Psychiatric hospitals 3.  Coercive measures The practice followed in the visited establishments is to use coercive measures against aggressive patients by restraining them with safety straps and administration of sedatives. In the majority of the cases, sedatives prove to be sufficient, so restraint as a coercive measure is used rarely and only in exceptional cases. However, the representatives of the Mechanism found that the documentation of the use of coercive measures in several establishments was inconsistent or kept unreliably, e.g. the extension of restraint was recorded before the actual decision on extension was made246, the duration of coercive measure application and the time when it started were not recorded, the reasons for the relevant decision were presented with various degrees of precision, the doctors did not extend the measure at required intervals247, the documents lacked the stamp or the signatures of the doctors248 and the invalid coercive measure report cards were used249. The analysis of CCTV recordings revealed that the entries in the documents (patient restraint checklists) were untrue. The restrained patients were not examined, although the entries confirming the examination were made in the checklist. In yet another case, the analysis of CCTV recordings revealed that the time of controls performed did not correspond to the time recorded in the checklists250. The representatives of the Mechanism also drew the attention of the hospital staff to the need to ensure intimacy to patients while using coercive measures. In some establishments251 patients restrained with straps were staying in the common rooms and were not separated in any way (e.g. with a screen) from other patients in the same room252. 4.  Disciplinary procedure The detained patients in psychiatric hospitals should not be disciplined, since it is not for the medical staff to react to potential misdeeds and offences. The visiting team only allows for financial liability for damages caused by the patient who is an adult. However, in some of the visited establishments various forms of usually unconstructive punishments are used, including collective responsibility which the Voivodeship Psychiatric Hospital in Warta Voivodeship Psychiatric Hospital in Warta, Voivodeship Psychiatric Hospital in Olsztyn 248 Regional Forensic Psychiatry Centre in Gostynin. 249 Voivodeship Hospital for Neurotic and Psychiatric Patients in Suchowola. 250 Autonomous Public Voivodeship Hospital in Gorzów Wielkopolski 251 Autonomous Public Voivodeship Hospital in Gorzów Wielkopolski, Voivodeship Hospital for Neurotic and Psychiatric Patients in Suchowola, Voivodeship Psychiatric Hospital in Olsztyn 252 See: § 7(2) of the Ordinance of the Minister of Health on using and documenting the coercive measures and the assessment of the justification for their use (Dz. U. of 2012, item 740). 246 247 97