Report on Conditions in Psychiatric Establishments in Georgia record of the patient’s mental and somatic state of health and of his treatment. The patient should be able to consult his file, unless this is considered to be irrelevant from a therapeutic standpoint. And the patient as well as his family member or lawyer may request the information of the medical file. “ In accordance with the UN standards: „A patient in a mental health establishment shall be informed as soon as possible after admission, of all his or her rights in accordance with these Principles and under domestic law in a form and a language understandable by the patient.“84 Accordingly, it is desirable that an introductory brochure setting out the establishment’s internal regulations and patients’ rights be issued to each patient on admission in a language he/she understands. In the majority of establishments patients had a little information concerning their disease, treatment and expected outcomes. They also were not aware of diagnosis and said that the doctor better knows what is good for them. The question, posed by Monitoring Group, whether patients received explanation regarding the duration and volume of treatment, was answered negatively by patients. The only regrettable exception is that in order to seek consent of the patient the doctors usually explain to the patient that in case they do not sign the consent document they will have to stay in the facility for at least 6 months, and if they sign the document, they will be “set free/ discharged” in the nearest future. Furthermore every patient signs the informed consent document in Georgian regardless the fact whether the patient speaks Georgian or not. Doctors clarified that Georgian document is approved officially and if there is a form in other language in medical file, it will be considered as violation. National Preventive Mechanism considers that in order to ensure that patients are adequately informed an establishment has to ensure translator for non-Georgian speaking patients. As already mentioned, the majority of patients were sure that they were unable to revise their decision on voluntary treatment after signing the relevant consent form. The majority even did not know what did they sign. They noted that when signing they were anxious or under psychotropic medications and accordingly could not realize what they were signing. Some of them even stated that they had not signed any document, though later they could vaguely recall signing the documents only after the Group showed them the signed form. National Preventive Mechanism strongly believes that the patient shall be offered to sign document on information only when he/she is able to understand his/her own state/condition. COMPLAINTS MECHANISMS Appe against involuntary placement decision The possibility of a patient to appeal against court’s decision on involuntary placement has a paramount importance in terms of protection of patient’s rights. Accordingly, all legal instruments concerning persons with mental disorders focus on this issue. Article 25 of Recommendation Rec(2004)10 of the Committee of Ministers of Council of Europe specified the requirements for states that are necessary for ensuring the right of appeal for patient. 84 85 Principles for the protection of persons with mental illness and the improvement of mental health care, adopted by General Assembly resolution 46/119 of 17 December 1991, Principle 12. 8th General Repot, Para. 53 NPM Report 2012 CPT considers that in any place of deprivation of liberty, an effective complaints procedure is a basic safeguard against ill-treatment in psychiatric establishments. Specific arrangements should exist enabling patients to lodge formal complaints with a clearly- designated body, and to communicate on a confidential basis with an appropriate authority outside the establishment.“85