For involuntary placement to be lawful, the placement procedure must be clearly explained by law and followed.

In Bulgaria the procedure for placement in a mental health care institution against your will is explained in the Health Act.

The placement procedure must comply with the following steps:

Step 1 – Examination in the institution

If you are brought as an emergency case to a hospital/ward, the head of the hospital may decide you need further treatment for up to 24 hours. In exceptional cases this term may be prolonged with 48 hours with a decision by the district court. 

If the head of the hospital decides that you need longer compulsory treatment he/she should immediately send a request accompanied with relevant evidence and a psychiatrist’s opinion for that to the district court.

Your placement for involuntary treatment might be requested also by a prosecutor.

Step 2 – Information about the decision

If the head of the hospital has decided to keep you in the institution, the institution must inform the court within 24 hours and send the request and the reasons for the necessity of placement to the court. 

Step 3 – Notification by the court

You must be informed by the court about the request for your involuntary treatment. You may object and present evidence within 7 days. The court is obliged to schedule a hearing 14 days after it received the request. 

For the court hearing your attorney at law must be informed and be present together with you. If you don’t have an attorney at law, one will be appointed by the court. (see the next steps). If you do not feel able to go to the court, the court would come to see you as it is obligatory for the judge to get personal impression of you.

In the exceptional emergency case when you stay in the hospital for 72 hours, the court must schedule a hearing immediately and you are brought to the hearing by the hospital staff.

In addition, for the emergency case the head of the hospital is obliged to inform your family member or a close person. 

Step 4 – Notification about the court hearing

After receiving the information, the judge must immediately inform the prosecutor, your attorney at law and the psychiatric hospital and an expert psychiatrist about the date of the consideration of the placement in a mental health care institution against your will. 

Step 5 – Court hearing

The hearing in the general case must take place within 14 days after the court has received the documents. 

A prosecutor, your attorney and you, and an expert psychiatrist to give opinion must be present. 

The judge may appoint a psychiatric assessment to take place in 14 days if the evidence show that your condition presents a threat for you or others and a psychiatrist confirmed that you suffer some mental disorder or disability. The court must hear you after the expert psychiatrist gives his/her opinion. 

The hearing in emergency case must take place the next day after the judge has received the documents and in this case he/she can allow 48 hours treatment. 

Step 6 – Reasoned decision of the court

The judge may initially approve a placement in a psychiatric hospital for up to 3 months. The decision must very clearly explain the grounds on which you will be kept in a psychiatric hospital (if this is the case) and especially why that is necessary in your case. The reasons cannot be superficial and generic. 

The decision should also appoint the hospital in which your treatment will take place and whether you have ability to give informed consent to treatment. If the judge decides that you are not able to give informed consent he/she would appoint a person from the circle of your close ones to do this. 

Step 7 – Information about the decision

The decision must be given to you, your legal representative and other participants in the hearing.

Step 8 – Appeal

You have the right to appeal the decision within 7 days from the day it was held. You can submit the appeal if you believe that there is a fault in the facts or in the legal reasoning, or any of your fundamental rights were not respected. The appeal procedure is explained in the Health Act.

What human rights violation may there be?

If your involuntary placement process did not comply with the given procedural requirements, it may result in a violation of the right to liberty and security of the person. 

Read more about the complaint possibilities.

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Last updated 26/01/2019