alleged violence against a patient and sending a notification to the investigating authority. Also, in 2020,
the State Agency for Regulation of Medical and Pharmaceutical Activities has not examined the cases of
involuntary hospitalization of patients receiving formally voluntary psychiatric care.
For protection of the patients’ rights, it is essential the institutions to introduce a unified in-hospital
complaints review and feedback procedure, which should be human rights centered, accessible, simple,
fair and transparent. It should be noted that despite the recommendation issued by the Public Defender,
the Law of Georgia on Psychiatric care still fails to regulate complaints review and feedback procedures.
Methods of physical restraint were also specified at the legislative level. Notwithstanding the abovenoted, a number of important issues related to restraint procedures remain beyond the legislative
regulation. In particular, the Law on Psychiatric Care only refers to verbal reassurance and medical
treatment as methods of de-escalation,384 while many other effective methods of de-escalation exist. In
addition, the instruction on the implementation of physical restraint was not amended to determine the
obligation to develop a special register / journal; place and circumstances of the restriction; specific
characteristics of used special means; obligation to document the injury and staff obligation to interview
the patient.
The Public Defender has been discussing the problem of long-term hospitalization for years and considers
that the measures should be taken immediately to solve this problem. The first task is to assess the needs
of the patients placed in the psychiatric institutions for more than 6 months in order to discharge them
from the institution and refer them to the community-based services, as well as to develop a plan for
setting up housing based on the number of future beneficiaries of the shelter. Unfortunately, this was not
done in the reporting year. The Ministry informed us with a letter that, within the technical assistance of
the French Development Agency, a study on the geographical location of services is underway, which will
form the basis for the development of a plan for the deinstitutionalization of mental health services.
With one of the recommendations, the Public Defender, aiming the deinstitutionalization in the
psychiatric institutions in 2020, demanded the assessment of the patients and the transfer of those
beneficiaries to the services close to the family environment who do not require inpatient treatment. This
recommendation has been partially implemented. It should be noted that in 2019, long-term housing
designed for 24 beneficiaries was opened in Batumi. In addition, according to the information provided
by the Ministry, 4 more housings will be built in Kutaisi, Poti and Senaki during 2021-2022.
The Public Defender welcomes the activities of the Ministry and further notes that the measures to be
taken in terms of housing should be based on needs assessment and evidence. However, it is important
one institution not to replace another, the newly created one, as the institutions are not compatible with
deinstitutionalization policies. In order for service beneficiaries to become independent and have the
opportunity to engage in public life, it is important for the state to prioritize accelerating the
384
Law on Psychiatric Care, Article 16.1
118
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