4.2. Ill-treatment Treatment of patients by staff During a visit to the Psychiatric Hospital of Batumi Medical Centre,282 the monitoring team found that, as in previous years, the rude treatment by staff was still taking place in the facility.283 The above was confirmed by the director of the facility and was noticed by the monitoring team as well. As for the National Mental Health Centre, the Special Preventive Group did not receive any information about physical or verbal abuse by staff during its visit to the facility.284 It should be emphasized that the administration and medical staff of the facility are indifferent towards patients/beneficiaries. The Special Preventive Group describes conditions in the 2nd and 7th wards, as well as in the shelter, as extremely degrading. In addition, the patients’ needs, including relating to somatic health, are neglected. These issues are discussed in detail in the relevant chapters of the report.285 In addition to the above, the Special Preventive Group found that the staff of the National Mental Health Centre used the labour of patients/beneficiaries in exchange for giving them cigarettes or extra portions of food. Some patients/beneficiaries clean toilets, yards, bring food from the kitchen, help staff to care for other patients or to physically restrain an agitated patient. The Special Preventive Group assesses this practice as an exploitation of patients/beneficiaries’s labour,286 because on the one hand, patients are unable to engage in other meaningful and therapeutic activities as an alternative, and on the other hand, they are forced to agree to the above in order to satisfy their needs relating to food and cigarette. Visits to both facilities revealed that formally voluntary patients287 could not leave the facility voluntarily, as in previous years. Patients sign a written informed consent form without having adequate information.288 Sometimes psychological pressure is exerted on patients in order to persuade 282 September 18-19, 2019. Manifested in verbal and physical abuse. 284 22-25 April, 2019. 285 See chapters on physical Environment and somatic health. 286 Abuse of position of vulnerability, United Nations Office on Drugs and Crime (UNODC), Concept of Exploitation in the Trafficking in Persons, p. 21, available at: <https://bit.ly/3118bRo> [last accessed: 20.01.2020]. 287 It should be noted that during the visit of the Special Preventive Group, only one patient was involuntarily placed in the Psychiatric Hospital of Batumi Medical Centre and three patients - in the four divisions of the National Mental Health Centre. 288 For example, there was a case when the informed consent was signed by one of the patients of the National Mental Health Centre, even though the patient could not to read or write. In addition, the patient says he was against the placement at the hospital when the relevant decision was made and still remains against the inpatient treatment. 283 101