The Egyptian law 71/2009 ‘Care of mentally ill patients’: knowledge and opinions of service providers, relatives, and patients with substance abuse

Background
The new Egyptian law for the care of the mentally ill has set strict criteria specifying the circumstances under which a person can be involuntarily detained in mental health institutions. The New Law does not specify whether addiction, as a psychiatric disorder, should be treated differently from other psychiatric disorders. Since the law was decreed by Parliament, the number of admissions of patients with drug addiction has reportedly declined.
Objectives
To explore the knowledge and attitude toward the New Law ‘Law for the Care of the Mentally Ill Patient’ (71/2009) among service providers, patients, and patients’ relatives and how it is perceived to have affected the service to addiction patients.
Participants and methods
A total of 505 patients with substance misuse, 213 relatives, and 172 substance misuse healthcare workers (providers) were assessed using specially designed questionnaires.
Results
More than 90% of service providers had heard about the new mental health law in Egypt. More than 50% of substance users and their relatives were not aware of it. About two-thirds of the patients agreed with provisions of the New Law as they relate to addiction, whereas more than two-thirds of service providers did not. Attribution of illness affected patients’ agreement with involuntary admission. More patients who agree to enforcing treatment view addiction as an illness (72 vs. 60%, =6.79, =0.009). There is a dominant perception that the law does not allow involuntary admission of addiction patients for treatment (about 80% of service providers and 87% of relatives). Sixty-four percent of patients in this sample agreed on involuntary treatment for a period of time until patients can make rational decisions about their treatment and 69% of the patients’ relatives believed that the law needs to be modified to allow involuntary admission for addiction patients.
Conclusion
There are considerable ambiguities about the regulations of commitment for treatment as well as the duration of treatment and discharge for patients with addiction problems under the new mental health law (71/2009). This is only matched by an overall negative attitude of the studied stakeholders, especially service providers, which may be attributed in the latter case to a large gap in training.