National Preventive Mechanism During the monitoring the Group members examined the infrastructure of all the abovementioned establishments and held confidential interviews with patients therein. The Group members also interviewed the administration personnel, medical personnel, social workers and lawyers of the establishments. During the monitoring all documentation and record books of the establishments were also checked. Monitoring was a i m e d to check compliance of conditions, treatment and nursing methods with the rules established under Georgian legislation50 and international/European standards51. It is a positive feature that the Group members did not encounter obstacles in any establishment during the monitoring. The administrations and staff of the facilities demonstrated their readiness to render assistance. The Group members did not confront with any limitations to move through the territory of the facilities, to interview patients therein and to have access to the documentation. GENERAL OVERVIEW One of the main priorities of the monitoring was to evaluate treatment of patients. It shall be noted that practice of illtreatment by personnel is almost eliminated in the psychiatric establishments, however in several instances the patients still indicated they were subjected to rude treatment by this or that nurse (or nurse’s assistant (orderly). Patients, as a rule, were satisfied with living conditions in the newly opened establishments. The main concern for them was “to go home” as they were not allowed to. The physical restraint is used in absolute majority of facilities. The aim of the Monitoring Group was to check whether this procedure was resorted to in compliance with relevant laws and standards. In rare cases the restraint was allegedly used to punish the patients. In certain cases fixation record book indicating information on time and duration of fixation, as well name of person responsible for fixation, was not processed. As found out by the Monitoring Group, some facts were not registered in the record book even if the latter was processed in the establishment. The liquidation of psychiatric establishment located on Asatiani Street, Tbilisi is one of the major positive changes in psychiatric treatment field; this establishment was substituted by several psychiatric establishments - Rustavi Mental Health Centre, M. Asatiani psychiatry Institute, psychiatric Division of Referral Hospital, Psychiatric Department of Academician O. Gudushauri National Medical Centre and Psychiatric Division of Hospital №5. This change positively influenced the living conditions of majority of patients – newly built and refurbished establishments are equipped with standard, new furniture and equipment and all facilities are naturally lighted as rather wide windows were installed therein. The Monitoring Group positively mentions that the newly opened facilities have no window gratings; however this change has its adverse effects too – the windows cannot be opened for security/safety reasons and accordingly natural air ventilation in rooms and in the majority of corridors is not available; in addition, no ventilation systems are installed. As the Monitoring Group members have learnt on site, these newly opened establishments were intended for shortterm, so called acute patients; accordingly the equipment is designated for intensive supervision and not to create a quiet, cozy environment for patients. Every bed has fixation equipment, the bedroom door has 1/3 of glass windows and the door locks and handles can be removed from outside enabling the administration to lock it from outside, while toilets and bathrooms cannot be locked from inside. As found out by the Monitoring Group, the long-term, so called 50 51 Law of Georgia on Psychiatric Assistance, law of Georgia on Rights of Patients, Order #87/n of the Minister of Labour, Health and Social Aff airs on approval of Rules concerning Placement in Psychiatric Hospital. Principles on Protection of Persons with Mental Illness and the Improvement of Mental Health Care adopted by the UN General Assembly Resolution N46/119 dated 17 December, 1991; Recommendation No. R(83)2 Concerning the Legal Protection of Persons Suff ering from Mental Disorder laced as Involuntary Patients adopted by the Committee of Ministers of the Council of Europe; Recommendation Rec(2004)10 of the Committee of Ministers to member states concerning the protection of the human rights and dignity of persons with mental disorder ; Recommendation 1235 (1994) on psychiatry and human rights adopted by the Parliamentary Assembly of the Council of Europe;, 8th General Report of European Committee for the Prevention of Torture and Inhumane and Degrading Treatment or Punishment (CPT). www.ombudsman.ge NPM Report