- 12 III.
INVOLUNTARY PLACEMENT IN PSYCHIATRIC ESTABLISHMENTS
A.
Preliminary remarks
25.
The CPT is called upon to examine the treatment of all categories of persons deprived of their liberty
by a public authority, including persons with mental health problems. Consequently, the Committee is a
frequent visitor to psychiatric establishments of various types.
Establishments visited include mental hospitals accommodating, in addition to voluntary patients,
persons who have been hospitalised on an involuntary basis pursuant to civil proceedings in order to receive
psychiatric treatment. The CPT also visits facilities (special hospitals, distinct units in civil hospitals, etc) for
persons whose admission to a psychiatric establishment has been ordered in the context of criminal
proceedings. Psychiatric facilities for prisoners who develop a mental illness in the course of their
imprisonment, whether located within the prison system or in civil psychiatric institutions, also receive close
attention from the CPT.
26.
When examining the issue of health-care services in prisons in its 3rd General Report (cf. CPT/Inf
(93) 12, paragraphs 30 to 77), the CPT identified a number of general criteria which have guided its work
(access to a doctor; equivalence of care; patient's consent and confidentiality; preventive health care;
professional independence and professional competence). Those criteria also apply to involuntary placement in
psychiatric establishments.
In the following paragraphs, some of the specific issues pursued by the CPT in relation to persons who
are placed involuntarily in psychiatric establishments are described.10 The CPT hopes in this way to give a
clear advance indication to national authorities of its views concerning the treatment of such persons; the
Committee would welcome comments on this section of its General Report.
B.
Prevention of ill-treatment
27.
In view of its mandate, the CPT's first priority when visiting a psychiatric establishment must be to
ascertain whether there are any indications of the deliberate ill-treatment of patients. Such indications are
seldom found. More generally, the CPT wishes to place on record the dedication to patient care observed
among the overwhelming majority of staff in most psychiatric establishments visited by its delegations. This
situation is on occasion all the more commendable in the light of the low staffing levels and paucity of
resources at the staff's disposal.
Nevertheless, the CPT's own on-site observations and reports received from other sources indicate that
the deliberate ill-treatment of patients in psychiatric establishments does occur from time to time. A number of
questions will be addressed subsequently which are closely-linked to the issue of the prevention of ill-treatment
(e.g. means of restraint; complaints procedures; contact with the outside world; external supervision).
However, some remarks should be made at this stage as regards the choice of staff and staff supervision.
10
As regards psychiatric care for prisoners, reference should also be made to paragraphs 41 to 44
of the Committee's 3rd General Report.
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