hours at fixed times in order to make it easier for patients to initiate contact. The necessary contact details should be displayed in the wards so that they are clearly visible to patients. Furthermore, complaints should be recorded centrally and evaluated on a regular basis. This makes it possible to detect recurring issues and implement counter-measures if necessary. on patients’ mental health – particularly if they 94 have no way of keeping themselves occupied. Physical restraint At one general psychiatric clinic visited by the National Agency, it was observed that a patient had been physically restrained in a bed on the corridor of one of the wards. Without a partition wall to shield them from view, the patient was visible to passers-by. 6.2.2 – Outdoor exercise In the child and youth psychiatric clinic visited by the National Agency, it was not guaranteed that patients could exercise outdoors every day. Even in prisons, it is a legal requirement that each person must have the opportunity to spend at least one hour per day outdoors and be able to exercise there. For children and juveniles, the ability to exercise outdoors should be guaranteed to an even greater extent. Outdoor exercise has unique health benefits that cannot be replicated 93 by any other measure , and it is crucial to the development of young people. In similar facilities, outdoor exercise is made possible via a secure outdoor area. In the view of the National Agency, accommodating patients under physical restraint in this way constitutes a violation of human dignity that must be avoided. Patients under physical restraint should be protected from view and, as a matter of principle, should be accommodated in a room. In some cases, patients under physical restraint were only checked at specific intervals. This meant that the possibility of personal contact was not available at all times. According to the Federal Constitutional Court’s judgment of 24 July 2018, the application of physical restraint constitutes a serious interference with the right to freedom of the person (Article 2 (2) sentence 2 in conjunction with Article 104 of the Basic Law) and poses a 95 serious risk of injury. Thus, any restrictions to this right may only take place on the basis of a formal law that is sufficiently precise and takes sufficient account of the principle of 96 proportionality. The measure must be ordered by a doctor and requires monitoring. Furthermore, it must be ensured that one-onone supervision is provided by therapeutic 97 personnel or care staff. For any physical restraint applied for more than just a short 98 period of time, a court decision is required. The measure is to be documented 99 comprehensively. The person concerned should be informed after the measure of the 6.2.3 – Deprivation of liberty Segregation In forensic psychiatric clinics, patients can be segregated from the wider community during crisis situations. According to one forensic psychiatric clinic, segregation periods lasted up to one year in some cases. Such lengthy periods of segregation represent a huge interference with an individual’s rights of personality and are unacceptable from a human rights perspective. They should be limited to the shortest possible period of time. Segregation must be closely monitored in order to bring about a relaxation of the measure as soon as possible. Steps should therefore be taken to enable a reduction in the duration of segregation. Insufficient social contact and constant isolation can have a significant negative impact 94 Weyers/Siegrist, “Soziale Beziehungen und Gesundheit, Impulse für Gesundheitsförderung”, 4th. quarter, 2011, LVG für Gesundheit und Akademie für Sozialmedizin Niedersachsen e.V. (ed.), p. 2-3 95 Federal Constitutional Court, judgment of 24/07/2018, file no.: 2 BvR 309/15, 2 BvR 502/16, margin no. 83 96 Ibid., margin no. 76 et seq. 97 Ibid., margin no. 83 98 Ibid., margin no. 69 99 Ibid., margin no. 84 93 Arloth/Krä, "StVollzG-Kommentar” [Commentary on the Prison Act], 4th Edition, section 64 of the Prison Act, margin no. 1 72

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