A/HRC/40/59/Add.2 74. The collective rooms accommodating juvenile inmates do not always have sanitary facilities inside, obliging them to ask the guards for permission to access the bathroom during the night. Furthermore, the mattresses provided for the juveniles did not appear to be fireproof and there were no fire extinguishers placed within reach, thus entailing a considerable risk of death in case of fire. VIII. Psychiatric institutions 75. The Special Rapporteur acknowledges that the National Mental Health Act (Act No. 26657) of 2010, in force since 2013, is an important step towards guaranteeing the rights and adequate treatment of persons with mental health conditions or psychosocial disabilities. In practice, however, there seem to be extreme discrepancies in the implementation of these norms. While Braulio Aurelio Moyano hospital in the city of Buenos Aires appeared to offer generally adequate material accommodation, the situation of patients institutionalized at Alejandro Korn neuropsychiatric hospital in the city of La Plata (also known as Melchor Romero hospital) was completely incompatible with human dignity. In particular, patients residing in the acute section of the hospital, both male and female, were subjected to clearly inhuman and degrading conditions. The building accommodating these patients was found to be literally falling apart, sanitary installations were broken and toilets and bathroom were found to be filthy and flooded. To overcome the shortage of staff, some patients were reportedly forced to take excessive amounts of medication, including sleeping pills, and no action was taken to keep the premises in an acceptable sanitary state. Left without proper care and attention, patients capable of doing so were changing the diapers of those with more severe disabilities so as to maintain a minimum level of personal hygiene. It is the considered view of the Special Rapporteur that the acute sections for both women and men in the neuropsychiatric hospital are beyond repair, absolutely unfit for the accommodation of human beings and, therefore, must be closed without delay and replaced with adequately staffed and equipped institutions where patients with psychosocial disabilities can live and be treated with human dignity in accordance with their specific needs. 76. Furthermore, in the Aurelio Crespo hospital in Cruz del Eje, the staff did not appear to be properly trained in providing care for patients with specific needs, and allegedly tend to resort to physical means of restraint and unjustified containment practices, such as tying patients to their beds, or the use of threats and beating, in order to keep the patients under control. In that institution, the Special Rapporteur was also able to verify the existence of an isolation room. 77. The Special Rapporteur is concerned at the alleged use of electroconvulsive therapy and electroshock treatment, medication as the primary basis of therapy, and prolonged hospitalization for social rather than medical reasons. He is also concerned at irregularities linked to medical records, and at the absence of informed consent by the patients concerned for hospitalization that is formally qualified as “voluntary”. The Special Rapporteur notes with concern the insufficient availability of community-based mental health services for people with psychosocial disabilities for such services to be effective. IX. Other persons in vulnerable situations A. Pregnant women and women with children in detention 78. While the Special Rapporteur welcomes the fact that Act No. 26472 (Custodial Sentences Enforcement) provides for the possibility of house arrest for convicts with dependent children, this measure seems to be rarely applied in practice, and there seems to be a general lack of alternatives to the deprivation of liberty for women with children that would be in line with the United Nations Rules for the Treatment of Women Prisoners and Non-custodial Measures for Women Offenders (the Bangkok Rules) and with standards relating to the best interests of the child. 14