National Preventive Mechanism Qutiri Psychiatric Establishment. During the monitoring of this establishment none of the patients complained on ill treatment. However, it should be mentioned, that during the reporting last year period several patients submitted complaints to Public Defender concerning alleged ill-treatment from staff, basically from security officers. Investigation was launched concerning one case based on the recommendation of Public Defender. The written submissions from the establishment, mentioned reprimands for 14 employees, however no ill-treatment facts were identified.53 Bediani Facility Patients claim that some orderlies treat them roughly and scornfully. As a rule, patients do not discuss this issue with “bosses” (they mean director and doctors) as they feel awkward. “The orderlies shout on patients. Once I asked the orderly the reason for shouting and he answered: to have fear of me.” Patients did not confirm facts of beating. Some of them cannot confirm facts of rude treatment either. One of the patients declared that “beating is excluded”. Another patient mentioned a conflict between an orderly and a patient – the orderly tried to wake up the patient rudely and the latter reacted aggressively. “Generally [orderlies] are not rude”, the same patient added. While answering questions on reasons for dismissal of employees, the patients said that drinking or escape of patient might serve as such reason. Shouting might serve as a basis for reprimand. The director clarified that due to the geographical location of the establishment the decisions on dismissal of personnel should be cautious as there are little hopes to hire a better employee. In addition, he said “they are not afraid of loss of 300 GEL”. Therefore he prefers to use strict reprimands and control behavior of orderlies rather than fire them. The director of the establishment mentioned one case when he saw the orderlies making the patients to unload the tracks (food products). He decided to use disciplinary measures against them. Khelvachauri Psycho-Neurologic Hospital. Some patients claimed rude treatment from orderlies and other patients. One patient claimed that two weeks before, upon arrival at the hospital he was beaten by staff members and placed in the isolation room (he was a voluntary patient). In some establishments (Khelvachauri Psycho-Neurologic Hospital, Psychiatric Department of Hospital N5, Surami Psychiatric Hospital, Qutiri) the patients also claimed that some other patients are quite violent, even showing signs of physical aggression. The personnel either do not notice such facts or do not react adequately upon them. The reason for this gap is insufficient number of personnel and their improper training. At any case this issue should be properly addressed by the administrations of psychiatric establishments. The National Preventive Mechanism of Public Defender considers that prevention of conflicts and all forms of violence among patients, as well as appropriate response to such cases should be main concern for the assisting staff. The mere existence of such conflicts clearly indicates to insufficient attention of personnel towards patients or lack of professionalism. One of the reasons of this problem can also be inadequate number of staff members. The 8th Report of European Committee for the Prevention of Torture (CPT) states: “It is also essential that appropriate procedures be in place in order to protect certain psychiatric patients from other patients who might cause them harm. This requires inter alia an adequate staff presence at all times, including at night and weekends. Further, specific arrangements should be made for particularly vulnerable patients; for example, mentally handicapped and/or mentally disturb edadolescents should not be accommodated together with adult patients“ (para. 30). For the prevention and record of ill-treatment it is recommended that trauma record book is run in every establishment indicating trauma of a patient, date, trauma origin (according to patient’s explanation) and assistance rendered. It is also recommended to run the record book for external visual examination upon admission to the hospital that should register physical injuries of a patient upon admission and their origins. At the present moment such information is recorded in nurse’s journal or patient’s medical history paper. Accordingly, the Monitoring Group did not have an access to systematized information. There are neither indications nor 53 Our question tried to find out the cases of disciplinary measures for improper treatment towards patients; apparently, the 14 cases of administrative misdemeanours were not related to treatment with patients. www.ombudsman.ge NPM Report