CAT/OP/PRT/1/add.1
c) additional measures are taken to support the establishment of community
based services, in order to aid the discharge of patients who are only in long term
hospital care because of their lack of access to community care.
92.
During 2018, combined efforts of the Ministry of Justice and the Health Ministry lead
to improvements on mental health quality in prison establishments. These efforts have
resulted on the publication of the Decree-Law 70/2019 24th May that adapts the rules
applicable to the execution of internment measures of persons not criminal responsible and
with psychological disorders in mental health units not integrated in the prison system.
93.
This decree-law implements Article 126 of the CEPMPL and it reaffirms the principle
of preference regarding the execution of measures applied to persons with psychological
disorders in non-prison mental health units, whenever security reasons allow it. This will
favour their rehabilitation and their reintegration into the family and social environment,
whenever possible.
94.
Another example of those efforts is the inventory of patient’s situation admitted in the
Psychiatric and Mental Health Clinic of Santa Cruz do Bispo in order to assess a possible
revision of their internment and their release under Articles 92, 93 and 94 of the Criminal
Code. A report of the working group established for this purpose under the Ministerial Order
No. 5744/2018, of 11 June was completed and sent to the responsible ministers on the 25 th
February 2019.
95.
Recommendations a) and c) made in the report correspond to problems detected at
least 10 years ago, when the first National Mental Health Plan (NMHP) was drawn up.
During the austerity period (starting at 2011), implementation of the NMHP was halted,
affecting mainly the development of multi-disciplinary teams in the community. In 2018 the
Government decided to relaunch the NMHP, reinforcing the principles of community
psychiatry and the development of multidisciplinary teams.
97.
By 2019, the Ministry of Health has programmed the development of 5 community
teams, one in each health region of the country.
98. Regarding rehabilitation, several socio-occupational units were created in the last year,
as well as home support teams, under the auspices of the Integrated Continuing Care program.
However, there is still a significant need to increase human (non-medical) resources and
structures in the community, in order to compensate for the lateness of the mental health care
network, namely outside the big cities.
99.
With regard to recommendation (b), the Monitoring Committee has developed a
manual of compulsory hospitalization procedures for dissemination in mental health services.
100. The SPT further recommends that mental health professionals be provided with
adequate training on international human rights standards, particularly the CRPD. In
addition, the number of psychiatrists, nurses, psychologists, occupational therapists,
and social assistants should be increased.
101. Since 2018, the CRPD has been addressed at various regional and national meetings,
involving not only psychiatrists but also other professionals (eg, other mental health staff,
lawyers, judges, etc.). The incorporation into the Mental Health Law of CRPD concepts will
be an important driver of change in mental health practice.
102. With regard to human resources, the Government is aware of the needs, which are
fully described in official Referral Networks documents, for both adults and
children/adolescents populations. The National Mental Health Taskforce/DGS acknowledges
the need to increase the number of mental health teams in the community, since this is a
crucial barrier to mental health reform in Portugal.
11
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