National Preventive Mechanism
be stressed that enabling patients to accomplish daily rituals - such as eating in proper conditions - represents an
integral part of programs for psychosocial rehabilitation of patients. Table setting during nutrition process is a
factor which should not be ignored either.”71
Private companies in accordance with executive contracts provide nutrition for newly opened facilities. As to the old
establishments (Qutiri, Surami, Khelvachauri, Gldani, and Bediani) food is being cooked on site. During the
monitoring process, the Group did not receive any particular complaints on food quality at the establishments. In
some of them, for instance, in Bediani, exists a rather positive practice when menu for the upcoming week is agreed
with the patients and, subsequently, posted publicly. In some establishments menu is not available to patients at
all (Referral).
In addition, it shall be noted that the Monitoring Group observed cases related to nutrition service which were
not in compliance with CPT recommendations.
Firstly, it should be mentioned that during nutrition process patients of the establishments are using spoons
only. As found out, they have no knives or forks and so the nutrition process cannot be called normal. In addition
to that, there is no enough dining room space for all patients (Referral Hospital) so they have to wait for their turn
to eat. Therefore, in the new establishments where food is delivered already cooked, some patients are not able to
eat it in hot condition.
Walk
None of the establishments allow patients t o have independent outside walks notwithstanding o f voluntary or
non-voluntary status of patients. The doors of every establishment/division are locked and guarded by a security
officer or orderly. Any movement of patient outside the building should be approved by a doctor or a nurse. In
Asatiani Establishment, Psychiatric Department of Gudushauri Hospital, Tbilisi mental Health Centre the
Group was informed that doctors make the list of those patients who are allowed to walk outside independently.
In Bediani establishment patients enjoy relatively greater extent of freedom – the door of the hospital is open
an patients can move around the courtyard freely (they are not allowed to leave the courtyard). In the courtyard there
is always an orderly supervising the patients. Often in such cases it is difficult to differentiate orderly from patients, and
such practice might, in a sense, be perceived as a stimulus for establishment of informal relationship between personnel
and patients. The patients placed in the Psychiatric Department of Referral Hospital, Psychiatric Department
of Hospital N5 and Senaki Dispensary do not have possibility to go for walk. Non-existence of recreation area
aggravates the situation. Even food is served in wards where the patients spend the most of their time.
As one employee of Gudushauri Psychiatric Department said, previously patients were allowed to go for a walk in
the common courtyard of the Hospital which was better arranged and larger compared to department’s courtyard.
Nowadays patients can walk only in the department’s courtyard – it was decided so by the new administration of
the hospital who stated that patients with mental disordered created discomfort to others by their odd behavior.
The same employee also noted that doctors make the list of patients who are allowed to freely move outside t h e
territory of the Hospital. The question of the Monitoring Group whether there was at least one incident justifying
prohibition of walks in the common courtyard was answered negatively.
The aforementioned fact deserves special attention as it comprises elements of discrimination of persons with
mental disorders. As UN Principles for the Protection of Persons with Mental Illness and the Improvement of Mental
Health Care provide “There shall be no discrimination on the grounds of mental illness”.72
The patients of Gudushauri facility state that they are allowed to one-hour outdoor walks twice a day in the internal
courtyard.
71
72
8th General Report, para. 35.
Principle 1, para. 4;
www.ombudsman.ge
NPM Report
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