Search results

1

Patient aggression towards health care professionals

100%

Mroczek B., Mormul J., Kotwas A., Szkup M., Kurpas D.

Progress in Health Sciences

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2014

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vol. 4

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issue 2

67-74

EN

Purpose: To estimate the frequency of aggressive behaviors in health care institutions, and determine their influence on emotional reactions of medical workers. Materials and methods: The study involved 201 health care professionals from the regions of Lower Silesia and Opole in Poland. The authors employed the exposure to patient aggression inventory, based on the questionnaires of Merecz and Nowicka & Kolasa; this inventory divides patient aggression towards medical workers into seven different forms. Results: In over 90% of cases, health care professionals fell victim to patient aggression in a workplace. It mostly took forms of verbal aggression, a raised voice and shouting. A physical attack was reported by 45.6% of the surveyed; it resulted in physical injuries in 27.9% of psychiatric hospital workers and 24.7% of general hospital workers. As a reaction to patients’ verbal aggression, medical workers usually calmly explained that such behavior was improper. Violence and aggressive behaviors of patients evoked workers’ anger, fear, a feeling of resignation and the loss of their sense of safety. In most case's victims of patient aggression either coped with the problem themselves or asked their co-workers and superiors for help. Conclusions: Aggressive behaviors of patients arouse in medical staff, mostly anger. Medical workers usually cope with patient aggression themselves; nurses more often than other health care professionals ask their superiors and co-workers for help. It is necessary to conduct further research into the problem of patient aggression towards medical staff so that actions ensuring safety for workers can be taken.

2

Prawne aspekty stosowania przymusu bezpośredniego w szpitalach psychiatrycznych

75%

Mróz K.

Zeszyt Studencki Kół Naukowych Wydziału Prawa i Administracji UAM

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2017

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issue Numer Specjalny

103-121

PL

Artykuł porusza najważniejsze zagadnienia związane z problematyką stosowania przymusu bezpośredniego w szpitalach psychiatrycznych. Opracowanie przedstawia sytuacje, w których dozwolone jest wszczęcie trybu przymusowego postępowania medycznego wobec osób stwarzających zagrożenie dla życia lub zdrowia własnego, najbliższego otoczenia bądź bezpieczeństwa powszechnego, wbrew ich woli. Gwarancję realizacji zasad poszanowania praw i wolności jednostki stanowią przepisy ustawy o ochronie zdrowia psychicznego dotyczące stosowania w granicach konieczności środków przymusu bezpośredniego.

EN

This paper discusses major issues related to the application of coercive measures in psychiatric hospitals. The situations are presented when a physician is authorized to initiate compulsory medical procedure against persons posing threat for their own life or health, their immediate surroundings or common security - against their own will. Provisions of the Mental Health Act regarding the application of direct coercive measures within the limits of necessity are vital guarantee of respecting the rights and freedoms of an individual.

3

Sądowa ocena zasadności umieszczenia osoby z zaburzeniami psychicznymi w szpitalu psychiatrycznym bez jej zgody (wybrane zagadnienia)

63%

Wojcieszak-John A.

Ruch Prawniczy, Ekonomiczny i Socjologiczny

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2023

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vol. 85

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issue 1

169-181

EN

The purpose of the article is to determine how the judicial evaluation of the appropriateness of admitting a person with mental disorders to a psychiatric hospital is carried out, from the perspective of meeting psychiatric-psychological and formal prerequisites. The considerations undertaken focus on the analysis of the prerequisites for admission to a psychiatric hospital in the so-called emergency and observation mode. The file research was carried out at the district court in Poznań and included cases from 2018–2020. The results of the research showed that it is necessary to introduce legislative changes consisting, among other things, in the introduction of a statutory deadline within which the court is obliged to issue a decision on the validity or lack of grounds for admission to a psychiatric hospital; as well as the amendment of Article 23 of the Act on the Protection of Mental Health in such a way that admission to a hospital would require approval by the head of the ward (the doctor in charge of the ward) within 24 hours of admission, and the head of the hospital would notify the court of the above within 72 hours of admission.

PL

Celem artykułu jest ustalenie, w jaki sposób przebiega sądowa ocena zasadności przyjęcia osoby z zaburzeniami psychicznymi do szpitala psychiatrycznego z perspektywy spełnienia przesłanek psychiatryczno-psychologicznych oraz przesłanek formalnych. Podjęte rozważania koncentrują się wokół analizy przesłanek przyjęcia do szpitala psychiatrycznego w tzw. trybie nagłym i obserwacyjnym. Badania aktowe przeprowadzono na terenie okręgu Sądu Okręgowego w Poznaniu i objęły one sprawy z lat 2018–2020. Wyniki badań pokazały, że konieczne jest wprowadzenie zmian legislacyjnych polegających m.in. na wprowadzeniu ustawowego terminu, w którym sąd obowiązany jest wydać orzeczenie w przedmiocie zasadności albo braku podstaw przyjęcia do szpitala psychiatrycznego, a także znowelizowaniu art. 23 ustawy o ochronie zdrowia psychicznego w taki sposób, aby przyjęcie do szpitala wymagało zatwierdzenia przez ordynatora (lekarza kierującego oddziałem) w ciągu 24 godzin od chwili przyjęcia, a kierownik szpitala zawiadamiałby o powyższym sąd w ciągu 72 godzin od chwili przyjęcia.

4

Stowarzyszenie „Misericordia” jako przykład dobrych praktyk humanizacji leczenia pacjentów z zaburzeniami psychicznymi

51%

Lada A.

Praca Socjalna

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2022

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vol. 37(3)

117-129

EN

Helping the sick has become a part of the social life. The organization of the institutional aid has been imporving. More and more people get involved in the philanthropy, volunteering, and charity activities. The desire to help the sick, the disabled, children or the elderly triggers good in people and the willingness to share both material goods and, what is most important, time, company and presence. People with mental disorders constitute this unique group that is often perceived as a closed and inaccessible group. This article presents the characteristics of the functioning of a psychiatric hospital based on the concept of total institutions by Erving Goffman and a specific attempt to humanize the treatment of patients with psychiatric disorders. Then, as an example of good practices in this area, the Association of Help for the Sick “Misericordia” from Lublin will be presented, which supports and helps people suffering from various diseases and mental disorders to be able to function independently in the social space as best they can. The article presents the history of the association, the profile of its founder and associates, as well as the nature of work with people with disabilities.

PL

Pomoc osobom chorym stała się elementem życia społecznego. Coraz lepiej zorganizowana jest pomoc instytucjonalna. Filantropia, wolontariat, akcje charytatywne to działania, w które coraz chętniej angażują się ludzie. Pragnienie niesienia pomocy osobom chorym, z różnymi niepełnosprawnościami, dzieciom czy seniorom wyzwala w ludziach dobro i chęć do dzielenia się zarówno dobrami materialnymi, jak i tym, co najistotniejsze: czasem, towarzyszeniem i obecnością. Osoby z zaburzeniami psychicznymi stanowią tę grupę, która często postrzegana jest jak zamknięta i niedostępna. W prezentowanym artykule przybliżona zostanie charakterystyka funkcjonowania szpitala psychiatrycznego na podstawie koncepcji instytucji totalnych Ervinga Goffmana oraz swoista próba humanizacji leczenia pacjentów z zaburzeniami psychiatrycznymi. Następnie jako przykład dobrych praktyk w tym obszarze przedstawione zostanie Stowarzyszenie Niesienia Pomocy Chorym „Misericordia” z Lublina, które wspiera i pomaga, by osoby dotknięte różnymi chorobami i zaburzeniami natury psychicznej mogły jak najlepiej i na miarę swoich możliwości samodzielnie funkcjonować w przestrzeni społecznej. W artykule przybliżone zostaną rys historyczny stowarzyszenia, sylwetka założyciela i współpracowników oraz charakter pracy z osobami z niepełnosprawnościami.

5

Narkomania jako zjawisko społeczne- historia problemu w Polsce

44%

Bielewicz A.

Archiwum Kryminologii

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1988

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issue XV

251-286

EN

The phenomenon of drug addiction has been known in Poland for at least several dozen years. In the period of the second Republic, it was not a major social problem. In 1933, the total of 295 addicts were hospitalized in Poland. According to pre-war researchers, the number of drug addicts could be estimated at over 5 thousand persons in the early 1930s. The pre-war addicts took first of all classic drugs: morphine, heroin, and cocaine. Also codeine, Somniphrene and Pantopon were rather frequently taken. Less frequent was the use of hashish, mescaline and peyotl. Headache wafers played the part of substitutes. According to the data of the health service and the Warsaw public prosecutor's office, about three – fourth of drug addicts were men. Most addicts were in their thirties; hardly any could be found among the youth, as far as morphinism is concerned in particular. This type of addiction could be found nearly exclusively among persons aged over 30. The situation shaped ,somewhat differently as regards codeine addicts: also younger persons. could be found in this group. In the socio professional structure of addicts included in the files of the Warsaw public prosecutor's office, clerks prevailed; their percentage amounting to 30. The second most numerous group were craftsmen and tradesmen-,13 per cent, and the third on -representatives of medical professions (chemists, doctors, surgeon, assistants, nurses, midwifes) of whom there were 9 per cent. The percentage of workers was 2, of prostitutes-5, and artists-4. In the opinion of the most of the pre-war researchers, the above socio-professional structure is distorted. According to them, drug-addiction was much more widespread among officers (of the air force and navy in particular), artists, writers and journalists. As regards religion, pre-war addicts constituted as varied a mosaic as the entire society in those days. There were among them representatives of all of the most numerous religious groups then found in Poland. Roman Catholics were most, and members of the orthodox church-least :susceptible to drug addiction. The pre-war researchers of drug addiction devoted a lot of attention to the problem of etiology of this ,,social disease'' Some of them stressed above all the medical-others-the economic and political, and still others - the cultural or those related to civilization causes. There were also conceptions that laid particular emphasis on physiology and biochemistry of the human body. The evolution of drug addiction in the post-war forty years may be divided into four stages. The first of them lasted till about mid-1960s. The extent of the phenomenon was then limited, with the average of about 400 persons treated in out-patient clinics, and about 150 -in psychiatric hospitals. Also the police statistics point to small sizes of this phenomenon. In 1967, as few as 9 offences directly related to drug addiction were recorded in Poland. Drug addicts of those days descended from rather specific circles. They were mostly representatives of medical professions, that is persons with a relatively easy access to drugs. Over 90 per cent of all morphine addicts were employees of the health service. Drugs taken most frequently were the classical ones;(morphine, cocaine), tranquilizers (Glimid, Tardyl) and stimulants (amphetamines). In thest period, one could hardly speak of drug addiction as a subcultural phenomenon. It was mainly a medical problem. The majority of the drug taking persons were those already dependent. The addicts of those days formed no close groups sharing a given ideology, specific symbols or language. The taking of narcotic drugs was not a social but an individual behaviour in most cases. The second stage are the late 1960s and the early 1970s. In that period, a rapid growth in the extent of drug addiction can be noticed. In the years 1969-1973, the number of patients treated because of drug addiction in out-patient psychiatric clinics was quintupled, and in psychiatric hospitals, tripled. In 1972, there were about 3,150 patients treated in psychiatric clinics, and about 600 in psychiatric hospitals. Also the number of offences directly related to drug addiction grew rapidly. While in 1967 there was not a single instance of unauthorized giving of narcotic drug (art. 161 of the Penal Code) or of forging prescriptions (art. 265 § 1 of the Penal Code), 105 and 417 such acts respectively were recorded five years later. In 1971, over 3,000 persons "taking narcotic drugs" were registered in the police files. As found in a sociological study carried out in 1972 among students of all grammar, vocational and elementary vocational schools in Gdańsk, Sopot and Gdynia, 8.3 per cent of the respondents had contacts with narcotic drugs. In the case of about 45 per cent of this group, these contacts were occasional. According to the authors of the study, this percentage is the "minimum frequency of occurence" of drug taking "in the population of school youth in Gdansk, Gdynia and Sopot.'' In this early 1970s, the number of persons in danger of becoming addicts (i.e. those who took drugs regularly) and those already dependent was estimated at about 30 thousand. In the discussed period, also the character of addiction underwent changes: it became a subcultural phenomenon. The base on which it developed were the youth contestation movements which emerged in Poland as well. Addiction was given a cultural dimension by the ideology of the hippie movement. Taking drugs ceased to be an individual behaviour and became a social one which expressed certain attitudes and symbolized the affiliation to a given subculture. The young who took drugs formed smaller or bigger groups with strong internal bonds and a great sense of solidarity. They used specific symbols (way of dressing, recognition signals, rich repertoire of gestures, aliases, etc.) and quite a rich language (characteristic names of drugs and activities related to their taking). The very taking of drugs was acompanied by more or less developed rituals (narcotic coctails, seances, etc.). In that period - and later on as well -the phenomenon of drug addiction was concentrated among the youth and in highly urbanized and industrialized regions. In 1972, nearly 75 per cent of persons hospitalized for the first time were those aged under 25, and over 60 per cent-under 29. In 1970, over 90 per cent of addicts treated in hospitals lived in towns. The limited drug marked. caused the youth to resort to substitutes on the unpracedented scale. In those years, general use of such substances as trichloroethylene, Ixi (washing powder), Butaprene (glus), ether, benzene, solvents and others started. Yet the major typ of addiction still remaind that to opium and its derivates, particularly in men, and to sleeping-draught and tranquilizers in women. The third stage in the evolution of drug addiction are the years 1973-1976. In that period, a nearly 27 per cent decrease in the total of patients of psychiatric clinics, and a 40 per cent one in the case of those treated for the first time could be noticed. The morbidity index went down from 3.5 to 2.0. A similar trend, though less dynamic one, concerned also hospital service. In an attempt at explaining this phenomenon, three factors should be mentioned. Firstly, the early 1970s are the period when youth movements started to die out. Also a relative social peace reigned in those years, which caused drug addiction lose its socio-cultural base. Secondly, the medical authorities introduced a number of limitations in the accessibility of drugs in that period. Thirdly, repressive action of the police also influenced this tendency to a high degree. The prosecution agencies not only increased their efficiency greatly, but also acquired a much better knowledge of the addicts circles. These actions however proved insufficient to fully control addiction. The fourth stage in the evolution of addiction started in the late 1970s. In the years 1977-1984, the number of patients treated in out-patient clinics increased twice over, and that of hospitalized persons - five times over. The indicates of dissemination and morbidity grew rapidly. Beginning from mid-1970s, the number of persons registered in the police files grew nearly two and a half times over. Also the number of deaths due to over dosage went up from year to year. In 1978, 18 such cases were recorded, with the number amounting to as many as 117 in 1986. The number of offences directly related to drug addiction went up from 1,093 in 1978 to 3,014 in 1983. The number of persons taking narcotic drugs was estimated at about 500-800 thousand in 1983; that of persons in danger of becoming addicts - at 99-95 thousand, and of actual addicts - about 40 thousand. Such is the minimum spread of the discussed phenomenon. The unprecedented dissemination of drug addiction may be attributed to the emergence of two factors of which one is technological, and the other one psycho-social. In mid-1970s, the technology of production of a strong drug from poppy was worked out in Poland, which resulted in a great amount of strong narcotics appearing on the market. on the other hand, crisis started to accumulate in Poland in mid-1970s, which resulted in a growing frustration among the youth. The concurrence of these two factors brought about the explosion of drug addiction.

6

Orzecznictwo sądowo-psychiatryczne w świetle 4200 ekspertyz szpitalnych

44%

Uszkiewiczowa L.

Archiwum Kryminologii

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1960

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issue I

297-359

EN

The present contribution discusses the results of 4200 forensic-psychiatric reports given, in the years 1953 to 1957, by twenty-one mental hospitals and the Department of Forensic Psychiatry of the Psychoneurological Institute, where copies of such reports, given by all the major mental hospitals in Poland, are collected. The present contribution does not take into consideration 300 reports in which no symptoms of a disease have been found with the subjects investigated, nor yet any mentally abnormal states, as well as 460 reports concerning reactive psychoses and 80 cases of simulation which arose only after the arrest of the investigated. (Cases of reactive psychoses and simulation will be dealt with separately, because of the altogether peculiar problems involved). Even though the leaving out of the account of the psychiatric examinations carried out in the Public Prosecutors’ Offices and the Courts of Law does not allow us to draw conclusions with regard to all those offenders suffering from mental disorders who have been submitted to examination, nevertheless, the large number of hospital reports available would seem to constitute valuable psychopathological and criminological material. 1. In investigating the cases sent by the Public Prosecutors’ Offices and the Courts to mental hospitals for psychiatric observation, we find, on the basis of available material, that the percentage of psychoses – setting aside reactive psychoses – is small, as it does not exceed 22 per cent. Three items: psychopathy, mental deficiency (most frequently a light feeble-mindedness or moronity) and alcoholism jointly account for a total of 50.8 per cent of the cases, and if, over and above that, we take into consideration post-traumatic mental disorders, epilepsy, post-encephalitic disorders and such like cases, it will appear that as many as over three-fourths of the reports given concern non-psychotic states. Psychopathy accounts for 27.4 per cent of the cases, alcoholism and mental deficiency for 15.8 per cent each, post-traumatic disorders for 5.9 per cent, epilepsy for 4.7 per cent, and post-encephalitic disorders for 1.5 per cent. In the material under investigation cases of psychopathy amount, in reality, to more than 27.4 per cent, since cases of reactive psychoses and simulation, in which psychopaths figure extremely often, have been left out of the account. Similarly, there are probably more post-encephalitic states, which, having failed to be properly diagnosed, figure in cases which come under other heads, because of the lack of reliable interviews and the negative result of the neurological examination (in particular, in the mental deficiency and psychopathy groups). Cases of alcoholism, too, are less numerously represented in the material under investigation than would seem to result from the diagnoses contained in the reports. There can subsist no doubt that, apart from cases where the diagnosis reads ,,chronic (or else habitual) alcoholism", we also meet with alcoholism with a great many of such of the investigated with whom other pathological states have been diagnosed, and where alcoholism merely constitutes an additional factor, as a complication of other mental disorders. Altogether, the percentage of alcohol addicts amounts to at least 28. Among psychoses, schizophrenia is the one most numerously represented (510 cases). Only 29 delinquents suffered from manic-depressive psychosis, 62 from general paralysis, 30 – from involutional psychosis, 28 - from senile dementia. There were 19 cases of delusional psychosis, and 14 cases of paranoia. The number of cases with cerebral arteriosclerosis was 49, and that of cases of cerebral syphilis - only 20. In 44 cases it was a matter of twilight states with non-epileptics; here belong 30 cases of pathological drunkenness, 7 cases of pathological affect, 3 cases of ,,short-circuiting" (the so-called „Kurzschlusshandlungen” in German), and 4 cases of twilight states with an obscure etiology. 87.1 per cent of the reports concern men, 12.9 per cent - women. For every 100 men investigated there were only 14.9 women, while in the 1955 judicial statistics there were as many as 30 convicted women to every 100 convicted men. Cases of psychopathy, mental deficiency and schizophrenia constitute 61.3 per cent of the total of reports concerning women, while with men the above three items only amounted to 63.8 per cent after cases of alcoholism were added to them. Women are relatively most numerously represented in involutional disorders and manic-depressive psychosis. 2. When we examine the data concerning delinquency, it is obvious that it is the perpetrators of manslaughter, sexual offences and arson that are particularly numerously represented in the judicial psychiatric material. The most common offences against property, which constitute 33 per cent of the total number of offences in the material under investigation, reach the highest percentages in those cases which are not psychoses. On the other hand, among the offences perpetrated by persons suffering from psychoses there are relatively more offences against life and health, and, in particular, of manslaughter. Manslaughter amounts to 14 per cent of the offences committed by the persons investigated suffering from involutional psychosis, to 12.2 per cent of those committed by sufferers from schizophrenia, to 11.1 per cent of those committed by sufferers from paranoia, to 10 per cent, with sufferers from senile dementia, while with psychopaths the figure is only 5.7 and with oligophrenics - 4.7. Altogether, there were 288 cases of manslaughter or murder in the material investigated, and of these 77.4 per cent were divided between cases of psychopathy (67 cases), schizophrenia (67 cases), alcoholism (51 cases), and mental deficiency (28 cases). Among the 179 cases of sexual offences the bulk were cases of misconduct with persons under 15 years of age (93 cases), there were 43 cases of rape, 21 cases of incest, 12 cases of exhibitionist acts. Nearly 70 per cent of the sexual offences have been committed by psychopaths (55), oligophrenics (41) and alcohol addicts (28). On the other hand, the relatively highest percentage of such offences is to be met with those suffering from senile dementia, cerebral arteriosclerosis, and with mental deficiency. As far as arson is concerned, which in the material under investigation amounted to 3.3 per cent of the total number of offences, percentages higher than average ones are to be met with in cases of involutional psychosis, senile dementia, schizophrenia and mental deficiency. Out of a total number of 146 cases of arson, 53.4 per cent were accounted for by schizophrenia (40) and mental deficiency (38). With psychopaths and alcoholics comprised by the material under investigation cases of arson are extremely rare. Examining the delinquency of 158 epileptics, we establish that both the percentage of manslaughter and the number of cases of arson are small. What is worth while noting beside that is the fact that only in 24 cases the offence was perpetrated in a twilight state. The data concerning the delinquency of 510 schizophrenics bear witness to the fact that it was only a mere 8 per cent of the investigated that committed the offence during the first year of their illness, while the majority of cases the latter has been going on for above three years. When we analyze the 67 cases of manslaughter we find that it was only in two cases that the manslaughter was committed in the initial stage of the disease and constituted, as it were, the first visible sign of the schizophrenic process. In delusional psychoses cases of manslaughter were frequent, differently from cases of paranoia. In the few (29) cases of manic-depressive psychosis only one offence was committed in the depressive phase, white all the others were committed in the maniac phase or else in the hypomanic state. Deserving our attention is the lack of any more serious offences against life and health in this group. In the 30 cases of involutional psychosis more than one half of the offences consisted of those against life and health. Among the offences committed by the 49 persons with symptoms of cerebral arteriosclerosis, one-third consisted of offences of a serious character, while with the 25 patients suffering from senile dementia as many as one-half of the offences belonged to the category of serious offences. The delinquency of the 62 sufferers from general paralysis is almost exclusively reduced to offences of small importance of similar character as were the offences committed by the 20 sufferers from cerebral syphilis. In the 44 cases of twilight states (pathological drunkenness, pathological affect, and others) still 50 per cent of the offences consist of offences against life and health; 18 people fell victim to manslaughter. 3. The Polish Criminal Code, in force since 1932, contains provisions concerning, both in cases with mentally abnormal states, a state of irresponsibility and of diminished responsibility. A state of irresponsibility occurs when, at the time of committing the offence, the accused did not understand the significance of the deed he was perpetrating, or else was unable to direct his conduct because of psychosis, mental deficiency or other psychical disorders. A diminished responsibility occurs when, because of one of the reasons mentioned above, the ability of the accused to grasp the significance of the offence committed by him, and to direct his conduct was considerably limited. With regard to such and offender the Court may apply an extraordinarily mitigated penalty, while with regard to an offender who has been declared irresponsible, of course, no penalty at all may be applied. The offenders declared irresponsible are, by virtue of the Court's decision, transferred to a general mental hospital, if their staying at large could be dangerous for the legal order. They cannot be released from the hospital by the Court earlier than after the lapse of one year. An offender with regard to whom a diminished responsibility has been decreed and who is dangerous to the legal order may also be placed in a mental hospital (he, too, can be released from there by the Court not earlier than after the lapse of one year at the least). If the Court has sentenced such an offender to serve a term of imprisonment, the question of whether or not the penalty decreed is to be served is decided by the Court after the offender's release from the mental hospital. In cases of psychosis, forensic psychiatrists always decree irresponsibility. In cases of mental deficiency their decree depends on the degree of such deficiency, while in the cases, most frequent in judicial practice, of mild subnormality (morons, debils) – also on the, category of the offence which has been committed. Psychopaths are, in principle, considered to be fully responsible. Altogether, out of a total of 3900 delinquents examined 24.7 per cent of the cases have been pronounced by experts to be irresponsible, 23.1 per cent of the cases – to have a diminished responsibility, while 50.7 per cent of the offenders have been declared to be fully responsible. 4. As far as experts' opinions are concerned with regard to the application of internment in mental hospitals of offenders pronounced to be dangerous for the legal order, as well as irresponsible, out of a total number of 946 offenders declared irresponsible, a mere 34 per cent have been pronounced to be dangerous. Moreover, in 31 per cent of the cases, experts have pronounced for the necessity of hospital treatment under ordinary circumstances. Finally, 35 per cent of the offenders pronounced to be irresponsible have been described as not standing in need of any hospital treatment. A diminished responsibility has been decreed by the experts in a total of 855 cases, but only 6.4 per cent of the latter number have been pronounced to be dangerous to the legal order and to stand in need of internment in a mental hospital. Apart from the above, only in 10 per cent of the cases, experts have pronounced in favor of the need for hospital treatment. In the remaining 83.5 per cent of the cases the experts have confined themselves to stating that the responsibility of the offenders in question was diminished which, in result, comes merely to a possibility of an extraordinary mitigation of the penalty being decreed by the law-court. It is evident from the analysis of the judicial sentences which we have just carried out that experts a[ too unfrequently declare in favor of the need of applying security measures. The result is an irrational punitive policy with regard to such offenders who ought to be approached first and foremost, from a psychiatric point of view. The Criminal Code provisions concerning security measures are obsolete and demand essential alterations, which can only be done by means of codification. Quite independently of the need for extending the network of ordinary mental hospitals, there also exists a necessity of creating a special type of establishments, of a psychiatric-cum-penitentiary character, for a certain category of offenders who exhibit abnormal mental peculiarities and tendencies to recidivism. Equally needed is the establishing of treatment homes for offenders who are alcohol addicts. As it ensues clearly from experiments made in various countries, the application of ordinary penalties to delinquents who require a special treatment from a psychiatric point of view is altogether inefficacious.

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