As is the case in prisons, all patients deprived of their liberty must be given at least one hour of 82 outdoor exercise per day. newly-admitted patients are segregated as a precautionary measure. The facility does not make case-by-case decisions on whether segregation is necessary for each new arrival. In another facility, it was clear from the patient files that some patients had been segregated without interruption for a period of several months, with no access to the clinic’s wider community. One facility had segregation rooms containing only a bed and a non-partitioned toilet. The amount of daylight entering the room is limited by frosted glass. Furthermore, segregated patients had nothing with which to occupy themselves – like a book, for example. Segregation constitutes a huge interference with rights of personality and should be limited to the shortest possible period of time. This matter must be reviewed closely in order to bring about a relaxation of the measure as soon as possible. In psychiatric institutions in particular, it is important to avoid any negative effects on mental health which might arise when patients have insufficient social contacts and are in constant isolation – particularly when they have no way of occupying themselves. Interpersonal contact helps achieve the aim of rehabilitating criminal patients. 7.2.6 – Over-occupancy There have been repeated cases of over-occupancy in several of the visited psychiatric facilities. In one facility in Baden-Württemberg, patients were accommodated in corridor beds. This is not an appropriate form of accommodation, as patients do not have the option of spending time alone. In one facility in Bavaria, an additional mattress with no bed frame was placed on the floor of the patient room whenever over-occupancy occurred. In such cases, lying on a mattress on the floor is humiliating for the person concerned. In cases of over-occupancy, several facilities in Bavaria, Lower Saxony and North Rhine-Westphalia also accommodated patients in rooms that were already at full capacity. This meant that patients had only a very confined space available to them, with no protection afforded to their privacy. As a general rule, over-occupancy should be avoided. However, humane living conditions must be guaranteed whenever over-occupancy does occur. 7.2.4 – CCTV monitoring 7.2.7 – Ability to lodge a complaint In some facilities, certain areas and patient rooms are monitored via CCTV. Persons held in psychiatric institutions should not be subjected to uninterrupted and indiscriminate CCTV monitoring. Under no circumstances can CCTV monitoring replace the presence of members of staff. The reasons for CCTV monitoring must be documented. In addition, the person concerned must be informed that monitoring is taking place. The mere fact that the camera is visible is not sufficient. It must be possible for the person concerned to discern whether the camera is running. In some facilities in Baden-Württemberg, Bavaria and Lower Saxony, patients were unable to lodge an anonymous complaint. Other facilities, for example, provide complaints boxes on the wards. A complaints box outside of a closed ward cannot be accessed by patients who are not allowed to use any of the exits. Mentally ill patients on closed wards in particular may encounter huge difficulties when trying to contact a complaints body. A patient advocate can act as an intermediary in such situations. Publishing the contact details of patient advocates or an ombudsman can make it possible for patients to lodge a complaint. The necessary contact details should be hung up in the wards so they are clearly visible to patients. In North Rhine-Westphalia, visual recordings in psychiatric institutions are in fact prohibited under section 20 of the Land Mental Health Act. 7.2.8 – Confidentiality of phone calls 7.2.5 – Outdoor exercise In the visited wards in Baden-Württemberg, Bavaria and Saxony, the National Agency observed that phone calls could either be made in the corridor of the living area without partitions, or only in the presence of a member of staff. Measures should be introduced to ensure that phone calls can be made confidentially. Examples from other facilities include phone booths, cordless Not all of the visited facilities gave patients the opportunity to exercise outdoors on a daily basis. Due to an unsuitable building design and the lack of suitable outdoor areas, only a small balcony was available for spending time outdoors in facilities in Baden-Württemberg and Bavaria when staff were unable to accompany patients outside. 82 Cf. CPT/Inf (2007) 18, paragraph 161 (Neustadt Psychiatric Centre) and, most recently, CPT/Inf (2014) 25, paragraph 139. 58