3. Healthcare facilities »»»»»»» 3. Healthcare facilities 6 visits 1 hospital for long-term patients 3 psychiatric facilities for adults 2 psychiatric facilities for children Summary report on psychiatric hospitals The Report entitled Forensic Treatment, Restraints and Other Topics deals with the performance of institutional forensic treatment, use of electroconvulsive therapy and restrictive measures, complaints and documentation and reporting of medical findings on ill-treatment. While we did not find any wilful ill-treatment, we encountered a number of very risky situations and conditions that, considering the cumulative effect, could have reached the threshold of ill-treatment for some individuals (e.g., a very strict long-term regime associated with isolation and lack of activities, long-term use of restrictive measures). Furthermore, the conditions at some units pose a threat to the staff and patients; specifically, the environment contains dangerous elements, drugs are sneaked into the units and the number of personnel does not correspond to the demands of the target group. The report was completed at the time when discussions where held on CPT’s recommendations and also on the issue of critical overcrowding of forensic treatment facilities. A number of recommendations are thus directed towards the Ministry of Health and the Ministry of Justice. We will continue negotiating on them in 2020. Summary report, overview of systemic ­recommendations from p. 116 Systemic problems of forensic treatment ― The State does not specify the capacity of hospitals that should be dedicated to forensic treatment or material and personnel requirements on hospitals. Many hospitals are overburdened, lack sufficient staff and improvise in ensuring safety and security of the relevant units. ― Lacking policy of forensic treatment as a whole, its concept both in hospitals and in out-patient care and prisons. As a result, patients remain in detention for longer than necessary and appropriate. The specific needs of minors are disregarded. ― The legal framework of forensic treatment has serious gaps. Some cases of interference with the patients’ rights lack any legal basis (restriction of going outside, removal of personal belongings, use of cameras and bars). In practice, there are also doubts as to the rules of involuntary treatment and there is no legal regulation on the transfer of patients to another hospital and interruption of institutional forensic treatment. The Defender therefore requests that a policy of forensic treatment be prepared and recommends that the hamber of Deputies request the Government to present a bill that would comprehensively regulate the issue of forensic treatment. Defender’s legislative recommendations in Annual report 2019 14