Poročilo Varuha človekovih pravic Republike Slovenije o izvajanju nalog državnega preventivnega mehanizma za leto 2011 V enem izmed zavodov smo nadalje kritizirali predvsem ugotovljene zamude pri pošiljanju predlogov sodišču za podaljšanje zadržanja oseb, ki so nastanjene na varovanem oddelku. Ta zavod pred sprejemom v varovani oddelek navadno pridobi soglasje pooblaščenca/ skrbnika za poseben primer in »formalno« tudi privolitev stanovalca, ki pa sicer (kot je zavod sam pojasnil) ni zmožen sodelovati v postopku sprejema. Zato o sprejemu zavod nato obvesti sodišče, ki tudi odloči o dopustnosti zadržanja. Čeprav ima tudi DPM nekatere pomisleke glede sedanje zakonske ureditve sprejemov na varovani oddelek, pa smo morali zavod opozoriti, da s takšnim ravnanjem krši trenutno veljavni predpis. Na varovanih oddelkih smo, razen v enem, pogrešali na vidnem mestu izobešen seznam pravic, ki jih imajo osebe na takem oddelku po ZDZdr. Prav tako nobeden od varovanih oddelkov ni imel izobešenega seznama zastopnikov pravic oseb na področju duševnega zdravja. V enem izmed zavodov so pojasnili, da je bil seznam pravic na oglasni deski, a ga je očitno nekdo odstranil. DPM je zato zavodom predlagal, da poskrbijo za namestitev seznama pravic in zastopnikov. V kar treh od obiskanih zavodov na varovanih oddelkih ponoči ni zagotovljene stalne navzočnosti osebja. Dogajanje na hodniku varovanega oddelka zaposleni (navadno dva na zavod) spremljajo (zgolj) po videonadzoru v dežurni sobi, ki je zunaj oddelka, po varovanem oddelku pa opravljajo le občasne nočne obhode (na približno dve uri) oziroma se odzivajo na klice. Dva zavoda imata dežurno sobo na varovanem oddelku, kar zagotavlja na tem oddelku večjo navzočnost osebja v nočnem času. V enem izmed obiskanih zavodov, kjer so ponoči trije zaposleni, pa je zagotovljena celo stalna navzočnost vsaj enega zaposlenega na varovanem oddelku. Glede na to, da stanovalci varovanega oddelka praviloma ne znajo uporabljati klicnih zvončkov, je po mnenju DPM stalna navzočnost zaposlenega bistvena za hitro odzivnost zaposlenih in za zagotavljanje varnosti stanovalcev na oddelku. V vseh obiskanih zavodih so nam zagotovili, da posebnih varovalnih ukrepov (PVU) ne uporabljajo. Smo pa v enem primeru opazili, da ima zavod nastavljeno evidenco »List evidentiranja fiksacije s pasovi Segufix«, kar bi lahko kazalo, da se takšni pasovi vendarle uporabljajo. O izvedenih fiksiranjih na posteljo smo našli tudi zapise, ki so bili sicer zelo pomanjkljivo izpolnjeni. Iz evidence ni bilo razvidno, da bi fiksacije odobril zdravnik, koliko časa so dejansko trajale, praviloma ni bilo zapisanih dodatnih opozoril in opažanj ipd. Zavodu smo zato predlagali, naj dosledno upošteva zahteve ZDZdr, tako glede načina odobritve uporabe PVU, obveščanja, časovnih omejitev in vodenja evidenc. Ker so v nekem zavodu fiksacije stanovalcev izvajali kar z rjuho, je DPM zavod opozoril, naj fiksacij ne izvaja z improviziranimi pripomočki, saj je tako izvedena fiksacija lahko neprimerna, neudobna in celo nevarna. Na vseh varovanih oddelkih so za stanovalce oddelka organizirane dejavnosti, ki se jih stanovalci udeležujejo glede na zmožnosti in interese. Pogosta je tudi praksa, da se stanovalci varovanega oddelka vključujejo v dejavnosti zunaj oddelka (npr. v delovno terapijo, ki poteka v prostorih delovne terapije; spremljajo jih na prireditve, ki jih organizira zavod ipd.). Takšno ravnanje ocenjujejo kot dobro, saj prispeva h kakovostnejšemu preživljanju časa za stanovalce, ki so sicer omejeni na varovani oddelek in s tem preprečuje tudi njihovo socialno osamo. Glede pritožbenih poti ugotavljamo podobne pomanjkljivosti kot pri lanskih obiskih. Tako smo opomnili osebje varovanih oddelkov, kjer ni nameščenih nabiralnikov, ki bi omogočali anonimno oddajo pritožb, saj stanovalci nimajo prostega dostopa do nabiralnikov zunaj oddelka. Poleg tega so pritožbene poti nejasne, če zavodi nimajo pravilnika/navodil glede postopka notranjega reševanja pritožb. DPM namreč meni, da je pomembno, da so stanovalci seznanjeni, kako bo njihova pritožba obravnavana in kdo je odgovoren za njeno obravnavo. 52 Državni preventivni mehanizem v Republiki Sloveniji po Opcijskem protokolu h Konvenciji OZN proti mučenju in drugim krutim, nečloveškim ali poniževalnim kaznim ali ravnanju Implementation of the Duties and Powers of the National Preventive Mechanism in 2011 Furthermore, in one of the institutions, we criticised the established delays in submitting proposals to the court to renew the detention of persons accommodated in the secure ward. Before admission to the secure ward, this institution normally obtains consent from the representative/custodian for special cases and ‘formally’ also the resident’s consent, who is (according to the institution) unable to participate in the admission procedure. The institution also notifies the court of the admission, which decides on the permissibility of the detention. Although the DPM also has several considerations concerning the valid legal regulation of admissions to the secure ward, we had to warn the institution that such conduct violated the applicable rules. In all secure wards except one, we noted that there was no list of rights of persons exhibited in a visible place in such wards under ZDZdr. Nor was a list of representatives of the rights of persons in the field of mental health found in any of the secure wards. It was explained in one of the institutions that the list of rights had been posted on the bulletin board, but that someone must have removed it. The DPM suggested that the institutions provide lists of rights and of representatives. In three of the visited institutions, the personnel are not constantly present in the secure ward at night. The employees (usually two per institution) monitor the halls of the secure ward (only) through video-surveillance in the duty room, which is outside the ward, and perform periodic night rounds (every two hours) in the secure ward or respond to calls. The duty room in two institutions is located in the secure ward, which ensures the greater presence of personnel on this ward at night. In one of the visited institutions, where three employees stay overnight, the constant presence of at least one person in the secure ward is provided. Considering that the residents of the secure ward usually do not know how to use call bells, the constant presence of an employee is, in the opinion of the DPM, essential for a quick response from personnel and for the safety of ward residents. We were assured at all the visited institutions that special protection measures (PVU) were not used. However, we noticed that one institution had prepared records entitled ‘Records of restraint using Segufix belts’, which could indicate that such belts were in fact being used. We also found records on bed restraint, which were insufficiently completed. The records did not show whether the restraint had been approved by a doctor, its duration, and usually did not include additionaI warnings or observations. We proposed that the institution strictly observe the recommendations specified in ZDZdr, both in terms of approving PVU, time limits and record-keeping. Because one institution performed restraint of residents by means of a sheet, the DPM warned them not to use improvised means, as such restraint may be inappropriate, uncomfortable and even dangerous. Activities are organised in all secure wards which are attended by the residents according to their abilities and interests. It is common practice for the residents of the secure ward to participate in activities outside the ward (e.g. occupational therapy on the premises for occupational therapy; residents are escorted to events organised by the institution, etc.). We consider such conduct good, as it contributes to improving the quality time of residents, who are otherwise restricted to their ward, and prevents their social isolation. As far as complaints procedures are concerned, we observed similar irregularities as in previous visits. We had to reprimand the personnel of the secure wards, where there are no collection boxes to file complaints anonymously, since the residents do not have free access to collection boxes outside the ward. Moreover, the complaints procedures are not clear if the institutions do not have rules/instructions concerning the internal resolution of complaints of the DPM, it is important for residents to know how their complaints will be treated and who is responsible for that. National Preventive Mechanism in the Republic of Slovenia under the Optional Protocol to the UN Convention against Torture and Other Cruel, Inhuman or Degrading Treatment or Punishment 53