CAT/OP/ROU/1 should resort to the involuntary placement procedure so that patients can benefit from the legal safeguards in place. 121. The delegation was informed that several patients placed in psychiatric hospitals and who had been in various institutions for many years could not be discharged as they had no family and nowhere to go. The Subcommittee is concerned about the lack of intermediate centres for providing social support pending final discharge from an establishment. As a result, many patients in psychiatric hospitals are not there to receive treatment, but because the hospitals to a large extent operate as social welfare centres for persons without resources or a family to support them. The Subcommittee is of the view that the internment of individuals without mental impairments in a psychiatric or psychoneurological institution may amount to inhuman and degrading treatment. 122. The Subcommittee recommends the adoption of measures, such as the establishment of half-way houses, to ensure that patients do not remain in psychiatric hospitals for socioeconomic rather than medical reasons. The State party should also speed up its efforts to establish community-based services for persons with mental disabilities and with psychosocial disorders to avoid hospitalization. Poverty and the absence of family support should never be a reason for placement in a psychiatric hospital. The State party should develop social support services to help long-term patients reintegrate into society. 2. Patients admitted by court decision 123. The Penal Code (arts. 109–110) and the Code of Criminal Procedure (arts. 245–248 and 566–572) provide the legal basis and procedures for placement and compulsory treatment imposed on persons lacking legal capacity. The legislation provides that such persons can be hospitalized in a psychiatric hospital with security measures by court decision and on the basis of a medical-forensic examination. The compulsory placement in a medical facility can be imposed on offenders who are mentally ill, addicted to drugs or other substances or who suffer from infectious diseases. The duration is undetermined and can last until recovery. The decision is reviewed every 12 months, on the basis of a medical-forensic examination. 124. The delegation visited the security psychiatric hospital in Grajduri, where all patients had been admitted by court decision. The delegation was disturbed by the living conditions in the institution and the state of desperation of the patients it met. It observed severe overcrowding in all units of the hospital. At the time of the visit, the hospital had 340 patients in facilities with a capacity for 240. Other major problems include staff shortages and the lack of activities for patients. There are too few doctors and nurses, only one psychologist, only one social worker and no occupational therapist. Nurses often have to cope with a great many patients, which places them at risk. Staff members reported that it was not uncommon to have only one or two staff in charge of 100 patients. The delegation observed that, perhaps due to the lack of staff, excessive medication was used to keep patients under control. 125. The Subcommittee recommends providing the resources necessary to ensure adequate living conditions in the security psychiatric hospital in Grajduri. Immediate measures should be taken to alleviate overcrowding and increase the number of health professionals working with patients detained in such institutions. Health professionals should be qualified and receive training on international human rights standards, particularly the Convention on the Rights of Persons with Disabilities. In addition, the number of psychiatrists, nurses, psychologists, occupational therapists and social assistants should be increased, multidisciplinary care should be provided to the patients and rehabilitation, occupational or recreational activities should be proposed. 126. More worryingly, health professionals recognized that patients with all kinds of psychiatric illness were placed in the security psychiatric hospital in Grajduri, including persons with intellectual disabilities for whom, according to the professionals, compulsory placement in such an institution would not be necessary. The delegation was also concerned to learn that some of the patients who had recovered, according to the medical assessment, 19