- 11 16. The Psychiatric Unit at Gennimatas General Hospital is located in a separate two-storey building of the Hospital. In spite of an official capacity for 17 patients, additional beds were regularly placed in the Unit, and it accommodated 25 patients on the day of the visit, 18 of whom involuntary. The Unit’s highest recorded occupancy level in 2017 had been 35. Most patients did not stay longer than a few weeks, whereas two patients had been hospitalised long-term, one of them for over two years. The Unit had a newly refurbished annex designed for acute admissions (including patients’ rooms, nursing station and small exercise yard), which was not yet in use due to a lack of staff. 17. Occupying a large wooded area in the outskirts of Athens, Sotiria General Hospital specialises in the treatment of cancer, pulmonary and heart diseases. Its small Psychiatric Unit is housed in a single-storey pavilion with an official capacity of 20 beds, extended by up to 10 more auxiliary beds in the Unit’s corridor. The Unit accommodated 24 patients on the day of the visit, 12 of them involuntary. The average length of stay at the Unit was some 23 days. 18. Each Psychiatric Hospital or Unit in a General Hospital is additionally responsible for servicing specific out-patient care centres and safe houses/hostels. The CPT’s delegation visited two hostels located within the perimeter of Dromokaiteio Psychiatric Hospital.11 The development of outpatient services and assisted living units is part of the on-going reforms, with such centres established in many Greek municipalities. Indeed a considerable number of patients met at Dromokaiteio Hospital, the Unit at Evangelismos and at the Athina Clinic suffered from long-term mental disorders. Many would have benefited from placement in an assisted living setting or from outpatient care arrangements. By letter of 7 June 2018, the Greek authorities informed the CPT that they had called upon Evangelismos Hospital to take action in order to transfer long-term mental health patients who had been at the Unit for long periods to community-based mental health units. The CPT trusts that the Hospital’s efforts to have those patients transferred will be effective and would like to be informed about the action taken. Moreover, the Committee recommends that the same approach be followed throughout the psychiatric care system. 19. Having undergone a psychiatric assessment resulting in a recommendation for in-patient care, a patient (or his/her family) could, in practice, opt for placement in a private clinic. That said, the law providing for such a possibility12 is contingent on by-laws and supervision regulations, which have not yet been enacted. Nevertheless, it is not uncommon for the hearings prosecutor to approve such transfers, if the patient’s family so requests, either immediately after the psychiatric assessment or in the course of treatment in a public institution.13 The CPT recommends that a clearer legal basis be established for involuntary placement/treatment in a private health-care institution, ensuring that such measures are surrounded by appropriate safeguards (see, in particular, paragraph 52). 11 12 13 The Hospital was also responsible for providing services to several more hostels and autonomous living units outside the Hospital perimeter. See Section 101 of Law 2071/1992, and Section 16 of Law 2716/1999. In 2017, the Athens hearings prosecutor approved 188 such transfers.