Forensic Psychiatry Once upon a time: between treatment and punishment – BBC News in Serbian
Kata, widow Nikola Đermanović from Loznica, « loyal to immoral life » and prone to drink, « in an unconscious state was wounded by a man from the rifle ».
It was convicted in 1860. year to jail and 50 baked hits, of which she was so scared that it was suddenly « from the mind ».
That is why « home for S ‘of the Mind Sayrah », one of the first psychiatric institutions in the Balkans, was sent.
Behind her, only a name and a pair of dashes from the life marked with suffering was left.
« The floor was the first forensic patient who was admitted and treated in some way in the home, » said Ljiljana Simic, Assistant Director of the Clinic for Psychiatric Diseases « Dr Laza Lazarevic », for the BBC in Serbian.
Forensic psychiatry, a branch in which medicine and law intertwine, deals with the treatment of people who have violated the law because of the mental disorders, in the state of incompatibility.
When asked to return to jail from home, the floor escaped and losing each trace.
New patients arrived at home and developed the largest psychiatric institution in Serbia today, Clinic « Dr. Laza Lazarević ».
Forensic patients, today are referred to different special institutions, including the Prison Hospital.
Terms in individual hospitals are such that Milan Ljubičić, a sociologist who deals with mental disorders and psychotherapists, says that staying in them « more like punishment, but for treatment ».
« Everywhere in the world, with us, mentally ill people are considered insufficiently used useful, which makes enough funds for their treatment.
« In a special prison hospital where people who are in the state of incompatibility performed an unlimilable work, the conditions for treatment are difficult.
« Patients surround the grids, there is no greenery or privacy, and a special problem is overpopulation, » Ljubicic says.
During 2021. year in the Prison Hospital in Belgrade, there were 200 patients more than predicted, writes in the International Committee to Prevention of Torture (CPT) from 2021.
« There were five patients in a 12-square room. The rooms were so much coincided that the beds were touched.
« Most large rooms have only one small table and insufficient chair for all patients at the same time. Patients had to change to use a chair during meals or sit on their own bed, » writes in the report.
Patients who are gone to receive after leaving the hospital remain in forensic institutions for the rest of their life, it has shown earlier Research of the Helsinki Committee for Human Rights from 2015.
While conditions in which pine forensic patients are slowly improving, building Home For the s’ Mind Sayman In Belgrade, also known as Doctor’s Tower, in which the first of them were housed, he collapsed in years.
How was Dr. Tower created?
Except for the monastery, until the middle of the 19th century, there was no place for the treatment of psychiatric patients in Serbia.
« The smaller part and only those who were restless and dangerous to the environment were closed in aps or were guarded in which the Collections of District Hospital.
« ‘Just to want to die soon for’ was a secret and public exclamation of doctors of the age because they did not have funds or ways to help such pals. He wrote Jovan Danicthe hospital manager for mental illness, at the end of the 19th century.
The decree of Knez Mihail Obrenovic arises « home for S ‘Mind Sayman » 3. March 1861. years.
« In this more, it will be received, and preserve and treat only with the mind of the sucker of each profession, building (parallithie) and from falling sickness, both male and women, and how they adults« , Writes in the document.
The Chamber was housed in Doctor’s Tower, in the immediate vicinity of the Clinic « Dr Laza Lazarević » in the center of Belgrade.
A multi-storey building surrounded by greenery and orchards should have been a family house of Dr. Vita Romite, a doctor of Kneza Miloš.
However, the first years of the doctor’s towers were dark.
Initially, only a doctor was employed in the home without psychiatric education, because at the time, this branch of medicine did not even exist.
During the night, paramedics were worried about patients « Guys inevers, and often rusty, who bonded restless patients, and others locked in the city, Danić writes them.
Triple whip, violent chair and binding belt were used in « treatment ».
Arrival Mladen Jankovic, then physiciciaSupervised doctor of the Kragujevac district at home 1865, the conditions improve, and from the use of violent funds gradually gives up.
By the middle of the 20th century, patients passed Golgota, says Ljiljana Simic.
« States and movements that patients could not control were solved by being connected, closed into special rooms, showered with cold water, » enumerates.
The « revolution », as it is called, is formed in the middle of the 20th century when drugs that helped them.
However, it took a few more decades that psychiatry becomes independent discipline, independent of neurology.
Attention begins to directly on different types of treatment – individual, group, work therapy, and today Serbian psychiatry absolutely follow world flows, says Simic.
Forensic psychiatry in Serbia today
Although Serbia is not lag behind the expertise and availability of drugs, some patients remain trapped in the system with many shortcomings.
About 20 percent of forensic patients in some institutions could immediately be dismissed if the community would accept, writes in the report Helsinki Committee from 2015.
« Many patients falling into the category of social cases remain in this institution for life, » reports in the report.
Djordje Alempijevic, a teacher of court medicine who took part in this research, says that the situation has not changed much since.
Often forensic patients committed a criminal offense within the family, which is why relatives reject them and are not ready to accept them after leaving the hospital, he indicates.
Social protection institutions, which otherwise there are waiting lists for accommodation, are also open to receive them.
This means that the patient can stay in the hospital much longer than he would be in prison that he was destined as if he had violated the law aware of his own actions.
« The solution could provide the state with quota so that social protection institutions first offer 20 or 30 percent of vacancies to psychiatric institutions.
« Thus psychiatric hospitals could empty, » said Alempijevic.
But this solution requires construction of more than new institutions.
In addition to overcrowding, the report of the Committee to Prevention of Torture also records that there are not enough employees in the prison hospital.
Treatment is often reduced to giving medication, primarily benzodiazepine, which act on the central nervous system by reducing the activity in the brain.
They are mainly used to treat anxiety, insomnia and tension.
« The only light spot is a few, but mostly enthusiastic medical staff who strives to meet the needs of patients.
« However, work in such conditions and consists of combustion, which is generally not talked about, » says Sociologia Ljubicic.
The convicted patients were given a measure that implies treatment, Alempijevic reminds.
« This measure does not mean that only you need to lock them and get them off the streets.
« Modern treatment does not only imply psychopharmacterapy, but also all other forms.
« Regardless of the commitment of people who work, inevitably in such conditions, there is a decline in the quality of treatment, » says Alempijevic.
In previous years, psychiatrists in Serbia are pointed out And to lack forensic institutions for children who committed a criminal offense under the influence of large psychological disorders.
Doctor’s tower today
Doctor’s tower was built two centuries in Guberevac, then on the outskirts of Belgrade.
The place that Doctor Vito Romita chose a suspicion of vizier, and asked for construction to be suspended.
The vizier is afraid of « What is the wall of the house similar to the factory », because « with these houses can be harmed by cannons in the city », Ivana Vesković writesfrom the Belgrade Institute for the Protection of Cultural Monuments based on the archival document.
« Romita defended himself not to wall house with the intention of attacking the fortress because he would not build from the mud with the inner walls of wood.
« Architecturally, although unites different styles and influences, most of the tower, which has received the name: a square shaped stone without processing, with small windows on the ground floor, » writes Vesković.
The building belongs to Laza Lazarević Clinic and there is a reconstruction plan, but the decision on funding is awaited.
« Doctor’s Tower is our pricket, a historical monument, multiple important.
« We hope that material resources will be provided for its renovation, » Simic says.
The building is under the protection of the Belgrade Institute for the Protection of Cultural Monuments, from which they did not respond to the questions of the BBC journalist on its destiny.
‘Everyone can happen’
In addition to the prison hospital in Belgrade, forensic patients are treated in institutions in Vršac, Gornja Topica and Kovin.
Last year, new forensic departments in the hospital in Padinka Skela, belonging to the Laza Lazarević Clinic, « members of the International Committee for Prevention of Torture (CPT), » says Simic.
« Our patients have comfortable space, we have enough health workers, various types of therapy apply.
« The goal of any treatment is that the patient as soon as socially rehabilitated and involved in life. Our interest is not to sit there for years, » says a psychiatrist.
There are still widespread stigmatization of mentally ill, especially forensic patients.
« We are afraid of them, and behind that fear that we will become mad, so and our irrational play that these people are unpredictable, aggressive, although they have proven to be » normal ‘violent than these first « says Ljubicic.
In such a widespread belief, the state is easier to « get off the street and put behind the grid » but to be at large and rebraskva law, which could lead to charges that Alempijevic said wrong.
« The situation in forensic institutions is a regular basis closely related to the entire situation in society and only one resor – justice, health or social protection is responsible for itself.
« It should be recognized as a problem of the state and its citizens because everyone can become part of that problem at some point, » he concludes.
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