Admission to special supervision wards
All patients in ward I3 of Ljubljana University Psychiatric Hospital were given statements which they
signed upon admission and the decisions issued; nevertheless, we proposed that, after a while, each
patient be given the opportunity to again provide their consent to their accommodation in the special
supervision ward, and to have the opportunity to understand their status with a suitable explanation
and be provided with all information or clarifications relevant for them, since certain patients do not
remember this later, and appear to be ignorant and unaware of their position (display restlessness,
dissatisfaction).
In their response to the preliminary report, the management of Ljubljana University Psychiatric Hospital
claimed that the recommendation was partly incomprehensible, since the hospital followed the ZDZdr
in all cases when accommodating patients in special protection – secure (closed) wards. The patients
are informed of the time limits on how long they may/must stay in such a ward according to the ZDZdr,
with a court decision, which they have in their possession. If they agree to treatment in a secure ward, they
sign a suitable form, and the same therapeutic procedures apply to them as in open wards, which means
that when they speak to a doctor, they learn everything about the treatment and the envisaged duration.
The NPM additionally clarifies that the recommendation referred to patients who had consented to
admission and accommodation in a special protection ward. We believe that it would be right if, after a
while, particularly in cases of long-term stays in such wards, their willingness to stay in such wards was
verified again.
Special protection measures (SPM)
In 2014, we recommended that the Unit for Forensic Psychiatry ensure the implementation of special
protection measures in a way that completely prevents the viewing by other patients of patients to
whom a measure is being applied (by removing other beds, installing suitable screens or other means of
separating the patient to whom the measure is being applied from other patients). Since we determined
that the recommendation we made on our visit in 2014 had not been not observed, we repeated it on the
occasion of the latest visit.
During this visit to the Unit for Forensic Psychiatry, we also established that the form “Record of use
of special protection measure (SPM)” was the same as after its revision on 2 July 2015. There is still no
special section on measures implemented before the implementation of SPM. We thus repeated the
recommendation from 2014.
When reviewing records on implementing SPM, we established certain irregularities in record keeping;
we thus recommended that the Unit for Forensic Psychiatry particularly inform the staff about the
meticulous completion of documentation, which is in fact determined in the ZDZdr regarding SPM.
In their response to the preliminary report on the visit in 2016, the management of the Department of
Psychiatry stated that they had examined the said irregularities, pointed out the errors, and conducted
monitoring during an internal assessment and regular annual inspection of the Ministry of Health. No
new errors had been detected, and the management would make sure that no new errors are made.
All persons responsible for completing documentation had been informed about penal sanctions for
violations anticipated by the ZDZdr.
We recommended that the management of Idrija Psychiatric Hospital consider the colour of the rooms
used for physical restraint, and the possibility of reducing the number of beds to one, or to install a
screen between the beds to prevent other patients from seeing the patient subject to SPM.
In their response to the preliminary report, the management of Idrija Psychiatric Hospital explained that
the renovation of certain rooms in which special protection measures were implemented was included
in the short-term plan of investment maintenance for 2016/2017 in order to improve their appearance.
82
IMPLEMENTATION OF THE DUTIES AND POWERS OF THE NPM IN 2016
NATIONAL PREVENTIVE MECHANISM UNDER THE OPTIONAL PROTOCOL TO THE UN CONVENTION AGAINST TORTURE AND OTHER CRUEL, INHUMAN OR DEGRADING TREATMENT OR PUNISHMENT
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