CAT/OP/GAB/1 generally wear white coats and the patients have an open regime. Patients are generally accompanied all the time by a family member, which seems to have a positive effect on the treatment and, in particular, facilitates the patient’s return and reintegration into the family and the community. 96. The Subcommittee is seriously concerned by the lethargic state of the patients it met, caused by the uniform and virtually systematic administration of high -dose neuroleptics (mainly Haldol). It notes that these treatments are administered with out a thorough health check being conducted on admission and often without the prior consent of the patient or his or her family. The Subcommittee notes that the drug treatment of patients who are not enrolled in the National Health Insurance and Social Guarantees Fund is paid for entirely by the patients’ families. 97. The Subcommittee is also concerned by the isolation cells used for patients during acute attacks, which have bars and do not have mattresses, so that the patients have to lie on the floor. 98. The Subcommittee is alarmed by the unacceptable living conditions in the closed ward of Melen hospital, where the sanitary conditions are extremely poor, there is a putrid smell of faeces and there are no showers or furniture, notably mattresses or beds. It also notes the report received during its visit that the Governor of Libreville sometimes asks for “stray people” to be “rounded up” and placed without their consent in the isolation ward of the psychiatric hospital. The Subcommittee notes that patients held in the ward are sometimes detained for several months in inhuman and degrading conditions that can be construed as torture. 99. The Subcommittee recommends that living conditions in Melen psychiatric hospital be improved and that the closed ward be shut down immediately. It calls on the authorities to establish clear procedures for decisions to place a patient in an isolation cell. The Subcommittee also recommends that a multidisciplinary approach be adopted when developing treatment plans, which must be adapted to each patient, and that the doses of neuroleptic drugs be kept to what is strictly necessary. The medical treatment of patients who are not registered with the National Health Insurance and Social Guarantees Fund should be paid for by the hospital. It also recommends that sufficient human and financial resources be allocated to the mental health sector, more qualified psychiatrists be recruited and hospital facilities be equipped with adequate infrastructure for both leisure and work. 100. The Subcommittee also recommends that the authorities adopt a mental health policy in line with the obligations assumed on ratification in 2007 of the Convention on the Rights of Persons with Disabilities and develop a national strategic plan to that effect. VII. Repercussions of the visit and conclusion Repercussions of the visit 101. In some of the places visited, including Libreville and Port -Gentil criminal investigation departments, the fear of reprisals was ubiquitous. The Subcommittee noted on several occasions that detainees were afraid to express themselves freely with the delegation and some even claimed that they would certainly be subjected to ill-treatment for having talked to the Subcommittee members. 102. The Subcommittee also fears that disciplinary action might be taken against the Commander of Port-Gentil central police station, who — without the consent of his GE. 15-10283 19/24