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psykiatriske institutioner garanteres minimumrettigheder

D. Psychiatric establishments

3. Living conditions

96. Material conditions for patients at Dobrany Psychiatric Hospital were generally adequate; the wards were clean, sufficiently ventilated, well-maintained and had good access to natural light. However, in some pavilions, patients’ rooms or dormitories were austere and impersonal, with no furniture other than beds and bedside tables. Additional attention should be given to improving the decoration of patients' dormitories and bedrooms.  
 
 

97. In several wards (such as 8 and 13B), the dormitories were locked during the day, leaving a meagre living space of between 2 and 4 m² per person. The CPT considers such limited living space as inadequate, especially for patients on ward 13B where the communal bathroom also served as a smoking area and there was restricted access to outdoor exercise (cf. paragraph 98 below).  
 

      In this respect, the CPT’s delegation was informed about the plan for the further development of Dobrany Psychiatric Hospital, including the renovation of certain wards (such as ward 13B) and the building of new additional accommodation. These measures, when combined with the plan to further reduce the number of beds in the hospital, would lead to increased living space for patients and thus to an improvement in their quality of life. The CPT welcomes the plan for the renovation of Dobrany Psychiatric Hospital and would like to be kept informed of its implementation. Further, the CPT would like to be informed about the measures taken to further reduce the capacity of Dobrany Psychiatric Hospital. 
 
 

98. For the CPT, offering at least one hour of daily outdoor exercise for psychiatric patients has always been a fundamental minimum requirement. Although the delegation noted that walks in the hospital grounds featured prominently in the daily programmes of all the wards visited, it found that, in a few of the wards visited these walks were frequently cancelled. For example, on ward 13B outdoor exercise appeared to take place irregularly, with only a few outings during the first four months of 2006. When the delegation asked staff on ward 13B for an explanation, several reasons were invoked, amongst others inclement weather conditions and security risks due to a shortage of staff. 
 

      However, the delegation met with several patients from ward 13B who apparently had been denied their walks as a sanction for misbehaviour. This would be unacceptable. Every patient should be allowed at least one hour of outdoor exercise every day, if their medical condition so permits. Given that the hospital has constructed a special fenced-off area close to ward 13B, security reasons cannot be invoked to deny such exercise. 
 

      The CPT recommends that the Czech authorities take the necessary steps to ensure that, as a matter of principle, all patients at Dobrany Psychiatric Hospital whose medical condition so permits are offered at least one hour of outdoor exercise every day; in particular, restriction of the right to outdoor exercise should never be used as a punishment. 
 
 

99. With respect to Brno Psychiatric Hospital, the wards were generally adequately-lit and well-ventilated, in a good state of repair and clean. However, some of the wards, and in particular ward 18 and the ward for acute patients (“JIPP”), were overcrowded, while other wards lacked decoration and had an impersonal atmosphere. 
 

      The CPT's delegation was given to understand that Brno Psychiatric Hospital is engaged in an expansion project. The CPT would like to receive more details about this project; in particular, the Committee would like to be informed as to whether the project will contribute to remedying the lack of living space observed in some of the wards. Further, special attention should be given to improving the decoration of patients’ dormitories and bedrooms. 
 
 

100. In both hospitals, patients on a number of wards habitually wore pyjamas during the day. This is not conducive to strengthening personal identity and self-esteem; individualisation of clothing should form part of the therapeutic process. When patients do not possess their own clothes they should be provided with appropriate individualised clothing. The CPT recommends that patients who are not bedridden are encouraged to wear clothes other than pyjamas during the day.