ANNEX - CASE STUDIES ON GOOD PRACTICES ANNEX 3: GERMANY – REFORM OF THE ACT ON CRIMINAL LAW-RELATED COMMITTAL TO A PSYCHIATRIC HOSPITAL OR AN INSTITUTION FOR WITHDRAWAL TREATMENT IN NORTH RHINE-WESTPHALIA (STRUG NRW) The StrUG came into force on 31.12.2021. It standardises detention according to sec 63, 64 Criminal Code (StGB) in the Land of North Rhine-Westphalia (NRW).508 Until the reform, the legal text was largely unchanged since 1999, apart from isolated amendments. The revision of the legal text was due to multiple reasons: • In its decision of 4 May 2011, the Federal Constitutional Court (FCC) demands, amongst other things, the compliance with the principle of proportionality, a therapyand freedom-oriented enforcement of the detention • Empirical knowledge of the treatment of persons with psychosocial disabilities has evolved • The average period of detention is 10.2 years in North Rhine-Westphalia, which is longer than the national average. 33% of those placed under sec 63 Criminal Code had been detained for more than 10 years as of December 31, 2017.509 Treatment, except for compulsory medical measures, is only permissible based on the right to self-determination. For this reason, persons concerned are no longer referred to as patients but as detainees (untergebrachte Person) in the legal text, who may or may not undergo treatment on a self-determined basis. According to sec 3, the detainees' dignity and personal integrity must be respected and protected. Life in forensic psychiatric detention is to be adapted to the general living conditions outside, provided that security concerns do not prevent this. De- 122 tainees shall be given space and opportunity to maintain and develop their individuality. In addition, detainees have a right to appropriate accommodation, food, treatment and care (sec 3 para 2). However, the principle of individual accommodation is missing entirely. Currently, facilities of forensic psychiatric detention are overcrowded. Often, overcrowding leads to multiple occupancy of rooms. The lack of privacy can trigger conflicts and disrupt therapeutic treatment.510 However, at least double rooms are common even without overcrowding: Often psychiatric hospitals for forensic psychiatric detention are orientated towards regular hospitals (including general psychiatry) where rooms with at least two beds are the standard. Of course, it should be noted that the duration of detention is generally much shorter in general hospitals. In addition to complying with the principle of proportionality, the FCC demands that forensic psychiatric detention be oriented toward therapy and liberty. This includes the requirement for individualization of treatment, which must offer a realistic prospect of release.511 In order to achieve the objective of rehabilitation, detainees have a legal right to the removal of restrictions on their liberty.512 The degree of deprivation of liberty is based on the predicted danger (sec 4 para 1) and expressed in levels (sec 4 para2), meaning that measures to deprive a person’s liberty must be defined and justified. The degree of deprivation of liberty is indicated in degrees: from 0 (little: the detainee is entitled to live outside the facility in an external facility or their own home) to 4 (intensive: the primary place of residence of the detainee is the facility. They are not entitled to leave it). This new direction is important: the focus no longer lies on measures that need to be assessed (and granted), but interventions are to be defined and justified from the point of view of ensuring the protection of the general public. With its decisions in March 2011 and July 2018, the FCC strengthened the right of self-determination of detainees. The UN Convention on the Rights of Persons with