Reasons for outpatient compulsory treatment by a psychiatrist
Application of measures medical direction forcibly is possible only to those persons who have committed acts characterized by public danger and enshrined as features of certain articles of the Criminal Code. Such measures take the form of providing medical care aimed at curing the subject of the crime, improving his mental indicators, which is necessary to prevent him from committing criminal acts in the future.
Persons who have become subjects of crimes in relation to whom there are doubts regarding the usefulness of their mental state, are subject to referral for forensic psychiatric examination. The expert's conclusion about the person's insanity is the basis for the termination of the case. In this situation, the subject of the crime is subject to mandatory compulsory medical intervention.
Legislators have identified an exhaustive range of grounds that may influence the need to use compulsory medical actions:
The appointment of compulsory treatment measures can be carried out in cases where the presence of a mental disorder becomes the basis for the emergence of confidence in the social danger of a person and the possibility of causing harm to himself and to those around him. Thus, the purpose of medical intervention is justified by the need to protect society not from a criminal act, but from the possibility of its commission.
At the time of imposing compulsory treatment measures, the court is obliged to take into account the existing medical indicators of the person and his social danger. The level of gravity of the committed act is not taken into account. The act itself can only be perceived as a symptom of a disease.
The court does not have the right to establish compulsory treatment measures in relation to persons who have become subjects of crimes, in the absence of one of the four above grounds.
Considering the materials of each specific criminal case, and studying the characteristics of the person who committed the criminal act, the court is obliged to make a decision on the need to apply compulsory treatment measures to the offender.
In cases where one of the grounds for prescribing such measures exists, the court is obliged to refuse to establish a punishment and determine medical measures that must be forcibly applied to the person in order to recover and prevent the commission in the future.
When assessing the social danger of the subject himself, the court determines the measures of medical intervention that may be expressed in the prescription:
The court determines the type necessary treatment based on recommendations that are justified by the result of a forensic psychiatric examination. According to its internal conviction, the court may go beyond the recommendations.
The appointment of outpatient compulsory observation and treatment is carried out by the court, regardless of his sanity or insanity. Compulsory observation and treatment by a psychiatrist in outpatient setting is a measure that is necessary to create security both for the subject of the crime and for the society surrounding him.
Persons in respect of whom a decision has been made to recognize their insanity may be transferred to guardianship. At the same time, the application of compulsory psychiatric treatment measures to them may not be mandatory. In such cases, the court orders compulsory medical supervision, with the person being registered with the medical institution that carries out psychiatric treatment, according to his place of residence.
Providing psychiatric medical care is mandatory for medical institutions.
Persons whose insanity has not been recognized and for whom a non-custodial sentence has been imposed may be required to undergo outpatient compulsory observation and treatment procedures. This duty must be fulfilled regardless of the wishes of the convicted person.
Time frames required for complete cure persons who committed criminal acts cannot be identified court decision. The reason for this is the impossibility of determining the specific period of time required for the complete cure of the criminal subject.
Such a period can be determined exclusively by a medical institution on the basis of indications that are noted during the process of its treatment.
On the part of the administration of the psychiatric clinic, a submission is sent to the court indicating that the criminal has been cured. Completion of compulsory treatment, which has positive result, is the basis for its termination on the basis of a procedural document issued by a judicial authority.
Outpatient forced surveillance and treatment by a psychiatrist may be prescribed if there are grounds provided for in Article 97 of this Code, if the person, due to his mental state, does not need to be placed in a psychiatric hospital.
For example, according to the court's ruling, R. was exempt from criminal liability for committing a socially dangerous act in a state of insanity, provided for in Part 3 of Art. 30, paragraph "c" part 2 art. 105 CC; She was prescribed compulsory medical measures - outpatient compulsory observation and treatment by a psychiatrist. She, in a state of insanity, attempted to kill her infant. The state prosecutor raised the issue of canceling the ruling and sending the case for a new trial, believing that the court unreasonably applied compulsory outpatient observation and treatment by a psychiatrist, whereas, according to the conclusion of psychiatrist experts, R. needs compulsory treatment in a general psychiatric hospital. According to the state prosecutor, the court did not take into account the nature and degree of social danger of the act, the severity of the consequences, and the likelihood of a repetition of the unlawful behavior.
The Judicial Collegium for Criminal Cases of the Armed Forces of the Russian Federation left the court's ruling unchanged, indicating the following. According to the conclusion of forensic psychiatrists, R. suffers from a mental disorder in the form of depressive-paranoid syndrome. At the time of the offense, she could not understand the actual nature and social danger of her actions and control them; she was declared insane and in need of compulsory treatment in a general psychiatric hospital. However, resolving issues of insanity and imposing a type of compulsory medical measures falls within the competence of the court. As established in the case, R., being in a state of insanity, attempted to kill her infant child, and then herself attempted to commit suicide. According to the testimony of the victim's representative and witnesses, R. has been living with her family since the crime was committed, her health has improved, she is taking care of the child, is aware of what happened, and is under the supervision of relatives. Taking into account the opinion of the doctor treating R., the court came to the correct conclusion about the possibility of curing R. without placing her in a psychiatric hospital (determined by the RF Armed Forces of December 7, 1999).
In some cases, a person requires treatment because he poses a danger to himself and others. This happens not only in cases of drug or alcohol addiction, which lead to loss of control over one’s behavior, but also in the presence of contagious diseases that require isolation of the patient from society.
The issue of compulsory treatment is quite complex. After all, in essence, a person is deprived of his freedom, although he has not committed an illegal act. IN different countries around the world this issue is being resolved in various ways.
Medical measures are provided for by the legislation of most countries of the world. According to international law, criminals suffering from mental illness are required to undergo compulsory treatment. It is believed that a criminal who suffers from a mental disorder cannot bear responsibility and fully understand the significance of his actions.
Treatment is usually considered as a “security measure,” that is, an opportunity to protect citizens from a person who poses a danger to them. In a similar sense, the law on compulsory treatment is interpreted by the legislation of most European countries.
In Russian legislation, the first mention of compulsory treatment of insane criminals appeared in 1823. Criminals were to be placed in mental homes, where they were kept separate from other patients.
In 1845, this law was amended: now treatment was required for people who were insane from birth, or for patients who had committed murder, arson, or attempted suicide.
In 1923, a law was passed according to which compulsory treatment was considered as a “measure social protection" In 1960, forced hospitalization was described in more detail. In particular, according to the new law, criminals, depending on the severity of the offense committed, could be held either in ordinary psychiatric hospital, or in a hospital that is part of the Ministry of Internal Affairs systems.
Currently, the procedure for providing medical care under duress is considered by criminal, executive and procedural legislation, in particular, it is described in the law “On the fundamentals of protecting the health of citizens in the Russian Federation.” The decision to impose a punishment is made by the court: otherwise, the provision of medical care without the consent of the citizen is illegal.
The legislation in the field of compulsory psychiatric care is best developed. Depending on the severity of the disorder and the committed act, either outpatient or inpatient treatment is prescribed. A stay in a specialized hospital may also be prescribed. This is done if the offender must be under 24-hour supervision by specialists. In this case, the time spent in hospital is counted towards the term of serving the sentence. If the need for detention in a medical institution disappears, the offender is discharged from the hospital, and before discharge, an examination of his condition is carried out.
IMPORTANT! The decision to terminate therapy combined with punishment is made only by the court.
According to the Criminal Code, compulsory treatment measures may be taken in the following cases:
When making a decision, the court must take into account how dangerous the offender is to society and whether he is capable of committing similar acts in the future. The question of predicting the behavior of a criminal suffering from a mental disorder is quite complex. Abroad, it is believed that compulsory hospitalization should be carried out in all cases where the offender exhibits increased level aggression. In this regard, compulsory treatment as a punishment is used quite widely. In our country, judges and experts take into account the severity of the condition, the prognosis, the presence of drug or alcohol addiction, the presence of a family, their own home, and a number of other factors. At the same time, as practice has shown, social indicators (committing criminal acts in the past, relationships with loved ones, level of social adaptation).
A criminal can receive outpatient treatment if the person does not require constant medical supervision. This usually happens if a person is aware of the presence of a mental disorder, follows the doctor’s recommendations, and also does not have significant behavioral deviations. Outpatient treatment is given to people with mental disorders transitory nature and ended by the time the court decision was made.
Inpatient hospitalization is required if the offender's disorder requires constant monitoring. In this case, the type of hospital (general, specialized, intensive observation) is determined by the court.
IMPORTANT! As a rule, the choice of hospital is made depending on the patient’s place of residence, which allows maintaining social connections and receiving the necessary support from relatives.
The type of compulsory treatment depends on the disorder that is identified in the offender.
Forced rehabilitation of drug addicts is carried out in drug treatment clinics and rehabilitation centers. Moreover, treatment can be prescribed not only after consideration of criminal cases: rehabilitation can also be prescribed after administrative offenses. In this case, treatment is carried out both outpatient and inpatient.
The issue of compulsory treatment of drug addiction is quite controversial: experts argue that in order to achieve the desired effect, motivation is required on the part of the patient, which, as a rule, is absent among experienced drug addicts.
In the USSR, there was a system of dispensaries in which alcoholics who had committed administrative or criminal offenses underwent forced treatment and rehabilitation. However, such a system has now been abolished, and therefore criminals suffering from alcoholism can, by court decision, be treated in drug treatment clinics or centers. Compulsory treatment is possible only if experts have established the fact of alcohol dependence.
If a criminal committed an illegal act while intoxicated, but does not suffer from alcoholism, it is impossible to send him for compulsory treatment.
Most often, mentally ill criminals undergo compulsory treatment. However, treatment does not cancel the fact of serving a sentence if the offender has been declared sane. The period of hospitalization may be counted towards serving the sentence.
According to paragraph 2 of Article 10 of the Law “On Preventing the Spread of Tuberculosis in the Russian Federation,” people suffering from open forms of tuberculosis and violating sanitary and epidemiological regulations, as well as evading examinations and therapy, can be forcibly hospitalized. Forced hospitalization of tuberculosis patients is carried out after a court decision, an application to which is submitted by the management of the organization in which the patient is under observation.
Compulsory treatment for tuberculosis in Russia is a rather acute issue. Can a patient with tuberculosis refuse hospitalization? This depends on the form of the disease, the presence or absence of Koch bacilli, and the accuracy in carrying out medical prescriptions and examinations.
In a number of countries, the punishment for rape and other sexual crimes is chemical castration. The offender is required to take drugs that reduce sexual desire or make it impossible to have sexual intercourse. This practice is widespread in the United States, but it is not used in Russia.
Compulsory hospitalization is necessary in the following cases:
Compulsory hospitalization may be prescribed in the following cases:
The decision to cancel their compulsory treatment is made by the court on the basis of a petition from the medical institution where the patient is kept. Treatment can also be prescribed for criminals who are already serving a sentence in prison: a person may develop a mental disorder or tuberculosis while in prison.
The period of treatment is counted towards the term of serving the sentence (one day of treatment for one day of imprisonment).
Claim about forced hospitalization can only be submitted by a representative of the medical institution where the person is undergoing treatment. This usually occurs if the doctor discovers that the patient is a danger to himself or others, is incapable of self-care, or suffers from a serious mental disorder, without realizing it, and refuses hospitalization.
If the court makes a positive decision, according to the law on compulsory hospitalization, the patient must go to an appropriate institution for treatment, or must begin outpatient treatment.
If hospitalization is avoided, the court may reconsider its decision. For example, instead of outpatient treatment, inpatient treatment may be prescribed. The treatment period may also be extended.
As a rule, the use of compulsory treatment measures begins immediately after the court verdict. Moreover, these measures are indefinite, that is, they can have any duration. Discontinuation of treatment is possible if the patient's condition improves.
Compulsory medical measures can be extended, changed or terminated only at the request of a doctor who has noted positive dynamics in the patient’s condition and filed a corresponding statement of claim. The issue of conversion of treatment is decided by the court.
A criminal can be forcibly hospitalized only by a court decision. In all other cases, treatment without the patient's consent is illegal. It is impossible to avoid court-ordered hospitalization, especially if the offender is found to pose a danger to society.
Compulsory observation and treatment by a psychiatrist on an outpatient basis may be prescribed if there are grounds provided for in Article 97 of this Code, if the person, due to his mental state, does not need to be placed in medical organization providing psychiatric care in inpatient settings.
1. Outpatient compulsory observation and treatment by a psychiatrist is prescribed to persons who have committed a crime and suffer from mental disorders that do not exclude sanity, as well as to persons who have committed socially dangerous acts in a state of insanity. In both cases, this compulsory measure of a medical nature is applied to persons who, due to their mental state, are capable of complying with the treatment and observation regime. Their behavior is orderly, they are able to understand the meaning of the measures applied to them. medical measures acceptance.
2. When deciding whether to impose this compulsory measure, the court takes into account: a) the nature and degree of mental disorder; b) the possibility of achieving the goals of using compulsory medical measures through outpatient compulsory observation and treatment; c) the influence of a mental disorder on the patient’s behavior (is it aggressive, does it represent real threat for himself and those around him, whether it indicates the likelihood of a repetition of a socially dangerous act, etc.).
According to Art. 27 of the Law of the Russian Federation “On psychiatric care and guarantees of the rights of citizens during its provision”, dispensary observation can be established for a person suffering from a chronic and protracted mental disorder with severe persistent or often exacerbating painful manifestations.
4. Persons sentenced to imprisonment, arrest or restriction of freedom undergo outpatient treatment in institutions that execute these types of punishments (Article 18 of the Penal Code of the Russian Federation).
Persons sentenced to punishments not related to deprivation or restriction of freedom undergo outpatient compulsory observation or treatment by a psychiatrist in medical institution at your place of residence. A court ruling on the application of this measure is sent to the specified institution; this is also reported to the internal affairs body, whose task is to control and ensure the person’s attendance at the psychiatrist at the frequency established by it.
Since 1997, Russia began to use outpatient compulsory observation and treatment with a psychiatrist, or APNL. Up to this point we have only taken stationary view medical measures, although in countries such as Germany, Great Britain, Australia, the USA, and the Netherlands, coercion is still used.
The first prerequisites for outpatient coercion were observed back in 1988. In Ukraine, Uzbekistan, Kazakhstan, Azerbaijan, and Georgia, the SSR in the Criminal Code included the transfer of a patient to relatives or guardians under the supervision of a doctor as compulsory medical measures. But this was only a prerequisite, since the USSR Ministry of Health at that time believed that outpatient practice no need.
Nikonov, Maltsev, Kotov, Abramov, lawyers and psychiatrists theoretically substantiated the importance of compulsory outpatient treatment. They said that among the patients there are people who have committed socially dangerous acts and do not need hospital treatment, but at the same time they need psychiatric control and various therapies. The authors also emphasize that in some cases, after inpatient treatment, patients could not adapt to life, which led to a deterioration of their mental state and an increased risk of endangering the public, while compulsory treatment cannot be resumed, since the court has already canceled it. In this case, the court’s replacement of inpatient treatment with outpatient treatment is a trial discharge, in which the patient can be returned to compulsory inpatient care.
The formation of APNL in different countries has its own characteristics:
Article 100 of the Criminal Code of the Russian Federation and some by-laws describe the country's APNL: a person who has been released from criminal liability and punishment is sent to a dispensary or other psychoneurological institutions, where they are treated on an outpatient basis. The patient must:
The instructions of the Ministry of Health and the Ministry of Internal Affairs of the Russian Federation oblige a psychiatrist to visit the patient at least once a month. The police help:
Also, health and internal affairs authorities can exchange information about APNL patients. Pros for facial outpatient treatment:
These benefits are typical only for individuals who are in a stable mental state and comply with the psychiatrist's instructions.
All persons who undergo outpatient compulsory therapy are divided into two groups:
APNL can also be classified:
Let's look at each of them.
We recommend the first stage for people who have been diagnosed with a temporary mental disorder or mental exacerbation (attack, paroxysm) chronic disorder psyche, provided that it ended before the examination and did not leave clinical manifestations who only need medical supervision or preventive therapy. It is also necessary to take into account that the patient maintains social adaptation and the ability to comply with the regimen.
Sometimes APNL is prescribed to people with negative personality mechanisms of OOD. But it is applicable when the patient was provoked to act by the situation itself, which arose not of his will and was resolved by the time the examination was carried out. This measure is also prescribed if the patient:
The primary stage is not assigned to persons:
In this case, you need to take into account:
An example of patient X., 40 years old, who committed OOD in a state of temporary psychological disorder. He was accused of causing bodily harm to his relative.
No development was observed previously. Electrician. While serving in the army, he suffered a traumatic brain injury with loss of consciousness. Afterwards the patient complained of headaches and dizziness. Sometimes drinks alcohol. Able to alcohol intoxication headaches intensify, the patient becomes irritable. A few days before the crime was committed, the patient’s wife was hospitalized in a somatic hospital. For 4 days he drank 150 grams of vodka. He experienced deterioration in health, loss of appetite, bad dream, feeling of concern for my wife. Before committing the act at work, he drank 150 grams of vodka. After the evening shift I came home. Communicated with his family and complained of feeling unwell, headache. For a long time he could not sleep; feelings of anxiety and restlessness did not leave him. According to family members, he got up at 3 am and took one tablet of diphenhydramine. At 6 o'clock in the morning the patient stood up again and began to say something inarticulate. When the mother went to the neighbors, the patient caught up with her on the landing and pushed her hard. A relative who was trying to drag her mother home was hit, after which she fell down the stairs and received fractures. Then the patient returned home, went to the kitchen, took a knife and wounded himself in the chest, damaging the lung. Witnesses said that the patient behaved silently, his appearance was terrifying, his eyes were bulging. The same condition was observed when the man was detained. In the police car he made no contact with anyone, did not pay attention to calls, and looked at one point with rounded eyes. After the operation, the patient regained consciousness, was able to adequately answer questions, referred to memory lapses, and could not believe what had happened.
During the examination, the experts made the following conclusion: at the time of the commission of the act against relatives, the patient had diffuse residual neurological symptoms, the EGG revealed signs paroxysmal activity. Complaints are characteristic of a cerebrasthenic state. The patient is depressed by the current situation, completely critical, and intellectually preserved. Psychotic phenomena and paroxysmal disorders No. This means that X., due to organic brain damage at the time of the offense, developed a twilight state of consciousness provoked by alcohol. The commission recommended that he be sent for compulsory outpatient observation and treatment by a psychiatrist.
The recommendation was made on the basis that H had no previous history of any mental disorders. This episode was the only one throughout his life, so there is no indication for inpatient treatment. However, the presence of a head injury does not allow us to give clear confidence that the disorder of consciousness may not recur. Therefore, the patient needs to be observed by a psychiatrist, undergo periodic examinations and EEG monitoring, and undergo appropriate resorption and dehydration therapy.
During outpatient compulsory treatment at the first adaptation-diagnostic stage, the patient undergoes further examination to clarify the basic etiological factors, which are the basis for the development of a psychotic state during OOD, paraclinical studies, or EEG, are also carried out. In addition, information is being collected on risk factors for relapse. Afterwards, recommendations are given about the absence of contact with persons with whom experiences during psychosis were associated, and social problems, in need of a dispensary.
At the second stage, a complex is determined for each patient rehabilitation activities and therapy, depending on the identified pathology. They do not need release from work, since at the time of their application they have no grounds for this, but there are exceptions and easier working conditions are recommended.
The patient must go drug therapy, psychocorrectional treatment, which explain the influence of adverse effects on the body and the importance of observing psychohygienic measures.
At the third stage, patients with organic damage brain. For them, control studies are carried out by a neurologist, ophthalmologist, etc. in order to identify the dynamics of pathological factors that are irritants for relapse. The following events are held here:
When improving EEG indicators and in general, the state of the psyche can be judged by positive dynamics and the achieved stable compensation of consciousness, which allows the court to note APNL. Continuation of APNL in in this case is 6-12 months. If any form of pathology occurs, the patient and relatives should immediately regularly visit a psychiatrist due to the possibility of relapse.
For people with negative personalities, at the first stage the main tasks are:
The patient and relatives are explained the legal status of the patient, and are also told about the importance of compliance with the observation and therapy regime. If there is a decrease in working capacity, provided there is no disability, then the person must undergo a medical and social examination. In addition, it is necessary to establish the forms of social assistance that the patient needs, for example:
At the first adaptation-diagnostic stage, with a stable mental state, the patient can take part in cultural events and work processes.
This phase contains a combination of biological therapy with therapeutic and correctional work over the psyche and providing social assistance.
Biological therapy is based on the principle of a differentiated approach, which should take into account:
Behavioral therapy includes training that:
The task of this stage is to smooth out and replace as much as possible the features that led the patient to commit an offense; for this purpose, the situation is improved:
On the second and final stage provide consultation and therapy to the patient’s relatives.
If the treatment lasted for more than 6 months, and the mental state was stable, and the patient constantly visited a psychiatrist and took the necessary medications, there were no episodes of delinquency or bad behavior, and he was able to undergo adaptation, then withdrawal from APNL may be considered.
This phase occurs after compulsory treatment, when the patient needs the help and control of a psychiatric service that promotes social adaptation. Treatment in a hospital and with a psychiatrist shows the following signs:
All of the above signs are the basis for changing the type of compulsory medical measure.
At the first stage of APNL, patients undergo supportive therapy, during this period social and everyday problems are solved, neurotic layers are removed for those in need, and assistance is provided in adaptation.
The second stage is responsible for achieving mental stability and adaptation through the implementation of individual, differentiated treatment and rehabilitation measures. The frequency of meetings with a psychiatrist depends on:
At the second stage, patients undergoing treatment for APNL experience a deterioration in their condition. For example, in schizophrenics, the manifestation of an attack is autochthonous, seasonal; in a patient with a brain injury, a relapse is provoked external stimuli. If on early stages deterioration of the mental state was detected, then a change in the APNL is not required, although in some cases it is still necessary.
Psychocorrectional measures contribute to:
The third stage is responsible for preparing the patient for the abolition of compulsory treatment. This stage is characterized by the following:
Before canceling a forced decision, conversations are held with the patient and relatives:
Almost all patients after discharge from hospital treatment have group II disability. Only 15% do not need it. Such people can return to their previous jobs. Typically, labor adaptation occurs in special occupational therapy workshops.
The psychiatrist and the police cooperate at this time to exchange information about the patient:
The exchange of information also provides for assistance to the police in times of increased threat to society.
The patient's positive attitude towards treatment, visiting a psychiatrist and various therapies, allow us to make a prediction about further cooperation with the patient after the abolition of APNL. Contact is also established with a relative who is critical of the person’s health condition. This contact gives:
All procedures are necessary to ensure that a dangerous situation does not reoccur.
Termination of APNL does not guarantee recurrence of the mental state imbalance. Therefore, it is necessary to take into account objective data that is obtained from:
Achieving adaptation contributes to:
But we should not forget that successful adaptation of patients in this group is often unstable, since minor difficulties, an antisocial environment, and alcohol consumption can lead to a breakdown. Successful adaptation data is considered:
This type of punishment can be applied by the court if a person commits a crime and needs treatment for a mental disorder, not excluding sanity - part 2 article 22, part 2 article 99, article 104 of the Criminal Code of the Russian Federation.
The Criminal Code of the RSFSR, Article 62, 1960, states: it is necessary to use compulsory treatment and the application of punitive measures against persons suffering from alcoholism and drug addiction. This law was applied only in cases where it was provable. However, in the late 80s, the norm began to be criticized, citing infringement of human freedom rights. But still, in 1996, the Criminal Code retained this punishment. This was reflected in articles 97, 99, 104. In 2003, an amendment was made - the abolition of punishment (clause “d”, part 1, article 97 of the Criminal Code). Now individuals must undergo only compulsory treatment within the penal system.
The above changes did not affect people who were in a state of mental disorder at the time the crime was committed (Article 22 of the Criminal Code). According to Part 2 of Article 97 of the Code, compulsory treatment is not used for all subjects, only for those whose mental disorder is capable of causing harm to themselves and other people. To persons related to Art. 97 can only be used by a psychiatrist (according to Part 2 of Article 99). Two parts of Article 104 of the Criminal Code state that when undergoing inpatient treatment or APNL, the patient’s sentence is counted.
From everything it follows that legal and medical relations consider this measure as:
These aspects are specified in Article 102 of the Criminal Code. Cancellation of the punishment occurs after the conclusion of a commission of psychiatrists is provided to the court. It is worth noting that it is quite complete this measure described in Part 3 of Article 97 of the Criminal Code.
But, despite this, the implementation of the measure has many unclear and contradictory issues in legal terms, which indicates the problematic nature of its application. Compulsory treatment must take place long time even at the first stage, in case of avoiding relapse. Otherwise, the resulting effect will disappear, and it will be impossible to resume APNL. And to apply these measures throughout the entire sentence, which can exceed 10-25 years, is clinically and organizationally unjustified.
It is also unclear who will implement the coercion, since the Law on Psychiatric Care does not allow medical institutions to carry out such actions against persons whose disorder is not severe.
In modern times, this is questionable, since compulsory measures with the execution of punishment in all cases are carried out properly and bring the desired effect.
If you notice an error in the text, please highlight it and press Ctrl+Enter
