CAT/OP/BOL/3 101. The Subcommittee was informed that the hospital had recently introduced the use of electroconvulsive therapy. The Subcommittee is concerned about the absence of a complaints mechanism and legal assistance services which would allow patients to report torture and ill-treatment. 102. The Subcommittee notes with concern the lack of judicial oversight of the confinement of persons declared unfit to stand trial in a criminal court. The absence of any form of interaction between judicial authorities and such persons means that the period of confinement may continue even after the disability has been overcome. 103. The infrastructure at the National Institute of Psychiatry is adequate. However, the Subcommittee observed that some rooms and spaces in the inpatient units were so scantily furnished that they were totally impersonal. Rooms contained nothing more than a bed and a bathroom; common areas appeared to have only dining tables and some plastic chairs. 104. The Subcommittee recommends that the State party should: (a) Enact mental health legislation regulating the operation of public and private psychiatric institutions in the country; (b) Implement legislative and administrative measures to prevent patients from being admitted and remaining in psychiatric hospitals for socioeconomic reasons and adopt a strategy for the deinstitutionalization of patients who have been admitted on the basis of disability and/or poverty and neglect; (c) Set up a complaints mechanism that is readily accessible to persons who are institutionalized in psychiatric hospitals and provide information about its existence in accessible formats; (d) Conduct regular inspections in psychiatric hospitals and deliver training to staff on the international obligations relating to the protection of the human rights of persons with disabilities, as established in the Convention on the Rights of Persons with Disabilities. VI. Situation of vulnerable groups A. Indigenous justice system 105. The Subcommittee notes the progress made in connection with the indigenous justice system, including the advances represented by a number of decisions handed down by the Constitutional Court and the drafting of a protocol for coordination and cooperation between the ordinary and indigenous courts. However, the Subcommittee regrets that, because certain material and territorial matters are excluded from the scope of the indigenous justice system, the Jurisdiction Demarcation Act does not conform to the Constitution or to international law. Consequently, the Subcommittee is concerned that, in practice, access to justice is still impeded for certain sectors of the population. 106. The Subcommittee met with indigenous community leaders who claimed that, even where it is legally possible, judges in the ordinary justice system do not refer cases to the indigenous courts because of cultural issues. Furthermore, the Subcommittee learned of violations of due process rights in the ordinary justice system, such as when hearings are indefinitely adjourned owing to a lack of indigenous-language interpreters.27 107. The Subcommittee notes with concern that the excessive use of pretrial detention disproportionately affects indigenous persons because their situation does not allow them to meet the requirements for alternative measures: they are asked to provide a fixed address, even when they live in community villages, and to declare a formal occupation, though they often work in the informal sector of the economy. 108. Confinement is particularly harmful to the physical and psychological health of indigenous persons because detention facilities have not been designed to accommodate 27 18 Caso de Adolfo Chávez, de lengua indígena tacaña, por ejemplo. GE.18-12272