- 14 C.
Patients' living conditions and treatment
32.
The CPT closely examines patients' living conditions and treatment; inadequacies in these areas can
rapidly lead to situations falling within the scope of the term "inhuman and degrading treatment". The aim
should be to offer material conditions which are conducive to the treatment and welfare of patients; in
psychiatric terms, a positive therapeutic environment. This is of importance not only for patients but also for
staff working in psychiatric establishments. Further, adequate treatment and care, both psychiatric and somatic,
must be provided to patients; having regard to the principle of the equivalence of care, the medical treatment
and nursing care received by persons who are placed involuntarily in a psychiatric establishment should be
comparable to that enjoyed by voluntary psychiatric patients.
33.
The quality of patients' living conditions and treatment inevitably depends to a considerable extent on
available resources. The CPT recognises that in times of grave economic difficulties, sacrifices may have to be
made, including in health establishments. However, in the light of the facts found during some visits, the
Committee wishes to stress that the provision of certain basic necessities of life must always be guaranteed in
institutions where the State has persons under its care and/or custody. These include adequate food, heating
and clothing as well as - in health establishments - appropriate medication.
living conditions
34.
Creating a positive therapeutic environment involves, first of all, providing sufficient living space per
patient as well as adequate lighting, heating and ventilation, maintaining the establishment in a satisfactory state
of repair and meeting hospital hygiene requirements.
Particular attention should be given to the decoration of both patients' rooms and recreation areas, in
order to give patients visual stimulation. The provision of bedside tables and wardrobes is highly desirable, and
patients should be allowed to keep certain personal belongings (photographs, books, etc). The importance of
providing patients with lockable space in which they can keep their belongings should also be underlined; the
failure to provide such a facility can impinge upon a patient's sense of security and autonomy.
Sanitary facilities should allow patients some privacy. Further, the needs of elderly and/or
handicapped patients in this respect should be given due consideration; for example, lavatories of a design
which do not allow the user to sit are not suitable for such patients. Similarly, basic hospital equipment
enabling staff to provide adequate care (including personal hygiene) to bedridden patients must be made
available; the absence of such equipment can lead to wretched conditions.
It should also be noted that the practice observed in some psychiatric establishments of continuously
dressing patients in pyjamas/nightgowns is not conducive to strengthening personal identity and self-esteem;
individualisation of clothing should form part of the therapeutic process.
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