1.6 Visit to the Idrija psychiatric hospital
In Chapter 5 of the report on the use of special protection measures,several cases were highlighted
by the NPM where the notification deadline was not respected and this makes the recommendation
of the NPM justified. We agree with the hospital that legal and ethical reasons can restrict the length
of the notification for the relative, and that its update should consider this aspects and study the
admissibility of notifying about the data on reasons for application of special protection measures and
other circumstances to the relatives.
The NPM suggests the hospital to ensure that the available medical documentation on application of
individual protection measures always includes a clear note on which less severe measures have been
taken before the introduction of special protection measures and why the same effect could not be
achieved using less severe measures.
It is recommended that the hospital ensures that the application of special protection measures is
always prescribed by the doctor - this should also be evident from the form on the application of a
special protection measure. There should also be enough space to precisely state the reasons for the
application of special protective measures.
In its response report, the hospital stated that the application of special protection measures is usually
prescribed by the doctor except when it comes to a sudden psychotic raptus and auto- or heteroaggressive behaviour. Medical personnel must immediately notify the doctor about the urgency of
a special protection measure. The hospital states that the time of application of special protection
measure is visible from the current form which is used in the hospital. The reasons for application of
special protection measures are already stated in the current form. These are:
- On the patient’s request.
- In order to provide medical treatment (such as infusion, probe etc.).
- Remedy or managing dangerous behaviour (risk of injuries, inventory damage etc.).
- Incapability of managing their behaviour due to a condition (such as intoxication with a psychoactive
substance, delirium as a part of dementia etc.).
- Other (description of reasons for special protection measures is given by the psychiatrist).
In order to obtain an overall image of the mental condition which resulted in the use of a special
protection measure, it is necessary to read “the blue paper” on which the medical personnel notes
the previous procedures taken to avoid the use of special protection measures, such as supportive
conversation, de-escalation techniques, physical activity - walking in the hall, switching to a conversation.
Prior application of a regularly prescribed therapy or received therapy, if necessary, is evident from the
patient chart. A form for direct observation is also available - it includes the date, time, movement,
walks or referral of patients and the signature of the person who is in charge of the patient. In the
future, the hospital intends to update the form of the hospital records on special protection measures
by merging the existing forms; this will contribute to a greater transparency in the implementation of
special protection measures.
It should be pointed out that the “end time” section was left unfilled in many examined cases. Since not
filling in this section might suggest a violation of the legal provision on maximal duration of the special
protection measures, it is recommended that the hospital warns the personnel that it is necessary to fill
in this section of the Records of the application of a special protection measure form.
The NPM suggests that a leaflet of the individual unit is given to the patients and relatives upon admission
to the hospital, a leaflet on the Mental Health Act and rights of the patients in the special surveillance
units should be given to these patients upon admission.
It is noteworthy that this recommendation of the NPM will be taken into account by the hospital.
IMPLEMENTATION OF THE DUTIES AND POWERS OF THE NPM IN 2013
NATIONAL PREVENTIVE MECHANISM UNDER THE OPTIONAL PROTOCOL TO THE UN CONVENTION AGAINST TORTURE AND OTHER CRUEL, INHUMAN OR DEGRADING TREATMENT OR PUNISHMENT
131
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