CYIL vol. 8 (2017)

CYIL 8 ȍ2017Ȏ RESTRICTIONS OF PERSONAL FREEDOM IN THE CONTEXT OF PSYCHIATRIC CARE … and non-medical staff on how to administer non-violent and non-coercive care. All cases of ill-treatment and deaths should be effectively investigated and prosecuted and redress provided to the victims and their families, including compensation and rehabilitation. The CAT Report explicitly highlights the need to investigate and prosecute two particular recent cases of deaths in Czech psychiatric facilities. The first case is death of 30 year-old intellectually disabled woman who suffocated with her own faeces in 2006 while being placed in a net-bed for the last days of her life due to aggressive behaviour. 72 The second mentioned case involves the suicide of a 51 year- old woman in 2012, who hanged herself in a hole torn in a net-bed where she had been placed for a night while no member of the health care staff was present. 73 4 .2 European Committee for the Prevention of Torture and Inhuman or Degrading Treatment or Punishment Report A long-term approach of the CPT towards means of restraint is expressed in its Revised standards for the use of means of restraint in psychiatric establishment for adults from 21 March 2017. We will, however, focus on the CPT Report from 2015. During its visit in the Kosmonosy Psychiatric Hospital, the CPT found that means of restraint were used in practice, while the average duration of uninterrupted mechanical restraint was 30 hours (the duration varied between ten and 82 hours). The CPT recommends that the use of means of restraint be limited for the shortest possible time, normally not exceeding six hours, while any prolongation should be reviewed by two physicians and „under no circumstances should patients continuously be subjected to mechanical restraint for more than 24 hours“. The use of means of restraint “should always be terminated when the reason for the restraint ceased to exist“. 74 The use of net-beds is another subject of the CPT’s concern. It first states that it “has repeatedly expressed its serious misgivings about the use of net-beds” and recommended that net-bed use be stopped “as soon as possible”, but “there has been no progress in this respect”. 75 Furthermore, patients in Kosmonosy were placed in net-beds under certain particularly bad conditions. They were restrained in full view of other patients placed in net-beds. The duration of the placement was in some cases exceedingly long (one patient was placed in a net-bed for the time equivalent of 108 days during a period of 180 days, another patient spent in a net-bed the time equivalent of 75 days during a period of 163 days). A serious problem was the lack of adequate supervision over the restrained patients: “in contrast with the rooms where patients were restrained by straps, there was no possibility of direct visual contact with staff, let alone continuous, direct and personal supervision by staff. 72 See iDNES.cz. Kvůli důstojnosti má matka šanci na omluvu za smrt dcery v síťovém lůžku. (28 June 2013.) accessed 12 April 2017. 73 See BÁRTOVÁ, Eliška, Smrt po sedmi hodinách v kleci. Nikdo není vinen. Aktuálně.cz. (17 April 2012.) accessed 12 April 2017. 74 Council of Europe. Report to the Czech Government on the visit to the Czech Republic carried out by the European Committee for the Prevention of Torture and Inhuman or Degrading Treatment or Punishment (CPT) from 1 to 10 April 2014, p. 68. accessed 29 April 2017. 75 Ibid ., p. 70.

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