1. Psychiatric hospitals During the reporting year, the Chancellor inspected six hospitals providing inpatient psychiatric care: the Pärnu Hospital psychiatric clinic, Wismari Hospital, the Kuressaare Hospital psychiatric clinic, the North Estonia Medical Centre psychiatric hospital, the Tartu University Hospital psychiatric clinic and the Viljandi Hospital psychiatric clinic. A couple of hospitals (Tartu University Hospital and Viljandi Hospital) now keep electronic records of events concerning restriction of the rights of individuals. The living conditions in the acute department of the North Estonia Medical Centre have been significantly improved compared to the last inspection. Smaller hospitals are also making an effort to expand possibilities for therapy, and many places have hired an activity supervisor or an occupational therapist. At the same time, the hospitals still have problems with drawing up treatment documents and using unjustifiably extensive video surveillance of patients. The inspections revealed that Kuressaare Hospital, Wismari Hospital and Pärnu Hospital did not always draw up decisions on involuntary treatment in time and in compliance with requirements. The liberty of patients undergoing treatment voluntarily is restricted arbitrarily if they are not allowed to leave the hospital or means of restraint are used on them. If on arrival in hospital a patient consents to treatment and to a stay in hospital, but at some point their condition requires them to be restrained, a decision on involuntary treatment must be drawn up after determining the need for restraint. Only the psychiatrist who directly assessed the patient’s condition may make a decision on involuntary treatment without court authorisation. Twenty-four-hour video monitoring of all patients in wards without exception unjustifiably interferes with the fundamental right of individuals to privacy. For example, extensive video surveillance was used in the acute department of the psychiatric clinic of the North Estonia Medical Centre, the Pärnu Hospital psychiatric clinic, and the Tartu University Hospital psychiatric clinic. Cameras were located in rooms for common activities (corridors, dining rooms and activity rooms), as well as in all the wards. The video stream could be constantly monitored from a nurse’s workstation, and in all hospitals the recording could be retained for a certain period. However, patients are not properly notified about the fact and extent of video surveillance; indeed, some patients were unaware that their wards were under constant video monitoring. 5

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