Correctional institutions Lack of space persists As far as the available space is concerned, the commission upholds the criticism that small double rooms fail to meet modern psychiatric standards. In this context, it is not overlooked that already before the last monitoring visit (in September 2017) a four-bed room had been divided into two two-bed rooms, which is positive. The criticism also still applies that women cannot access the terrace without intervention. With regard to this matter, the office of the regional government of Vorarlberg stated that additional conversion costs amounting to millions (should) be avoided in any case if – due to open questions regarding the further development of Rankweil Regional Hospital – they end up having to be posted as “lost” costs in a few years time. Conversion by 2024 X The Vorarlberger Krankenhaus-Betriebs GmbH company did not contest this statement, mentioned however that the implementation of the master plan for the construction of a new building for adult psychiatry is on schedule. The building should be taken into operation in 2024. The living conditions in a hospital are determined to a considerable extent by the amount of available space. This applies, in particular, to wards in which patients are not merely housed temporarily. 2.5.9.3 Insufficient documentation - Hall Regional Hospital Appreciative meeting A delegation of Commission 1 visited the Forensic Ward A6 of Hall Regional Hospital in July 2020. The cooperation on the part of the contacts with the delegation on this visit was exemplary too. An open and honest meeting ensued. All of the requested information was disclosed and documents provided. There are several positive observations in the visit report. These include that the documentation is now maintained in accordance with the Hospitalisation Act and measures that restrict freedom are reported to the patient advocacy. Documentation incomplete Of two documentation procedures viewed, one was incomplete because the reason for isolation was not fully mentioned. The self-harm was only verbally presented as suicidality. The justification in the documentation is “protection of the patient”. Attempted less severe alternatives to isolation are not mentioned. Measures that restrict freedom shall only be used in isolated cases if the type, extent and duration are essential for averting danger to the life and health of the patient or others, or for medical treatment or care, and they are not disproportionate to their purpose. 129