5. INVOLUNTARY PSYCHIATRIC TREATMENT 5.a. Institutional intervention: Transfer of persons with mental disorder symptoms for involuntary examination and hospitalization The general provisions regarding the duties of police personnel make no explicit reference to involuntary psychiatric treatment and namely to the recommended manner to treat patients during their transfer for involuntary psychiatric treatment or hospitalization. In many cases, patients are treated as dangerous individuals for public order and safety. They are transferred in a police car, in handcuffs and many times restrained behind their back (article 147 of P.D 141/1991 on the mechanical restriction of transferees) and under police custody, even when the sight of uniformed personnel intensifies their agitation and potential health issues. Many times they are not even given an explanation for their "arrest" or where they are taken and on occasions the police personnel uses improper expressions, namely "you are crazy", "we will take you to the madhouse", etc. At times, the patients ask the police officers to allow them to dress properly, as they are forced to leave their home without notice and they are not allowed to put on proper clothes. It has also been observed that transferred patients are held in the police station for hours or even overnight or for days until they are finally transferred to the proper institution, especially if this is situated in another prefecture or until a second on-duty psychiatrist becomes available. They are being held in custody suites or in a different area. This is partly justified by article 188 of P.D 141/91 regarding protective custody. The Ombudsman has repeatedly remarked that these circumstances are particular and under no circumstances are these citizens to be treated as arrested offenders nor is their transfer to take place in a manner that constitutes a brutal insult to human dignity. The use of restraint is considered disproportionate as a means of restriction of an arrested individual who does not put on any resistance, let alone for a citizen that is transferred as a patient and is fully cooperative or when police assistance is required in order to provide him with the necessary medical aid. The Ombudsman has addressed a letter to the Prosecution Office of the Supreme Civil and Criminal Court of Justice (Areios Pagos) requesting the issuance of relevant recommendations towards the local prosecution offices and the Hellenic Police. 5.b. Special issues that emerged in 2019 In most psychiatric clinics, organizational and functional gaps cause severe difficulties in managing cases of crises that occur in agitated patients. In particular, in 57