registering the use of chemical restraint; the problem related to state monitoring on administering adequate psychiatric care and protection of patients’ rights in psychiatric facilities; and psychiatric facilities being understaffed. In the 2017 parliamentary report, the Public Defender issued a proposal for the notice of the Parliament of Georgia to amend the Law of Georgia on Psychiatric Care to the effect of determining the following: the maximum duration of physical restraint; the duty to make an entry into a special registry (a special logbook) concerning physical restraint used against a patient, including the body injuries sustained by a patient and/or staff member in the process; the form of a special registry (a special logbook); detailed instructions concerning the direct use of physical restraint; specifications of the means to be used during physical restraint; the details of where to use physical restraint and who can attend this process; the requirements to be met by a specialised isolation ward; issues related to the use of video surveillance in the process of physical restraint; and after the use of physical restraint the duty to discuss the issue with the patient and to inform him/her about the right to appeal against physical restraint; also to introduce the definition of chemical restraint; the legal grounds and procedure of its use as an exception and to introduce the obligation of approving by an order of the Minister of Labour, Health and Social Affairs of Georgia the detailed instruction on the use of chemical restraint. Furthermore, the Public Defender recommended to the Minister of Labour, Health and Social Affairs of Georgia to amend the Instruction on the Rules and Procedures for the use of Means of Physical Restraint Against Patients with Mental Disorders as approved by Order no. 92/N of the Minister of Labour, Health and Social Affairs of Georgia of 20 March 2007. The Public Defender recommended to determine statutorily the following: the maximum duration of physical restraint; the duty to make an entry into a special registry (a special logbook) concerning physical restraint used against a patient, including the body injuries sustained by a patient and/or staff member in the process; the form of a special registry (a special logbook); detailed instructions concerning the direct use of physical restraint; specifications of the means to be used during physical restraint; the details of where to use physical restraint and who can attend this process; the requirements to be met by a specialised isolation ward; issues related to the use of video surveillance in the process of physical restraint; and after the use of physical restraint the duty to discuss the issue with the patient and to inform him/her about the right to appeal physical restraint. Unfortunately, the Public Defender’s above recommendation and proposal have not been fulfilled. 5.2. FORCED MEDICAL TREATMENT OF PATIENTS FORMALLY PLACED VOLUNTARILY IN INPATIENT FACILITIES AND THE USE OF PHYSICAL RESTRAINT Apart from the above problems, similar to the previous years, forced medical treatment of patients formally placed voluntarily in inpatient facilities and the use of physical restraint constituted a considerable challenge in the reporting period. 77

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