On 2 October 2017, we again visited Maribor University Hospital; this time the Unit for Forensic
Psychiatry (Unit). This was a review visit to see how the recommendations provided by the CPT during
its 2017 visit are being observed. In its report on the visit, the CPT made 14 recommendations. The NPM
established that the Unit has accepted but not yet (fully) implemented nine recommendations, while
the remaining five recommendations, including some of a more systemic nature, have also not been
implemented. It was recommended that the Unit seriously starts to implement the recommendations,
and that it makes every effort to implement the CPT’s recommendations in the shortest possible
time. During the visit, two new recommendations were made regarding the provision of systemic or
legal conditions for the Unit’s operation. We are still waiting for the response to these recommendations.
The general finding after the visit was that the situation in the Unit is improving, both in terms of
shortage of space and patient satisfaction. There is of course still room for improvement, as indicated
by the CPT’s recommendations.
Room in the Unit for Forensic Psychiatry
Restraint bed
Joint findings with recommendations
a) Overcrowding
Especially with regard to the visit to the Department, it was established that occasionally capacities in
individual departments under special supervision are exceeded. Overcrowding not only has a major
effect on the quality of the patients’ living conditions, but also results in increased workload for the
staff. All this can affect safety in the department and consequently also the frequency of using special
precautionary measures (SPM). Overcrowding has an especially negative effect when it comes to the
use of such measures, as due to the shortage of space, additional beds are being placed in rooms which
are intended exclusively for the implementation of SPM. This means that physically restrained patients
are exposed to other patients or even their visitors, which is not only unpleasant but also degrading to
the restrained patient. The unacceptability of such implementation of SPM was also pointed out by the
CPT during its previous visits. As a result of this overcrowding, we made the following recommendation
during this year’s visit to the Department:
• We recommend that, together with the Ministry of Health, the Department finds an appropriate
solution which will prevent the exceeding of capacities in individual departments under special
supervision, and finds an appropriate solution for physically restraining patients in a way that
separates the patient from other patients (unless they explicitly agree otherwise).
In its response to the preliminary report, the Department explained that every year capacities in individual
departments under special supervision are exceeded at specific times of the year, and that they depend
on the increase in the number of urgent admittances at the time, which is beyond the influence of the
Department. In recent years, the length of stay in departments under special supervision has been getting
longer, mainly due to patients who are hospitalised in the context of the ZDZdr – emergency treatment
without consent or under a court decision ¬– for whom the duration of hospitalisation is stipulated by
a decision, and whose medical condition implies further admittance to social care institutions (SCI),
whereby the department is bound to the court proceedings and free beds in institutions. This is a fact
beyond its influence, and part of the solution could be to shorten the duration of court proceedings and
to regulate the situation of available beds in these institutions.
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
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