2.4.4 Use of “time-out rooms” The CPT has developed standards for involuntary detention in “timeout rooms”, which apply to psychiatric institutions and facilities. The CPT is very worried about several issues, including increasing use of this measure and states that placing persons in time-out rooms without accompanying measures is not necessarily a milder measure than restriction of freedom by way of medication or mechanical means or other restrictions and may never be used as punishment. Time-out rooms may never be used as punishment In one facility, Commission 2 found numerous inadmissible restrictions of freedom that had been legally established by a court decision. They referred to the use of two time-out rooms for two residents who were extremely aggressive against third parties and, apart from this case, to the use of restrictions of freedom by mechanical means and by way of medication. Numerous inadmissible restrictions of freedom By reviewing all court judgements, the NPM found that the court of first instance spoke out against the routine use of time-out rooms because the previous use of milder measures had not been documented. In specialist literature, the use of time-out rooms as a therapeutic measure in curative educational settings is furthermore highly disputed. This is viewed as helpful only under very narrow framework conditions and may only be used for a very brief period of time, if at all. The subsequent investigative proceedings showed that the facility had undertaken a number of effective measures in order to implement the judgements issued in accordance with the Nursing and Residential Homes Residence Act. One of the two time-out rooms was closed completely. As far as the other room was concerned, within one year, they were successful in minimising forced placement in this room by 75%. The capability to consciously manage feelings and inner tension is important, particularly in socially challenging situations: interpersonal closeness, conflicts, disappointments and rejections as well as when expressing and implementing wishes and expectations. Such everyday situations and frustrations place excessive demands on some people to such a degree that they react with uncontrolled rage, moodiness, reproaches, impulse outbursts, aggression, but also emotional numbness, loss of self-esteem, or emotional withdrawal. Time-out rooms can, however, be easily misunderstood by intellectually impaired persons with personality disorders as a personal rejection and this can provoke new escalations. 81