Many people do not seek psychiatric and sometimes psychological help for fear of being stigmatized for life or because they simply do not know who to go to and what to expect from a consultation with a psychiatrist. The authors of the book “Going Crazy” not only popularly explain various psychological conditions and psychiatric diagnoses, but also have compiled a short reference guide in case you need a psychiatrist or psychotherapist.
Psychiatric registration
The Russian Psychiatric Institute is extremely developed, since in our country there is a real understanding of the prevalence and danger of disorders and diseases of the mental spectrum. The procedure for identifying mental pathology is quite simple and does not cause difficulties, especially for experienced specialists. The causes of mental pathologies are mainly the following factors:
- suffered tragedy, grief, bereavement;
- hormonal imbalances or changes;
- hereditary or genetic predisposition to this kind of disorder.
But mental health problems are not a death sentence. Modern therapeutic techniques are very effective and efficient, and therefore quickly cope with even complex mental pathologies.
Every citizen suffering from mental disorders is registered with a psychiatric dispensary. Such a measure is necessary to control people who are not entirely healthy, to protect them from the rest of society in case of dangerous or aggressive behavior, etc.
But when registering with a psychiatrist, a citizen is automatically deprived of some socialization opportunities, which include employment in certain positions and obtaining a driver’s license. That is why, after recovery, citizens strive to quickly get rid of the diagnosis and receive certificates confirming recovery.
The procedure for conducting a medical examination of drivers, in accordance with current legislation
The need to undergo a medical examination of driver candidates and drivers who are renewing their driving license was established by Order of the Ministry of Health of the Russian Federation No. 344n of 2015. This order consists of 4 annexes, each of which regulates individual points of medical passage. examination of vehicle drivers, as well as candidates for them.
Appendix 1 establishes the rules for passing medical examinations. examination, and also limits the list of medical institutions that can perform this procedure.
According to this application, the purpose of undergoing a medical examination is to determine the presence or absence of any medical contraindications to driving. You can familiarize yourself with the list of such restrictions in Decree of the Government of the Russian Federation No. 1604 of 2014.
Honey. the examination includes an examination by a therapist, as well as some specialized specialists, such as an ophthalmologist, narcologist and psychiatrist, and for women - a gynecologist. To obtain a license of category “C” and higher, it is also necessary to undergo a neurologist and an otolaryngologist.
After the examination, the citizen must receive an appropriate certificate-conclusion. The procedure for issuing such a medical document was approved by order of the Ministry of Health and Social Development of the Russian Federation No. 441n, dated 2012.
When to register
The circumstances under which a person can be registered vary:
- The patient himself expressed a desire to undergo treatment. He himself discovered some abnormalities in himself and turned to doctors for help.
- Therapy was prescribed forcibly. This is possible at the request of neighbors, family members, etc. Only those people who are a danger to society and can cause harm to others or themselves are treated forcibly.
In the second case, patients are usually confident in their own sanity and adequacy, therefore they are subjected to mandatory diagnostics in order to identify problems and choose the right therapeutic tactics.
Young people who have been rejected from military service can also get registered. It is better for them to attribute mental illness to themselves than to trample their boots. The same goes for cunning individuals who, through a psychiatric diagnosis, try to evade criminal liability. Such evaders are subject to a thorough examination and sometimes, unfortunately, they manage to deceive doctors.
There are also erroneous cases in psychiatry. Unfortunately, there are cases when absolutely healthy people receive treatment at the request of relatives. The issue of complete deregistration and cancellation of the diagnosis is especially important for them.
Why do you need a certificate from a narcologist and a psychologist for a vehicle driver?
According to data provided by the Federal Service that monitors drug trafficking in the country, periodic use of intoxicating substances is becoming the norm for more than 8 million people living in the Russian Federation. In addition, approximately 15% of road accidents occur due to the fault of persons in whose body alcohol or drugs were found.
Driving by mentally ill people is also a direct threat to the health and life of all individuals involved in road traffic. For this reason, the Government of the country decided to include a narcologist and a psychiatrist in the list of mandatory doctors who must undergo a medical examination to obtain a driving license.
A satisfactory conclusion from a narcologist is confirmation that an individual is not addicted to alcoholic beverages or drugs.
And an examination by a psychiatrist makes it possible to exclude or detect mental disorders in a candidate driver. A driver who has any restrictions or contraindications to driving poses a direct threat to the safety of the lives of all road users.
If contraindications to driving a car are detected, an individual will not be able to obtain a driver's license. However, with timely access to doctors and proper therapy, the ban on driving a car can be lifted.
How many are registered
To be removed from psychiatric observation, it is important to clarify some factors:
- After a year of treatment, the patient can stop taking medications and visiting the doctor. A citizen can work freely among ordinary people. But some doctors believe that it is still not worth stopping contacts with a psychiatrist completely. You should strictly follow medical recommendations in order to fully restore your mental state.
- After a three-year period, the former patient can be removed from the register, but only on the condition that during this period not a single sign of mental abnormality was observed.
- After 5 years, the case is archived. This speaks of a person’s complete healing, of his complete freedom. But these materials may be requested by some government agencies when investigating criminal cases, to clarify certain data, etc.
But these deadlines are individual and in some cases can shift in any direction.
There is no profession of “child psychiatrist” in Russia
Elena Bagaradnikova.
Photo: facebook.com Elena Bagaradnikova, executive director of the regional organization for helping children with autism spectrum disorders “Contact”:
“I understand perfectly well parents who are trying to avoid psychiatrists. After all, we actually don’t have child psychiatry as a specialty. We are several decades behind the West here.
And yet, in most cases, no one can replace a psychiatrist. Parents are not always able to notice and recognize the disease in time. And sometimes they don’t even know where to go with what.
A competent neurologist can point out any mental problems in a child, but in some cases it is still necessary to refer him to a psychiatrist to make a diagnosis.
A speech therapist will help solve some associated speech problems, and he will also notice problems for which he may recommend contacting a psychiatrist. Even a pediatrician can refer you for consultation to a psychiatrist, but currently he does not have enough screening tools for this.
How to deregister and cancel a diagnosis
Citizens who have been under the supervision of a psychiatrist often have to face the question of how to deregister from a psychoneurological dispensary. Especially in a situation where it is necessary to remove the diagnosis competently and quickly. Sometimes this requires the qualified assistance of a lawyer. First, he competently studies the doctor’s report on the timing and reasons for undergoing therapy.
Now we need to collect documentation confirming the patient’s health and his right to a full existence in society. If there are grounds and evidence, it is possible to confirm the error of the diagnosis. With the help of a specialist, the application is correctly drawn up. If necessary, a lawyer can represent interests in court. It is important to take into account that it will be extremely difficult to defend your rights without qualified assistance.
But more often the deregistration process takes place without the participation of a lawyer and happens like this:
- When the patient himself expresses a desire to be deregistered, special measures are taken to confirm recovery.
- Automatically, i.e. after a certain period of time, which is established at the legislative level.
In the latter case, the timing may vary depending on the patient’s behavior, the presence of exacerbations or aggression, etc. When the patient is automatically removed from the register, his personal file is sent to the archive, and the registration itself is canceled. But if a psychiatrist suspects violations in the mental state of health, then he has the right to cancel the automatic removal from the psychiatric dispensary register.
Validity of a certificate from a narcologist and psychiatrist for obtaining a driver’s license
To obtain a temporary residence permit or its extension, a citizen must provide a traffic police officer with a certificate of satisfactory state of his physical and mental health. In case honey. the examination has not been completed or the document confirming the health status of the individual has expired, the issuance of a driver’s license will be refused.
Note! Moreover, the applicant for a driving license will not be allowed to take the practical exam, since he cannot confirm the absence of diseases that may negatively affect his ability to drive a car.
The document must contain information about the medical institution, the driver’s personal data, as well as a specialist’s opinion regarding the presence or absence of contraindications to driving for the individual.
Due to the need to obtain an opinion from doctors such as a psychiatrist and narcologist, quite often drivers have a question about its validity period. However, it is worth understanding that a certificate received from a narcologist and a conclusion issued by a psychotherapist are two completely different documents. According to Government Decree No. 1097, adopted in 2014, these medical reports are valid for 12 months from the date of their receipt.
Sample report from a narcologist
When is rehabilitation illegal?
With the help of psychiatric clinics, illegal schemes for registering and then quickly removing a diagnosis are often implemented. Sometimes people who actually had mental disorders try to carry out the withdrawal process. Accelerated deregistration is carried out according to the following illegal schemes:
- issuing false statements and certificates from mental health centers;
- replacing personal data in the patient’s personal file;
- theft of medical records and other documents from the clinic;
- falsification of a medical report.
The legislation considers all these actions as criminal acts regulated by articles of the Criminal Code. For this you can lose your freedom, and for an impressive period.
Is it possible to keep the diagnosis secret?
Elena Bagaradnikova:
– We have laws on personal and medical confidentiality. But our laws are structured in such a way that they contradict themselves. For example, when we come to the PMPC, we bring open statements of diagnoses. That is, at the commission itself we disclose confidential information that the doctor told us.
If the child has ASD, their condition will be mentioned directly in the type of curriculum. Here it will not be possible to keep the diagnosis secret.
On the other hand, regardless of papers and diagnoses, if a child is already in school and, for example, reads slowly, thinks and speaks poorly, teachers will still notice.
And if the parents insist that the child is normative, they will begin to demand from him according to the norm. The child will get hurt.
Parents are often afraid that the diagnosis will be recorded in the child’s school medical record, that the school nurse will read it, that other adults and children will learn from her, and that the child will be teased at school.
But it is much more likely that a child will be teased simply because they see and do not understand the characteristics of the child himself, and not his diagnosis.
The same thing will happen when a child enters college - in all cases he will not be able to successfully pass exams or, after training, will not be able to work in some specialty due to his own deficits, if they were not taken into account when choosing a profession.
If the doctor refuses to remove it, what should you do?
The situation becomes more complicated if the doctor refuses to cancel the diagnosis. How to deregister from a mental health center in such a situation?
Typically, withdrawal is made after certain examinations and a commission. Only a psychiatrist can make the decision to remove it. If the doctor illegally refuses to remove it, you should contact another doctor, a paid one, who will act as an independent expert in diagnosis. He will conduct an examination and make his conclusion. The opinion of such a doctor should be trusted, since there is absolutely no bias or any other interest here.
If such a doctor decides that the patient is healthy, you need to act:
- contact the head physician or head of the medical hospital where you are registered;
- you need to send a written application requesting to change the doctor;
- send a request to form a commission and determine the true condition of the patient.
These actions are usually enough to confirm sanity and officially remove the patient from the register.
Conclusion
As a summary:
- If there are mental disorders, treatment and registration are prescribed.
- They are deregistered according to the scheme established by law.
- It is not safe to use illegal methods to cancel a diagnosis.
- If a psychiatrist refuses to deregister, you should undergo an independent examination, ask the director to change the doctor, or file a lawsuit.
Appeal to the courts is a last resort when others prove useless. Usually, an independent examination is sufficient to confirm/refute the sanity of a citizen.
What is the difference between a psychiatrist and a psychotherapist?
A psychiatrist is a specialist with a medical education who can advise, treat, determine a person’s legal capacity, and make an official diagnosis. People usually turn to him directly only when they feel some serious “system errors” in thinking and behavior - strange mood swings, a tendency to self-harm and suicidal thoughts, delusions and hallucinations. In a state medical institution, he also has very little time for each individual patient - so you should not expect such a doctor to work in detail with your traumas from childhood. But a psychiatrist has more knowledge and experience in treating severe diagnoses.
A psychotherapist is a doctor who worked as a psychiatrist for three years and then underwent special retraining. It can help both a person who cannot recover from unhappy love for a long time, as well as a patient with depression or a personality disorder. Such a specialist can use both psychotherapeutic and medicinal methods in treatment, and can combine them.
It is worth considering that any psychologist who has completed retraining courses can often call himself a psychotherapist, so you should definitely inquire about the availability of medical education and attitude to evidence-based medicine.
What problems can be referred to a psychiatrist?
Elena Bagaradnikova:
– There is no list of problems for which one would be advised to consult a psychiatrist, as such. Each specialist evaluates the features in his field, and if he sees that “problems are in the head,” he will send to a specialist who should understand what is happening in the head.
If a child has poor speech development, this is a reason to contact a psychiatrist. Mental retardation (mental retardation) is undoubtedly a diagnosis associated with varying degrees of cognitive impairment, and to make this diagnosis you need to visit a psychiatrist.
A speechless child, a child with behavioral disorders, or disturbances in the emotional-volitional sphere can also be sent to a psychiatrist. stereotypies or echolalia, etc.
PMPK staff who recommend contacting a psychiatrist must explain the purpose of this visit.
For example, in order to officially establish a diagnosis. Or to clarify the main or concomitant diagnosis. What diagnoses can be given to a child ? Mental illnesses in the ICD list alone are a hundred different names. Some of them affect adults, but some diagnoses, such as developmental disorders of language and speech, specific disorders of the development of learning skills, can also be given to a child. But the popular ADHD (attention deficit hyperactivity disorder) and ID (mental retardation) are actually not diseases, but syndromes. That is, sets of symptoms that have different, not always psychiatric, but, for example, neurological or other origins. As a rule, ID and ADHD are not the main diagnosis in the child’s record, but a concomitant one; it is “attached” to another disease, which became the cause of the syndrome. If this disease, of course, could be identified.
Types of care in health care settings
At the moment, the type of assistance from doctors at the above-described dispensary may include the following:
- Advisory assistance. This type of assistance is provided in a situation where a person himself decides to come to the institution. To provide this type of assistance, a person must agree, and his consent must be in writing. If a person is under 15 years old, his parents or guardians have the right to sign the document. If the patient does not visit the dispensary to receive the type of assistance described above, his card is sent to the archive for storage.
- Dynamic dispensary observation. This type of assistance requires an annual review. Why is this necessary? It is not always completely clear whether the patient has completely recovered or whether this is a temporary improvement. In such situations, a council gathers, which decides whether the patient is really sick, or can state the fact of cure.
Information about citizens who may require the help of specialists from a psychoneurological dispensary is added to the appropriate database. Subsequently, if a person needs to confirm the absence of observation, you can use this resource.
