Article 5 - Basic principles of state policy in the field of public health protection in the Kyrgyz Republic

The basic principles of state policy in the field of public health protection in the Kyrgyz Republic are: 1) respect for the rights of citizens to health protection and non-discrimination in the provision of medical care, taking into account the age and gender needs of various social groups and ensuring social protection in the event of loss of health by citizens; 2) accessibility of medical and sanitary-preventive care for all groups of the population, creation of equal opportunities for persons with disabilities in receiving medical care; 3) development of the healthcare sector in accordance with the needs of all groups of the population by forming a comprehensive integrated system of medical care and creating equal conditions for the functioning of healthcare organizations, regardless of their form of ownership; 4) free/preferential use by citizens of medical and sanitary-preventive care within the framework of the State Guarantees Program; 5) responsibility of citizens for maintaining and strengthening their health, the health of their children, parents and other persons; 6) scientific validity of medical and sanitary measures; 7) preventive focus of healthcare with the formation of a commitment to a healthy lifestyle among the population with the active participation of the population and public organizations in resolving healthcare issues; 8) responsibility of state authorities and local governments, legal entities and officials for failure to provide state guarantees in maintaining and strengthening the health of citizens; 9) responsibility of persons providing medical and sanitary care for failure to provide its safety and quality; 10) voluntary donation of blood and its components, as well as a guarantee of maintaining health and respect for the rights of the donor when performing the donor function, with the provision of state guarantees and social protection; 11) priority of observance of human rights and freedoms in the implementation of sexual and reproductive rights; 12) the focus of state programs on improving the demographic development of the Kyrgyz Republic; 13) implementation of generally recognized principles and norms of international law, as well as international obligations of the Kyrgyz Republic.

Article 76 - Types of psychiatric and drug addiction care and social protection guaranteed by the state

1. The state guarantees: 1) emergency psychiatric and drug addiction care; 2) consultative and diagnostic, therapeutic, psychoprophylactic, rehabilitation care in outpatient and inpatient settings according to the list of diseases approved by the Cabinet of Ministers; 3) all types of psychiatric, medical-psychological and drug addiction examination, determination of temporary disability; 4) social and legal assistance and assistance in finding employment for persons suffering from mental disorders; 5) resolution of guardianship issues; 6) consultations on legal issues and other types of legal assistance in psychiatric, drug addiction organizations and social inpatient institutions; 7) social and everyday arrangements for persons with disabilities and elderly citizens with mental and behavioral disorders, as well as care for them; 8) training of persons with disabilities and minors with mental and behavioral disorders; 9) psychiatric and psychological assistance in the event of natural disasters and catastrophes. 2. In order to provide persons with mental and behavioral disorders and their social protection, the state: 1) creates all types of organizations providing outpatient and inpatient psychiatric, drug addiction and medical-psychological assistance, if possible at the place of residence of the patients; 2) organizes general education and vocational training of minors with mental and behavioral disorders; 3) creates medical and industrial enterprises for occupational therapy, training in new professions and employment at these enterprises of persons with mental and behavioral disorders, including persons with disabilities, as well as special production facilities, workshops or sections with easier working conditions for such persons; 4) establishes mandatory quotas of jobs at enterprises, institutions and organizations of various profiles for the employment of persons with mental and behavioral disorders; 5) applies methods of economic incentives for enterprises, institutions and organizations providing jobs for persons with mental and behavioral disorders; 6) creates hostels for persons suffering from mental and behavioral disorders who have lost social connections; 7) takes other measures necessary for social support of persons with mental and behavioral disorders.

Article 82 - Diagnosis, Outpatient Care, and Dynamic Monitoring of Persons with Mental and Behavioral Disorders

1. The diagnosis of a mental and/or behavioral disorder shall be made in accordance with internationally recognized standards and classifications. It may not be based solely on a person’s disagreement with moral, cultural, political, or religious values accepted in society or for other reasons not directly related to the individual’s mental health condition. 2. For the diagnosis and treatment of a person with a mental and behavioral disorder, medical tools and methods permitted under the health care legislation of the Kyrgyz Republic shall be used. 3. Outpatient psychiatric care for a person with a mental and/or behavioral disorder, depending on medical indications, shall be provided either as consultative and therapeutic assistance or as dynamic monitoring. Consultative and therapeutic care is provided by a psychiatrist or narcologist upon the individual’s voluntary request, at their request, or with their consent. For a minor under the age of 18, it is provided upon the request or with the consent of parents or another legal representative. 4. Dynamic monitoring may be established regardless of the consent of the person with a mental and/or behavioral disorder or their legal representative if the individual has a chronic and prolonged mental and/or behavioral disorder characterized by severe persistent or frequently recurring pathological symptoms. It involves regular examinations by a psychiatrist and the provision of necessary medical and social assistance. 5. The decision to initiate or terminate dynamic monitoring shall be made by a commission of psychiatrists appointed by the administration of a psychiatric or narcological organization providing outpatient psychiatric or narcological care, or by a commission of psychiatrists designated by a health authority. Previously established dynamic monitoring shall be terminated upon recovery or significant and sustained improvement in the individual’s mental condition. After termination of dynamic monitoring, outpatient psychiatric or narcological care may continue in the form of consultative and therapeutic assistance at the request or with the consent of the individual or their legal representative. In case of changes in the mental state, the person may be subject to examination without their consent or the consent of their legal representative under the grounds and procedures set forth in Part 4 of Article 84 and Articles 85 and 88 of this Law. Dynamic monitoring may be resumed in such cases by decision of a commission of psychiatrists and narcologists. 6. Medical tools and methods shall be used solely for diagnostic and therapeutic purposes in accordance with the nature of the disorder. They must not be used as a form of punishment for the person with a mental and behavioral disorder or in the interest of other individuals.

Article 83 - Compulsory Medical Measures

1. Compulsory medical measures with respect to persons with mental and/or behavioral disorders who have committed socially dangerous acts shall be applied by a court decision, based on the grounds and in the manner established by the Criminal Code and the Criminal Procedure Code of the Kyrgyz Republic.

Chapter 11 - Specialized Psychiatric Care

68. Specialized psychiatric care in outpatient settings is provided by: - family medicine centers; - general practice centers; - family doctor groups; - mental health centers. 69. Conditions for the provision of specialized psychiatric care in outpatient settings of ADO/KDO mental health centers: laboratory diagnostic tests and consultative and therapeutic care are provided free of charge: - persons suffering from mental disorders; - children under the age of 18; - military personnel serving under contract (officers, warrant officers, sergeants, sergeants and privates), and conscripts; - internationalist soldiers who became disabled as a result of military service; - participants and persons who became disabled as a result of the liquidation of the consequences of the accident at the Chernobyl nuclear power plant; - persons undergoing an initial psychiatric examination, an initial forensic psychiatric examination, an initial forensic psychological examination and an initial forensic psychological-psychiatric examination by decision of judicial or investigative bodies; - persons who have become victims of human trafficking; - persons receiving monthly social benefits. For other categories of persons, as well as persons undergoing a repeat psychiatric examination, a repeat forensic psychiatric examination, a repeat forensic psychological examination and a repeat forensic psychological-psychiatric examination by decision of judicial or investigative bodies, laboratory diagnostic tests and consultative and therapeutic care are provided with payment of the full cost of medical services according to the price list. 70. Specialized psychiatric care in inpatient settings is provided by mental health centers. 71. Conditions for the provision of inpatient specialized psychiatric care: - hospitalization of patients suffering from mental illnesses is free of charge; - hospitalization of patients in psychosomatics and narcology departments is carried out with the introduction of a co-payment for the therapeutic profile. The amounts of co-payment, differentiated depending on the availability of rights to benefits, are provided in paragraph 60 of this Procedure.