In late February Srithanya Hospital director Dr Kiatipoom Wongrajit was in particularly high spirits having just celebrated his birthday. His buoyant spirits were soon brought sharply down to Earth, however.

Kiatipoom was hit with a police complaint accusing him and his hospital staff of unlawfully detaining Dr Prakitpao Thomthitchong. At that time, police were not particularly convinced that the tutorial-king was suffering from mental illness.

The case exploded into the headlines, creating unprecedented trouble for the hospital and shaking the psychiatric profession's reputation as well. That was until Monday when a court's ruling cleared things up.

Prakitpao was found to have suffered from psychosis and had been admitted to the hospital by his family after he had churned through Bt40 million in four months, mostly on a young woman who claimed to be his close friend and who had lodged the police complaint against Srithanya Hospital.

"Although it was the patient's own relatives who had taken him to the doctors, this situation can easily arise," says Professor Swang Boonchalermvipast, a medical law expert with Thammasat University.

Before a patient is admitted to hospital for treatment psychiatrists are required to ask a relative to sign an informed-consent form on behalf of the patient, who usually is mentally unfit to do so, Kiatipoom said.

In Prakitpao's case, he said, his mother signed the consent form, yet that turned out not to be acceptable as the final word as someone who is not even related was able to file a police complaint accusing the hospital of illegally detaining him, citing Article 90 of the Criminal Law.

"As time goes by and things change, the old ways may no longer work," Kiatipoom says.

Prompted by the Prakitpao case, the Department of Mental Health has decided to dust off the Mental Health bill and will get it passed into law to protect both patients with mental illness and the medical personnel who provide them with treatment.

Basically, the bill will allow sectioned treatment of people with mental illnesses. Figures from the department show only one in four of close to two million Thais who suffer from psychosis have been given proper medical treatment, an indicator of the poor access to treatment.

The United Kingdom and the United States once had a similar problem. They both introduced a legal mechanism similar to Thailand's new law to contain the problem, Swang said.

The other major factor that contributes to cases like those of Prakitpao is poor public understanding of mental illness and patients. A recent survey by the Abac Poll Research Centre showed the vast majority of people (90 per cent) do not have any understanding of psychosis.

"This type of misunderstanding is extremely dangerous. It can result in a mentally ill person being put in jail rather than into a hospital," Swang said. "And being left without proper treatment in jail, they could come out later and commit repeated crimes."

Jitrada Tantiwanichayasuk, 36, was almost sent to jail after shocking the community by stabbing several girls at Saint Joseph Convent School in September 2005. She was a mental patient who had missed treatment for quite some time, but it was not easy for psychiatrists to convince the police she needed to be hospitalised rather than jailed.

Arthit Khwankhom

The Nation

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Mental Health Bill

Main points

lForced treatment of mentally ill people

For those who are considered a danger to either themselves or others and mentally unfit to decide whether or not to seek medical treatment on their own.

lProtection of patients' rights

Focusing on informed consent of the patient, confidentiality of patient information, and the right to treatment.

lAppeal against forced treatment

Patients who face forced treatment will be able to appeal to the Mental Health Committee.

Source: Department of Public Health