The use of handcuffs during transportation Patients assisted by policemen, who are transported by ambulance to external consultations, are transported in handcuffs (sometimes joined with feet cuffs). This practice, seen in many hospitals, applies to all the detainees in order to avoid their escape. The practice of handcuffing patients arouses a lot of doubt of the NMPT representatives. Mental Health Protection Act of 19 August 1994122 lists measures by means of which the use of direct coercion is allowed. They include holding (ad-hoc and short-time immobilization of a person with the use of physical force), forced use of drugs, immobilization with the use of belts, grips, bed covers or straitjacket and isolation. Handcuffs are not listed there. CPT standards forbid the use of handcuffs when immobilizing psychiatric patients123. Thus, one can assume that in such cases handcuffs are used pursuant to the Direct Coercion Measures and Firearms Act of 24 May 2013124, according to which a police officer may apply direct coercion if his/her safety, life or health is at risk. The risk must be of a specific kind, though, and coercion must always be treated as an ultimate solution if other, lighter measures fail in order to achieve the intended purpose or specific behaviour125. However, article 46a of Mental Health Protection Act provides directly that when executing court decisions concerning admission to a residential care home or a psychiatric hospital, direct coercion is to be used based on the Mental Health Protection Act. Direct coercion measures provided by other legislative provisions may be applied in exceptional situations only after the previous use of direct coercion provided by that Act was to no effect or if the use thereof would be to no effect. Thus, handcuffs may be used only with respect to detainees who are placed in a psychiatric hospital based on a court decision, and in respect of whom the use of direct coercion measures listed in Mental Health Protection Act is to no effect or proves to be impracticable. ☞ Handcuffing every patient (only because he/she is a psychiatric patient) convoyed to a hospital or outside the hospital is a blatant abuse which is not justified by law. Body search Patients’ body search are carried out not only upon admission to the ward, but also e.g. after visitations. Body search is carried out in one stage (patient must strip naked) and not in two stages (first the patient takes off top clothes, after than he/she puts on their top clothes again and takes off 122 123 124 125 54 Consolidated text: Journal of Laws (Dz. U.) of 2018, item 1878. See item 3.3. Coercive Measures in Psychiatric Facilities for Adults. Standards of the European Committee for the Prevention of Torture and Unhuman or Degrading Treatment or Punishment [CPT/Inf(2017)6]. Consolidated text: Journal of Laws (Dz. U.) of 2018, item 1834. Zob. L. Dyduch, K. Świerczewski, W. Biedrzycki, Użycie lub wykorzystanie środków przymusu bezpośredniego przez policjantów, [The use of direct coercive measures by policemen] Legionowo 2014, pp. 15–16. PART IV – Situation in places of detention