Legal and organizational framework for outpatient prevention of dangerous acts of persons with mental disorders

The article deals with prevention of dangerous acts of persons with mental disorders by medical organizations providing mental health care in outpatient settings. Outpatient preventive activities cover two patient groups: those who have not previously committed dangerous acts (primary prevention) and those who have committed such acts. In the latter case prevention concerns repeated dangerous acts (secondary prevention). The main means of outpatient primary prevention are diagnostics of mental disorders and provision of qualified outpatient mental health care. Outpatient care is provided in the form of regular assessment and treatment and in the form of dispensary observation, established regardless of consent of the mentally disordered person or his/her legal representative. Active dispensary observation is established for patients who have a propensity to commit socially dangerous acts. Such observation belongs to measures of both primary and secondary psychiatric prevention and is carried out by outpatient medical organizations in cooperation with the Interior authorities. Another means of outpatient secondary prevention is execution of a compulsory medical measure, such as compulsory observation and treatment by a psychiatrist in outpatient settings. The author, on the basis of studying legal acts, special literature and medical statistics, comes to the conclusion about increasing importance of prevention of dangerous acts of persons with mental disorders by medical organizations providing mental health care in outpatient settings.