Report on the Performance of Activities of the National Preventive Mechanism for 2016 around 20. According to available information, even though funds had been available already in 2016, the construction could not have started given that it took one year for project documentation to be drafted, whereas now, building permit is waiting to be issued. Persons with mental disorders who do not have Certain persons with mental disorders supplementary health insurance are still charged who do not have supplementary health a participation fee during involuntary insurance are still being charged a hospitalization in psychiatric institutions, unless participation fee during involuntary their diagnosis is indicated in the decision of hospitalization in psychiatric institutions, Croatian Health Insurance Fund on the list of which is unacceptable. diagnoses the treatment for which is completely covered by compulsory health insurance, which is unacceptable. We made unannounced visits to the Department for Psychiatry of the Clinical Hospital Centre Rijeka and Department for Psychiatry of the Pula General Hospital. Moreover, after receiving a request for help because of difficulties experienced during work performance caused by unacceptable workplace conditions, we made targeted visits to the Psychiatric Hospital for Children and Youth as well as Department for Child and Adolescent Psychiatry of the Clinical Hospital Centre Osijek. Following completion of our visits, even though no conduct that could represent torture was established, there were those that may be classified as degrading and even inhuman; therefore, 10 warnings and 20 recommendations were issued. Considering that means of coercion restrict the rights of persons with more serious mental disorders, in 2016 we devoted more attention to their use. During our visit to Department for Psychiatry of the Clinical Hospital Centre Rijeka, we found a patient who was cumulatively being subject to the measures of isolation and restraint, which not only is contrary to the Ordinance on Types and Manner of Applying Means of Coercion on Persons with Serious Mental Disorders, but this may also constitute an infringement of Article 3 of ECHR, as was already established by ECHR Decision in the case M.S. v. Croatia (2015). At the same time, it is necessary to take into account that the premises used by this Hospital, for implementing the measure of isolation, are completely inadequate and that it is unacceptable that they are being used for this purpose. Even though Ordinance on Means of Coercion lays down that a restrained patient should be placed alone in a room always when this is possible, they are usually restrained in front of other patients. Thus, during our visit to the Department for Child and Adolescent Psychiatry of the Clinical Hospital Centre Osijek, we established a case of a child being subject to the measure of restraint while in an eight-bed hospital room, in front of adult patients, which may represent a security risk; in addition, being seen by other patients may cause a feeling of low self-esteem and may represent degrading treatment. Due to high number of unfilled systematized job positions for nurses / medical technicians, restraint procedures and measures are not always possible to carry out in accordance with the Ordinance on Means of Coercion – stipulating that such measures should be carried out by at least five persons – especially during the night or on weekends, which may result in violation of 33

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