CPG for Psychosocial Interventions in Severe Mental ... - GuíaSalud

Several protocols have been published that set out the involuntary hospitalisation procedure.
The majority coincide in urgent cases in general lines, although some points may differ in the different
health services:
– Initial approach by the general Emergency services or Primary Healthcare services (on
request of the family or of close friends who detect a serious decompensation of the patient,
who does not accept any approach of his or her clinical situation).
– With support of security forces if necessary, and
– Transfer to a hospital of reference with psychiatric emergency services where admission
is decided upon, following the regulation of article 763 of the aforementioned Law.
2. Civil Incapacitation and Tutorship. Incapacitation is the legal mechanism foreseen for
those cases where persistent, physical or psychic illnesses or impairments prevent a person from
coping on their own, and where the aim is to protect the interests and rights of the incapacitated
person, both personally and for hereditary purposes. Its legal regulation is included in articles 199
to 214 and following of the Civil Code and 756 to 763 of the Civil Procedure. The declaration
of incapacitation is the competence of the Judge of First Instance, by virtue of verification of the
causes that cause incapacity. Causes of incapacitation are persistent, physical or psychic illnesses
or impairments that prevent a person from coping on their own (art. 200) and, in the case of minors,
when this cause is foreseen to persist after the coming of age (art. 201).
The following are legitimised to start the incapacitation process:
– Spouse or descendants.
– And when absent, ancestors or brothers/sisters of the assumed incapable person.
– The Public Prosecutor when the persons mentioned do not exist or they have not requested
it.
Any person is empowered to inform the Public Prosecutor’s Office of the facts that may be
decisive for the incapacitation.
The incapacitation of minors may only be fostered by those who exert custody or guardianship.
This process gives rise to a judicial judgement, which will determine its extension and limits,
as well as the guardianship that the incapacitated person must be submitted to.
– Tutorship: will require the attendance of the guardian for any activity.
– Curatela (guardianship): needs the attendance of the tutor only for those acts established
in the judgement.
The incapacitation judgement will not prevent any new circumstances that may occur from
leaving the scope of the incapacitation without effect or modify it.
Tutorship is the consequence of an incapacitation process, which is established and constituted
as a duty that is established in benefit of the tutored person, always under the supervision of
the judicial authority. Tutorship is a legal institution whose aim is to guard and protect the person
and the goods of the incapacitated person.
The tutor is the representative of the incapacitated person. The following may hold this position:
– Spouse, children, parents, brothers or sisters:
– Any physical person considered appropriate by the Judge.
– Non-profit legal persons, whose purposes include the protection of incapacitated people.
The Autonomous Community is one of these legal persons.
124 CLINICAL PRACTICE GUIDELINES IN THE SPANISH NHS