With respect to the demand to reduce occupancy, the Sigmund Freud Regional Neurological and Psychiatric Hospital stated that the number of patients in a room could be reduced, which would mean the loss of at least four nursing positions. Until the completion of the structural expansion, they are attempting to compensate for the deficit by keeping two beds in the six-bed rooms free for patients whose placement is interrupted. However, there is an obligation to offer these patients a bed again, if necessary. Since the goal is to provide the patients with “their own” bed again, the number of beds actually set up cannot be reduced at the present time. Bed must be kept free The Federal Ministry of Justice regards this compromise with the standard of the CPT to be acceptable considering the renovation concept that is already in existence. It is true that the CPT did not comment on the living conditions at the Sigmund Freud Hospital during its last visit in February 2009. However, the CPT has repeatedly recommended the creation of a therapeutic environment with single rooms and small placement units (most recently after reviewing a forensic psychiatry station at a Lisbon hospital in July 2012, CPT/Inf [2013] 4). The CPT also recommends singlepatient rooms In light of this, the NPM welcomes the efforts of the Federal Ministry of Justice to encourage the competent legal entity to quickly expand the forensic station at the Sigmund Freud Regional Neurological and Psychiatric Hospital.  If six-person rooms cannot be separated structurally, setting up mobile partitions can increase privacy. 2.5.6 Deficits with respect to restraints – forensic department of the Hall Regional Hospital In the course of a visit to the forensic department of the Hall Regional Hospital, the commission found that a female patient had been restrained for over 14 hours. Thereupon, the commission inspected the nursing documentation. It was their conclusion that the documentation did not show that the nursing staff was continuously present during the restraint of the patient. This conclusion was supported by the fact that the patient had wet the bed repeatedly during the period of restraint and, according to her own statement, had to lie in the urinesoaked bed for about 30 minutes. The delegation also found that no mitigating measures had been documented. In addition, there was no documentation of a debriefing session with the patient. Tied down and left alone The delegation then visited the isolation room with the restraint bed. According to some commission members, this room had a “frightening character” and triggered associations with photos of Isolation room is reminiscent of a “death row cell” 107

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