National Service of Forensic Psychiatry in Lithuania

under the Ministry of Health

 
 
About us

MODEL OF FORENSIC PSYCIATRY CARE IN LITHUANIA

  

     Until 1991 there were no independent forensic psychiatry institution in Lithuania. Two in patient departments served for forensic inpatient evaluation in two psychiatry hospitals in Naujoji Vilnia and Utena. Outpatient forensic psychiatry evaluation was made by ordinary psychiatrists who had some experience in forensics in different cities. After court judgement forensic psychiatry patients/offenders have been placed and treated in ordinary psychiatric hospitals. This situation was bad for other patients and for staff too.
After liberation in 1991 some changes were made and forensic psychiatry service was included in Forensic Medicine and Psychiatry center under the Ministry of Justice. Independent Forensic Psychiatry Service was organized by the order of Health Minister in the 1994.
      Now Lithuanian Forensic Psychiatry Service has a 22 years history and during this time became organization with 10 outpatient departments in main cities and one inpatient department in Utena. We also have a specialized Child and Adolescent forensic psychiatry department. There are 26 forensic psychiatry experts and 11 forensic psychology experts in our Service. Each year about two thousands forensic psychiatry evaluations and about five thousands consultations are made in our Service. All specialists have their primary education on psychiatry or psychology after which they underwent one year special preparation in forensic psychiatry and psychology and took special exam in forensic psychiatry and psychology. So all our specialists have their primary license and additional forensic psychiatry or forensic psychology license. Each five year all specialists undergo additional qualification evaluation.
The forensic psychiatry evaluation and forensic psychiatry treatment are separated in Lithuania. In Lithuania we have specialized Rokiškis psychiatry hospital with three security levels where all forensic psychiatry patients/offenders are placed by court order. In this hospital works ordinary psychiatrists and they do not have forensic psychiatry license.
The Forensic Psychiatry practice in Lithuania is regulated by Laws: Constitution, Penal and Civil Codes, Health Minister and the Ministry of Justice Orders. The main Law for regulation of all kind of forensic evaluation and also of forensic psychiatry practice is Forensic Expertise Law from 2003. From 2014 the Committee for coordination of forensic expertise practice started to work. This committee includes members from all expertise institutions and coordinates the main principles of different expertise. The Ministry of Justices decree the Codex of professional ethics for forensic experts. Committee for coordination of forensic expertise practice carries supervision of the ethical principles of all experts in all expertise institutions.
     Lithuania Forensic Psychiatry Service under the Ministry of Health makes expertise work and also is the center of methodical - scientific research, organizes conferences on forensic psychiatry and tries to keep international professional contacts with forensic psychiatry services in different countries.
     We are sure, that despite differences in Law systems and structures of organizations, we have a lot of common points in our professional work - in the forensic psychiatry evaluation field. Today we have a possibility and big interest for professional contacts, scientific research, development of new methodological documents, for exchanging experiences, attitudes and competences. In Lithuanian Psychiatry Service now we are focused in to diminished responsibility evaluation, civil capacity evaluation in different areas of persons everyday life and diminished civil capacity. The other actual question is evaluation of malingering which stay very actual in our work. Evaluation of risk assessment of possible future criminal/aggressive behavior is actual for our experts. Also stay actual question about forensic psychiatry evaluations in cases with dual diagnoses: alcohol/drug dependence and schizofrenic spectrum disorder. What component was actually dominating during criminal action?
     Total level of criminal delinquency in Lithuania during 20 years was raised 4,37 times from 1985 till 2004. Irresponsibility because of insanity during 20 years (from 1985 till 2004) decreased 1,65 times. So the criminal dangerousness of mental ill persons is much less then have the healthy ones. In soviet Lithuania the construction of insanity formula at 1961 was started. New construction was fixed in Penal Code 17 str. at 2004. Insanity formula states that person is not guilty if he or she at the moment of criminal action cannot understand the meaning of his behavior because of mental illness or disorder. We know that about 3-5 percent of criminal offenders are recognized as irresponsible because of insanity in USA. In Russia such figure is about 0,5 percent. In Poland - 10-14 percent. In Lithuania we have about 9-11 percent irresponsible offenders. In Lithuania we found that main acts of irresponsible offenders with diagnosis F10 were against peoples life and health until 1991. After 1991 main acts against peoples life and health were done by irresponsible offenders of diagnosis F.10 and F.20.
     One of the pressing issues in the field of modern forensic psychiatry in Lithuania is the evaluation of limited civil capacity. The Civil Code of Lithuania until 2016 defined only a dichotomic attitude to civil capability: a person could be recognised by court as civilly capable or totally incapable. Such mental disorder as schizophrenia causes large variables in a person's possibility to act in different areas of civil life, while some cases of mental retardation were seen as being partly capable to act independently. This caused big difficulties to forensic psychiatrists by using only a dichotomic evaluation strategy. Forensic psychiatrists had to state that because of partial limitations to act independently, a person is incapable totally. Mostly all persons with serious mental disorders evaluated in Forensic Psychiatry Service until 2016 were recognized as totally incapable: from 90.3 to 85.1 percent.
     New statement in the Civil Code brings the possibility of a deeper multipronged individual attitude in forensic psychiatry evaluation. On the other hand, it brings new challenges for forensic psychiatry evaluation.

 

 

 

Updated: 2017 May 05 d.
 
Contacts
A.Kojelavičius str. 121,

LT-11106 Vilnius

Map

Tel. 8~5 2677200

E-mail.: info@vtpt.lt

State budget office.

Code 191671615

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