CYIL vol. 8 (2017)

PETR ŠUSTEK CYIL 8 ȍ2017Ȏ the necessity of improving the financing and the numbers of psychiatric staff in the Czech Republic. 69 Many Czech psychiatrists consider the use of means of restraint, including net-beds, at least given the current state of Czech psychiatry, necessary. They conclude that in the facilities where net-beds have been abolished, the use of more restrictive means of restraint such as psychotropic medication, protective strips, or placement in a seclusion room increases. From this point of view, cage-beds are actually a very moderate means of restraint. 70 4.1 United Nations Committee against Torture Report At this point we should recall the CAT Report from 2012. Among the three problematic areas regarding Czech psychiatric facilities identified in the Report, two are directly connected to the use of means of restraint. The CAT recommends specific measures that the State should take in order to stop human rights violations. The CAT is concerned about the following issues: – The continued use of cage-beds, despite the prohibition in law, and of net-beds as well as the use of other restraint measures such as bed strapping, manacles, and solitary confinement, often in unhygienic conditions and with physical neglect. Recommendation: The Czech Republic should take all necessary measures to ensure, in practice, the prohibition of the use of cage-beds, in conformity with the prohibition enshrined in the Act on Health Services. However, not even perfect conformity with the law seemed to be sufficient for the CAT as it recommended that the Act be amended to include the prohibition of the use of net-beds. The reasoning behind this recommendation is quite logical, since the CAT highlights that the effects of net-beds are similar to those of cage-beds. – The absence of investigations into the ill-treatment and deaths of institutionalized persons confined to cage and net-beds, including suicides. 71 Recommendation : The State should ensure the effective monitoring and independent assessment of the conditions in institutions, including hygiene and instances of neglect. A complaints mechanism should be established. Since the use of means of restraint stems from the inability of the staff to cope with aggressive behaviour of some patients, the State should ensure counsel and provide training to medical 69 Ibid ., p. 21. 70 See a statement of the senior consultant of the protective treatment department of the Psychiatric Hospital Bohnice MUDr. Jiří Švarc, Ph.D. in BUMBA, Jan, WINKLEROVÁ, Kristina, Psychiatr: Síťová lůžka jsou mírným omezovacím prostředkem. Rozhlas.cz . (25 January 2012). accessed 29 April 2017, or the statement of the director of the National Institute of Mental Health prof. MUDr. Cyril Höschl, DrSc., FRCPsych in Zdraví Euro. Síťová lůžka nejsou synonymem trestu . (22 April 2004). accessed 29 April 2017. See also ŠVARC, Jiří. Omezující prostředky v psychiatrii. Psychiatrie pro praxi. (2008, Vol. 9, No. 5), p. 243-245.: accessed 29 April 2017. Medical Tribune CZ. Čeští psychiatři odmítají kritiku mezinárodní organizace MDAC. (2 July 2014). accessed 29 April 2017. 71 United Nations Committee against Torture. Report of the Committee against Torture, Forty-seventh session 31 October – 25 November 2011, Forty-eight session 7 May – 1 June 2012 , p. 139. accessed 12 April 2017.

420