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13 May 2024

Advances in Mental Health Legislation in Portugal

After more than two decades since the promulgation of the Mental Health Law of 1998, Portugal takes a significant step by replacing it with a new decree. This change comes in response to the evolution recorded in the clinical area, as well as the international commitments undertaken by the country towards organizations such as the World Health Organization, the Council of Europe, and the European Union.

The new Mental Health Law not only updates and redefines the foundations and objectives of mental health policy but also enshrines and regulates the rights and duties of individuals in need of care in this area. Furthermore, it reflects a set of values that places the dignity of the human person as the guiding principle of all therapeutic approaches in this domain.

One of the significant changes introduced by the new legislation is the implementation of measures to ensure the effectiveness of the rights of individuals in need of mental health care. This includes the introduction of the 'trusted person' figure, who is chosen by the individual receiving mental health care to provide support in exercising their rights.

Additionally, advance directives of will are recognized, allowing the preferences of the individual to be expressed in advance.

Another relevant change concerns involuntary treatment, which replaces compulsory hospitalization. Now, involuntary treatment can only be applied in specific cases, such as refusal of medically prescribed treatment, and must be oriented towards the full recovery of the individual, respecting their autonomy as much as possible.

The preference for conducting involuntary treatment on an outpatient basis, whenever possible, is another important innovation of the new law, aiming for the integration of the individual into the community and reducing the need for hospitalization.

In addition to changes directly related to mental health care, the new legislation also impacts the forensic healthcare system. The repeal of certain provisions of the Penal Code allows for the cessation of security measures involving hospitalization that exceed the maximum duration provided for the type of crime committed by individuals who are not held accountable.

To ensure a smooth transition to the new regime, the Government coordinated efforts between the Ministries of Justice, Social Security, and Health to characterize the clinical and social situation of individuals affected by the legislative change and to ensure appropriate responses to their needs.

However, it is crucial to highlight that these changes are not only legal but also represent an evolution in the understanding and approach to issues related to mental health. By placing dignity and the rights of individuals at the forefront, Portugal's new Mental Health Law demonstrates a renewed commitment to promoting well-being and protecting human rights in the field of mental health.

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