Institutions for persons with disabilities Medical and therapeutic care limited The commissions reported that residents had different experiences with medical care during the pandemic. Whereas in one of the facilities visited in Vienna a general practitioner held surgery hours in the same building and was therefore available at all times, others reported that doctors’ visits were stopped completely. General practitioners were often reachable by telephone, there were, however, few house visits. In this context, the NPM would like to point out that there were problems with medical care in some facilities even before the pandemic. There was an extreme case of a facility in which a doctor prescribed all of the psychotropic medication once a year for twelve months and made no further house visits and had no other contact with the patients after that. It cannot be satisfactory if the availability of medical care continues to decrease during a pandemic. The public administration has to develop concepts here to provide persons who live in such facilities equal access to medical care. What complicated the situation further during the pandemic was the fact that external therapies had to be cancelled or postponed. In this context, the NPM would like to refer to a recommendation of the Human Rights Advisory Council, which emphasised that during the COVID-19 pandemic health care includes therapeutic programmes such as physio, logo and psychotherapy. A pandemic plan must thus include how these programmes can best be maintained while observing hygiene standards. X Medical care shall be guaranteed nationwide; even in institutions and facilities in remote places. Deficits have an even stronger impact in crisis situations. X Therapy programmes are a component of medical care and should therefore be available at all times to the extent possible. 2.4.8 Prevention of violence The lockdown was extremely difficult for persons who have aggressive outbursts and display particularly challenging behaviour because of their disability. The residents experienced great uncertainty due to the continuing emergency situation, the almost complete loss of social contacts and being “locked up” in the facility. Increased potential for aggression in some cases due to emergency situation 97 Several institutions and facilities reported that some of the residents’ potential for aggressive behaviour increased during the lockdown. Persons became increasingly nervous, displayed stereotypical behaviour and shouted a lot. There were also reports of physical violence towards other residents and the staff. The situation was exacerbated by staff shortages in some facilities.