National Preventive Mechanism The CPT 8th General Report provides that „In any event, a person who is involuntarily placed in a psychiatric establishment by a non-judicial authority must have the right to bring proceedings by which the lawfulness of his detention shall be decided speedily by a court.“86 Article 18.14 of the Law of Georgia on Psychiatric Assistance provides that a patient, his legal representative or relative may lodge an appeal in accordance with Administrative Procedure Code against decision on involuntary placement, denial or prolongation of such placement.87 In practice, patients and their legal representatives do not exercise the legal right to appeal against court decision on involuntary placement. The exception is Qutiri establishment case, that allocates accused and sentenced persons who were confined to involuntary treatment and are traditionally more active to appeal against court decisions.88 During 2011, 36 cases out of 100 were appealed in Qutiri establishment. Another s et o f cases of appeal, were observed in M. Asatiani Psychiatry Institute where 5 cases out of 62 were appealed. Neither in case of Qutiri nor in case of Asatiani establishments did the court render even a single decision in favor of appeal m a d e by patient. In all other cases lodging an appeal was complicated due to delayed receipt of court decisions by patients. Patients and doctors stated that usually the court decision is served within 2 weeks or more. During the oral proceedings in court, only the findings of the court is announced and not the motivation part. It is almost impossible in practice to appeal against this decision, even if there is accompanying wish by the patient The doctors of several establishments went as far as to state that in some instances patient’s deinstitutionalization takes place before the receipt of court decision on involuntary treatment. Internal Appeal Procedure – Complaints Box The practice proved that complaints box does not constitute an effective mechanism of receiving feedback as patients do not widely use such boxes even if available. Generally a social worker is a responsible person to open a complaints box (Gldani, Asatiani, and Bediani); however in the case of Qutiri establishment the administration is tasked with opening the complaints box. In Khelvachauri establishment a complaints box is opened once a month. There is no rapid complaints mechanism in the facility. Complaints box is not available in the following establishments: Psychiatric Department of Referral Hospital, Psychiatric Department of Hospital N5, Surami, Kutaisi and Senaki establishments. PSYCHO-SOCIAL REHABILITATION The CPT standards provide that „Psychiatric treatment should be based on an individualized approach, which implies 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 activities.“89 86 87 88 89 Para. 52 Article 2120 of Administrative Procedure Code „Lodging an appeal against the Order (Decision) of a judge concerning hospitalization of a person to provide involuntary psychiatric assistance.” Qutiri establishment is an exception in terms of prolongation of involuntary treatment – during 2011 there were 477 (!) cases of prolongation. Monitoring Group considers that the aforementioned is related to the specific population of establishment. CPT 8th General Report, para. 37 www.ombudsman.ge NPM Report