The Prosecutor's Office is investigating a suicide in the Nikšić hospital

The higher prosecutor's office ordered the autopsy of the body and ordered the GSR and ballistics expert examination, as well as the collection of information from citizens. The hospital was visited yesterday by representatives of the ombudsman institution, who for years warned about personnel problems in the psychiatry department

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Photo: Svetlana Mandić
Photo: Svetlana Mandić
Disclaimer: The translations are mostly done through AI translator and might not be 100% accurate.

The higher state prosecutor's office in Podgorica opened a case regarding the case of suicide in the hospital in Nikšić on April 28, when the patient, after seeking the help of a psychiatrist for two days in a row, killed himself with a firearm in the premises of that institution.

The prosecutor's office replied to "Vijesta" yesterday that the investigation into the case regarding the death of a person from Nikšić is ongoing.

"In the Higher State Prosecutor's Office in Podgorica, a case was established regarding the death of a person PR from Nikšić, whose lifeless body was found with a gunshot wound in a car, in front of the Nikšić General Hospital, on April 28, 4, which case is in the investigation phase, during which the order for the autopsy of the body was issued by the prosecution, and Danilovgrad Forensic Center were given orders for GSR and ballistics expertise, while the Police Directorate was ordered to collect the necessary notifications from citizens. After collecting all the required data and expert reports, the prosecution will make a decision in the case," the head of the prosecution's spokeswoman replied to "Vijesta" Beautiful Medenica.

The Nikšić hospital was visited yesterday by representatives of the institution of the Protector of Human Rights and Freedoms, which on several occasions, in the annual reports of the national mechanism for the prevention of torture, in vain recommended the General Hospital to strengthen the personnel capacities of the Department of Psychiatry.

"We started the procedure ex officio, in order to determine the circumstances of the case and possibly whether it was acted in accordance with the regulations and whether there were any omissions," the Protector of Human Rights and Freedoms told "Vijesta" Siniša Bjeković.

THE PROBLEM OF SHORTAGE OF PERSONNEL HAS BEEN LASTING FOR YEARS

The institution headed by Bjeković, as the National Mechanism for the Prevention of Torture (NMP), has been pointing out personnel problems at the Department of Psychiatry in the Nikšić hospital for years in regular annual reports and recommends that they be strengthened in accordance with the Act on Systematization. According to the systematization, seven psychiatrists are planned, and three doctors are currently working in that institution, one of whom is not on standby.

Members of the EMS during a control visit in September 2022, as stated in the report, found one psychiatrist employed on a part-time basis.

"It was pointed out that such a situation is unacceptable, with a potentially serious negative effect on the quality and scope of providing health services to patients undergoing hospital treatment at the Department of Psychiatry. In this sense, it was indicated that the urgent intervention of the Ministry of Health and the Hospital Administration is necessary in order to permanently overcome this problem", it is written in the annual report for 2022.

It was also noted that patients do not have the opportunity to stay in the fresh air, and that there is no form of Consent for hospitalization, that is, voluntary consent to stay in the Department of Psychiatry.

"In addition to the observed shortcomings, we emphasize that through a confidential conversation with the patients, confirmation of the humane and caring attitude of the staff towards the patients was obtained," the report states.

A year later, the NPM states that the personnel strengthening of the Department of Psychiatry was not implemented even last year and that the number of employed medical personnel (doctors, nurses/technicians) is still insufficient compared to the existing systematization.

"The general impression of the NPM team after the monitoring is that the conditions for the stay of patients at the Department of Psychiatry in Nikšić are adequate. Compared to the previous tour, a certain shift in the development of work-occupational therapy activities has been registered, but there is still a lack of full-time employees working as work-occupational therapists," the report says.

During the monitoring, representatives of the institution of the Protector noted that the hospital in Nikšić and the Department of Psychiatry do not have a written information sheet (brochure) that would be available to patients and their family members in order to familiarize them with house rules, rights during stay and treatment in the ward, possibilities and procedures for making appeals.

"Furthermore, the Department does not have a central Register of Incidents that would contain records of all unwanted events at the Department. The existence of this register would make it much easier for the institution's management to gain insight into all unwanted events and make it much easier to plan measures and procedures for the prevention of possible incident situations", they conclude, among other things, in the report for 2023.

THE ADMINISTRATION DOES NOT SEE THE GUILTY, THE MINISTRY IS CHECKING

The administration of the Nikšić hospital informed the Ministry of Health about the problems of the organization of the psychiatric service in a letter on May 17, twenty days after a thirty-five-year-old patient killed himself with a firearm in front of the institution.

The Ministry of Health responded to "Vijesta" on Friday that they will conduct an extraordinary external quality control of professional work and medical documentation related to the treatment of the deceased patient.

The Nikšić hospital did not have a psychiatrist on duty during the days when the patient needed treatment. The patient was helped by the doctor on duty, an internist, who contacted his doctor by phone - the head of the psychiatric service, which was also confirmed at the hospital.

The doctor recommended therapy to the colleague, which the patient received, he was offered treatment at the Clinical Center of Montenegro (KCCG), which he refused and committed suicide after leaving the health facility, on the ramp of the hospital.

Answering the questions of "Vijesti" regarding this case, the hospital in Nikšić said that the internal Commission for Quality Control concluded that the patient was treated in accordance with medical protocols, and that he was prescribed therapy. They also claimed that they did not have the possibility of forced hospitalization.

According to the Law on Health Care, a medical doctor and a psychiatrist/neuropsychiatrist, in the event that he assesses that the nature of the patient's mental illness is such that it can endanger his own life or health or the life and health of other persons, may refer him to hospital treatment in the appropriate psychiatric facility. institution, and the competent doctor of that health institution is obliged to accept that person for hospital treatment, without the prior consent of the patient, or an adult member of his family.

The law, in the same article, stipulates that a medical doctor and a psychiatrist who refers a patient to a psychiatric institution can request the help of the state administration body responsible for internal affairs, if he assesses that the patient is in such a condition that he may endanger the safety of people and the environment.

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