CAT/OP/PRT/1
there appeared to be no detailed medical justification for hospitalization. The form used
consisted of a series of questions with checkboxes to determine whether the person posed a
danger to society or him or herself. The judge made decisions on the basis of this form
without any additional evaluation of the situation of the person. The patients interviewed by
the delegation reported that they had appeared before the judge only to receive the decision
regarding their hospitalization after it had already been taken.
107. The Subcommittee is also concerned that the lack of community-based care may
result in overuse of psychiatric and non-consensual treatment, that is, deprivation of liberty
for health reasons, when other options might be better. Instead of a “last resort” policy, as
enshrined in the 1998 Mental Health Act, long-term psychiatric care in closed units is very
frequent, also in situations where people should or could have been in social care. As a
result, people with long-running psychiatric diagnoses are psychosocially disabled and tend
to be overmedicated. This group seems to be practically forgotten, and they are not
rehabilitated in the way they should be. The Subcommittee came across a couple of
examples where low-level community care would have been a far better option than longterm deprivation of liberty in psychiatric units.
108.
The Subcommittee recommends that the State party ensure that:
(a)
Multidisciplinary care is provided to all patients and rehabilitation,
occupational or recreational activities are proposed on a regular basis;
(b)
Detailed medical justification is provided for individual risk assessment
that forms the basis of admission to psychiatric care under court order, and the
person concerned has the possibility to appear before the judge before such a decision
is taken;
(c)
Additional measures are taken to support the establishment of
community-based services to enable the discharge of patients who are only in longterm hospital care because of a lack of community care options.
109. The Subcommittee also recommends that mental health professionals be
provided with adequate 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.
VIII. Next steps
110. The Subcommittee requests that it receive a reply to the present report within six
months from the date of its transmission to the Permanent Mission of Portugal in Geneva.
The reply should respond directly to all the recommendations and requests for further
information made in the report, giving a full account of action already taken, or which is
planned to be taken (including timescales), in order to implement them. It should include
details concerning the implementation of institution-specific recommendations and
concerning more general policy and practice.17
111. Article 15 of the Optional Protocol prohibits any form of sanction or reprisal, from
any source, against anyone who has been, or who has sought to be, in contact with the
Subcommittee. The Subcommittee reminds Portugal of its obligation to ensure that no such
sanctions or reprisals take place and requests that in its reply the State party provide
detailed information concerning the steps it has taken to ensure that this obligation is
fulfilled.
112. The Subcommittee recalls that prevention of torture is a continuing and wideranging obligation.18 It therefore requests that the Subcommittee be informed of any
17
18
18
The reply should also conform to the guidelines concerning documentation to be submitted to the
United Nations human rights treaty bodies established by the General Assembly (HRI/GEN/2/Rev.6).
See CAT/OP/12/6 and the Committee’s general comment No. 2 (2007) on the implementation of
article 2.
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