concluded that the admission was lawful and that the grounds for the restriction of personal liberty continued throughout the period of hospitalisation.

They based their decisions primarily on medical documentation and expert psychiatric reports.

However, the applicant defended herself on the grounds that the courts had not sufficiently assessed her own statements and evidence, had accepted the experts’ conclusions too uncritically and had not taken sufficient account of the interference with her family life as she had been separated from her young, breastfed child.

She brought those objections before the Constitutional Court.

What the Constitutional Court criticised the courts for

The Constitutional Court annulled the decisions of the general courts and found that the right to personal liberty and the right to a fair trial had been violated. The key point was its attention to the role of the court in detention proceedings.

According to the Constitutional Court:

• the court must not resign itself to its own legal assessment of the case,
• expert evidence is important evidence, but it is not in itself a decision on the lawfulness of the intervention,
• the court must examine whether the established medical condition actually fulfils the constitutional criteria for restricting personal liberty.

In other words: it is not enough that a doctor or an expert states a mental disorder. The court must independently assess whether there was a concrete, actual and sufficiently serious threat to justify involuntary hospitalization.

The duty to deal with the arguments of the hospitalized person

The Constitutional Court has also emphasised that the courts have a duty to deal with all the relevant objections of the person concerned and to assess the evidence presented by the hospitalised person himself, not to discount it in advance simply because it comes from him.

In the present case, according to the Constitutional Court, the courts did not sufficiently reflect the individual circumstances, including the applicant’s family situation, and did not explain convincingly why the situation could not have been dealt with in a less invasive manner.

The decision of the Constitutional Court is important not only for this particular case but also for future practice. It clearly establishes that detention proceedings are not a formality, that courts must not automatically confirm the conclusions of medical institutions and that the protection of personal liberty requires active and rigorous scrutiny of the lawfulness of the intervention.

At the same time, it recalls that even a person with a mental illness remains a bearer of fundamental rights, which can only be restricted if genuinely necessary and duly justified.