With regard to the Department’s response, the NPM emphasised that it was familiar with the problems regarding the admittance to secure departments of SCI, especially due to the lack of beds in these departments. The Ombudsman has been pointing out this problem for a long time, and striving for the issue to be resolved as soon as possible. We did however point out that court decisions are merely a legal basis for detaining a patient in a department of a psychiatric hospital under special supervision. If the hospital determines that detention is no longer necessary, it may at any time decide to move the patient to an open department or discharge them from the hospital. For compliance with the ZDZdr it just needs to notify the court of this fact. The Ministry of Health stated that it sees several obstacles to the implementation of recommendations which require investments. These recommendations will be implemented in accordance with financial capabilities. b) Use of daytime clothes For several years, the NPM has been reiterating its recommendation that patients who are not being treated for an acute problem or whose reason for treatment is somatic be allowed to wear ordinary daytime clothes during the day (more on this can be read in the general report of the Ombudsman for the year 2017). With such recommendations, which follow international standards and the recommendations of international supervisory bodies, it is not an irrelevant fact that NPM recommendations are also supported by professional standards, as the Extended Expert Council for Psychiatry with the Ministry of Health emphasised already in 2009 that it agrees that the clothes worn by people who are hospitalised in secure departments of psychiatric hospitals are exceptionally important for their self-image and personal dignity. We therefore made the following recommendation during this year’s visit to the Department: • The NPM recommends that the Department enables patients in Unit D1 who are not being treated for an acute problem to wear daytime clothes (e.g. tracksuits and similar). In its response to the preliminary report, the Department stated that, together with occupational therapy and the department’s social services, they set up a storage space for donated clothes in early June 2017, and have arranged for the washing of the clothes within the available capacities, so that more possibilities will exist for wearing these clothes even if the patients do not themselves have them. In some units, the patients can wash their clothes by themselves, under supervision and as part of occupational therapy, and information on this matter will be provided regularly at weekly groups with the staff and in the group with social workers, especially with regard to the donated clothes from the store. The washing of clothes will shortly be scheduled as a daily activity and the schedule will be posted on the units’ notice boards. c) Use of special precautionary measures During its visits, the NPM pays special attention to the implementation of SPM, as such measures (the ZDZdr defines two such measures, i.e. physical restraint using belts, and restricting movement to a single room) are an especially strong encroachment on the freedom of movement of an individual patient. It therefore always checks how the measures are implemented, how records are kept, how the people stipulated by the law are notified, and checks the duration of the measure. When checking the reasons for the implementation, the NPM usually asks for the help of the external expert, i.e. a psychiatrist. During this year’s visit to the Department, we made several recommendations regarding SPM, including the obligation of providing information on the implemented, and considering any special characteristics when installing the (protective) belt on a wheelchair. We emphasise two recommendations, which refer to the content of the forms that the staff must complete at the time of implementing SPM and update for the duration of the measure, and a recommendation regarding the removal of belts after the duration of the measure (a similar recommendation was also made by the CPT during its visit to the Unit): • The NPM believes that waiting for amendments to the ZDZdr cannot be the reason for the Department not adapting (as recommended by the NPM) the forms which are currently used during 64 IMPLEMENTATION OF THE DUTIES AND POWERS OF THE NPM IN 2017 NATIONAL PREVENTIVE MECHANISM UNDER THE OPTIONAL PROTOCOL TO THE UN CONVENTION AGAINST TORTURE AND OTHER CRUEL, INHUMAN OR DEGRADING TREATMENT OR PUNISHMENT