MONITORING PSYCHIATRIC INSTITUTIONS
Finally, the risks of overmedication, including the use of chemical
restraint, which often responds to a wish to control rather than to
provide care, are some of the practices that require strict supervision
to prevent abuse and should therefore be identified by monitoring
bodies during their visits.
Monitoring psychiatric institutions and the role of NPMs.
Monitoring bodies play a key role since, under international treaties
(OPCAT or European Convention for the Prevention of Torture),
state authorities are obliged to ensure unhindered access to places
of detention. Despite their different approaches to monitoring
psychiatric institutions, all NPMs at the Symposium acknowledged
that non-discrimination is one of their main guiding principles. Some
of them still encounter obstacles that are both internal (lack of NPM
members’ awareness and training on rights and needs of persons
with disabilities) and external (lack of access to the institutions,
questioning of their legitimacy to carry out this type of monitoring
in “care settings”). However, most NPMs and the SPT now include
this monitoring in their visit programmes (the CPT having already
many years of expertise in this area).
The Symposium also gave NPMs the opportunity to discuss the
challenges they face from a methodological point of view, in
particular the need for multidisciplinary visiting teams and the role
of health specialists (including psychiatrists) within those teams. A
constructive dialogue with staff at the establishments being visited is
also essential to enable the authorities to have a better understanding
of NPMs’ mandate and, where appropriate, be made aware of
the changes that are needed in the institution. The importance of
interviews in private with the persons deprived of liberty and the
need for NPM members to receive specific training on how to handle
these interviews was also discussed. Finally, several good practices
were identified, in particular the experience of NPMs which integrate
the perspective of former users of psychiatric services in their work,
including during visits.
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