Types of Compulsory Medical Measures
📘 GENERAL OVERVIEW
Article 93 of the Criminal Code of the Republic of Kazakhstan defines an exhaustive list of types of compulsory medical measures (CMMs) that may be imposed by a court. These measures are intended not to punish, but to provide treatment and ensure public safety when a person suffers from mental or behavioral disorders and has committed a criminal offense.
This article should be applied in conjunction with Articles 91 and 92 of the Criminal Code, which establish the grounds and purposes for applying CMMs.
📑 ARTICLE-BY-ARTICLE ANALYSIS
🔹 Part 1 — Types of CMMs
1) Outpatient compulsory supervision and treatment by a psychiatrist
📌 This is the least intrusive measure. It is applied to persons who:
have mild mental disorders;
do not require isolation but need supervision;
can be treated in outpatient settings.
Form of implementation:
regular visits to a psychiatrist;
taking prescribed medication;
compliance with a treatment regimen.
📎 Example: a person with borderline personality disorder who committed hooliganism and was found legally sane.
2) Compulsory treatment in a general psychiatric hospital
📌 Intended for persons who:
have mental disorders of moderate severity;
require supervision and treatment in inpatient conditions but do not pose a high danger.
📎 Related to Part 2 of Article 91 of the Criminal Code — applied when there is a risk of harm.
3) Compulsory treatment in a specialized psychiatric hospital
📌 Applied to persons who:
suffer from persistent mental disorders;
pose a danger to themselves or others;
but do not require intensive 24-hour supervision.
📎 Typically includes individuals with schizophrenia, perceptual disorders, and those requiring long-term treatment.
4) Compulsory treatment in a specialized psychiatric hospital with intensive supervision
📌 The strictest regime. Applied to persons who:
suffer from acute forms of mental illness;
have committed serious or violent crimes;
pose a high degree of danger (e.g., homicide, violent acts with grave consequences committed while insane).
🛑 Essentially, this is psychiatric isolation with constant medical and security supervision.
📎 Subject to regular judicial review (Article 96 of the Criminal Code).
5) Compulsory treatment in the form of chemical castration and treatment of sexual disorders
📌 Applied to:
persons who committed sexual offenses against minors;
those diagnosed with disorders of sexual preference (e.g., pedophilia, sadism, etc.);
only individuals over 18 years of age.
📌 Chemical castration is not a surgical procedure but a course of medication (anti-hormonal therapy) that reduces sexual drive.
📎 See also:
Article 91(5) of the Criminal Code;
Law of the Republic of Kazakhstan dated April 18, 2016 No. 488-V;
Government Resolution No. 830 dated December 21, 2018.
⚠️ This measure is imposed by a court based on a psychiatric opinion and cannot be applied automatically. It must be reviewed at least once a year.
🔹 Part 2 — Combination of CMMs with punishment
“The court may impose CMMs in the form of outpatient treatment in addition to punishment...”
📌 This means that CMMs may be applied:
in addition to the main punishment if the mental disorder does not exclude legal sanity;
particularly relevant in cases involving substance abuse, alcoholism, and persistent behavioral disorders.
📎 Example: conviction for driving under the influence (Article 346 of the Criminal Code) + outpatient treatment for alcoholism.
🔹 Part 3 — CMMs upon release after punishment for sexual offenses against minors
📌 A special provision:
applied not at sentencing, but upon release from imprisonment;
allows extension, modification, or termination of CMMs depending on behavior and medical assessments.
📎 Example: a person who served 7 years for child sexual abuse may, upon release, be subjected to chemical castration for 1 year with annual judicial review.
⚖️ PRACTICE AND COURT EXAMPLES
Case No. 2-1805/2022 (Shymkent):A 42-year-old individual convicted of sexual acts against a minor was diagnosed by a psychiatric commission with a sexual preference disorder. The court imposed:
8 years of imprisonment;
after release — chemical castration for 2 years and psychiatric supervision.
📚 RELATED LEGAL PROVISIONS
📌 Domestic law:
Criminal Code: Articles 17, 91–96;
Criminal Procedure Code: Articles 435–437;
Penal Enforcement Code: Chapter 23;
Law “On Public Health”;
Order of the Ministry of Health No. ҚР ДСМ-207/2020;
Government Resolution No. 830.
🌍 International standards:
UN Convention on the Rights of Persons with Disabilities (Article 14);
European Convention on Human Rights (Articles 3, 5);
ECtHR case law (Stanev v. Bulgaria; X v. Finland).
🧭 CONCLUSION
Article 93 of the Criminal Code of the Republic of Kazakhstan:
clearly classifies types of CMMs based on the level of intervention and degree of danger;
allows flexible combination of punishment and treatment where sanity is preserved;
enables continuation of treatment after release, especially in cases involving sexual offenses;
ensures a balance between public safety and the rights of persons with mental disorders.
Attention!
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