MONITORING PSYCHIATRIC INSTITUTIONS stay in the institution, depriving the person of private contacts with people on the outside (public telephones, when they exist, are often in the common areas of the institution and therefore do not allow for any privacy). Access to visitors is also difficult and even prohibited for persons who are in seclusion or under physical restraint. Contact between users is also sometimes prohibited. Other restrictions are imposed such as a ban on smoking. Sexual relations, while not necessarily prohibited, remain a taboo in a number of institutions, leading to a total absence of any preventive measures, specifically against unwanted pregnancies or sexually transmitted infections. Sometimes, constant supervision, such as in seclusion rooms, either via video surveillance systems, or by the nursing staff directly, also violates the person’s privacy. In extreme cases, supervision is also carried out in private areas such as the showers and toilets, and prevents the person from turning their bedroom light off, even at night. The testimony of one Symposium participant, who underwent the profoundly humiliating experience of permanent supervision, illustrated this problem. “In order to prevent me from leaving the hospital and from harming myself, I was put under close observation and had a nurse within arm’s reach every minute of every day for seven weeks of the four months I was a patient. I was not allowed to turn the lights off in my room, I was not allowed to have parts of my body out of sight of the nurse, I had to go to the toilet in front of the nursing staff. Any possession I had that I might use to harm myself with was removed and at one point, after I had tried to hang myself, nearly every single possession I had was taken away.” Graham Morgan, Mental Welfare Commission for Scotland, part of the UK NPM The justification given for these restrictions is generally safety or medical reasons (including prevention of suicides). This requires NPMs to call the authorities’ attention to the need to question the validity of certain practices commonly used by the staff. These various restrictions should never take the form of general rules imposed on all institutionalised persons, but rather should be the 27