the drawing up of a treatment plan for each patient. It should involve a wide range of
rehabilitative and therapeutic activities, including access to occupational therapy, group
therapy, individual psychotherapy, art, drama, music and sports. Patients should have
regular access to suitably-equipped recreation rooms and have the possibility to take
outdoor exercise on a daily basis; [...]
§ 40 Regular reviews of a patient's state of health and of any medication prescribed is
another basic requirement. This will inter alia enable informed decisions to be taken as
regards a possible dehospitalisation or transfer to a less restrictive environment. [...]
There were no experts (psychiatrists, psychologists) on the NPM team visiting
psychiatric hospitals, and hence the team was not able to assess treatments offered to
the patients. Representatives of the National Preventive Mechanism reviewed though
access to therapy workshops in each visited establishment. In one hospital the room for
therapy workshops was flooded and it was difficult to assess these activities, due to
their temporary cessation. Patients could read books from modest libraries and had
access to the tv room (the Institute of Psychology and Neurology in Warsaw). After
the visit, the Deputy Director of the Institute informed that the room had been already
repaired and that therapeutical workshops were held there.
In another hospital, patients said there were no therapeutical workshops at all
and they could only watch television, while „social life takes place in the smoking
room”). They also complained about limited possibilities to walk outside. According
to the medical personnel, those restrictions were linked to the state of the patients, to
the aggravation of their state in some cases, and to security reasons (Klinika
Psychiatrii Samodzielnego Publicznego Szpitala Klinicznego Nr 1 at Szczecin).
The lack of an efficient system of social therapy and rehabilitations leads to the
conclusion that only pharmacological treatment is delivered to those patients.
c) Treatment of patient and direct restraint
8th General Report on the CPT's activities [CPT/Inf (98) 12]
§ 44 [...] the CPT also pays close attention to the attitude of doctors and nursing staff. In
particular, the Committee will look for evidence of a genuine interest in establishing a
therapeutic relationship with patients. It will also verify that patients who might be
considered as burdensome or lacking rehabilitative potential are not being neglected.
§ 47 In any psychiatric establishment, the restraint of agitated and/or violent patients may
on occasion be necessary. This is an area of particular concern to the CPT, given the
potential for abuse and ill-treatment.
§ 48 [...] The CPT has on occasion encountered psychiatric patients to whom instruments of
physical restraint have been applied for a period of days; the Committee must emphasise
that such a state of affairs cannot have any therapeutic justification and amounts, in its view,
to ill-treatment.
§ 49 [...]Seclusion should never be used as a punishment.
§ 50 Every instance of the physical restraint of a patient (manual control, use of instruments
of physical restraint, seclusion) should be recorded in a specific register established for this
purpose (as well as in the patient's file). The entry should include the times at which the
measure began and ended, the circumstances of the case, the reasons for resorting to the
measure, the name of the doctor who ordered or approved it, and an account of any injuries
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