-923.
As already indicated, on its previous visit the CPT expressed serious concern about the
use of isolation and physical restraint (cf paragraphs 250-256 of the report on the 1993 visit).
The situation has considerably improved since.
It was now hospital policy not to isolate patients. An isolation room was seen during the
1996 visit, in the so-called emergency unit. The isolation room had been equipped for video
surveillance since 1993 but access to natural light was still limited and the small window was
unglazed. However, the medical staff said that the room was not used and the delegation found
nothing to suggest otherwise in the nursing and doctors' instructions registers. In its present
state, this room must remain out of use.
As for the use of physical restraint, the CPT is satisfied that its delegation no longer
found the situation described in paragraph 253 of its previous report. In the so-called emergency
unit, the delegation found that physical restraint was confined to exceptional cases. Detailed
instructions were given to the nursing staff by the doctors in respect of each patient. These
instructions required the staff in particular to increase surveillance if the patient was agitated and
to inform the doctor on duty of the use of physical restraint. In addition, the circumstances and
duration of the restraint measure were recorded in the nursing register.
The CPT considers that this procedure largely meets the recommendations it made in
paragraph 256 of the previous report. However, it would be desirable to provide in addition for
all measures of physical restraint to be recorded in the patient's file and in a specific register
established for this purpose, indicating the time of the beginning and end of the measure, the
circumstances of the case, the reasons for resorting to the measure and an account of any injuries
sustained by patients or members of staff. The CPT recommends that the Greek authorities
take appropriate measures to this effect.
24.
As regards the actual means of restraint, the delegation observed that the leather straps
were, as in the past, fixed to the bed with a padlock; this is not ideal, particularly if the patient
has to be unstrapped for an urgent reason.
The CPT noted that in their follow-up report (CPT/Inf (96) 8, p.34), the Greek authorities
indicated that as regards the Committee's recommendation on means of restraint, the views of
the Scientific Committee of each of the three hospitals visited in 1993 had been requested and
that their reply was expected. The CPT would like to know whether that reply is now
available.
3.
Discharge of patients
25.
In general, considerable efforts were being made at the Mental Hospital for Children in
the sphere of dehospitalisation of chronic patients (e.g. programmes for autistic children;
development of fostering families or return to the child's biological family). Such efforts
naturally take time and also depend on the existence of outside facilities. The CPT dealt with this
matter at length in its previous report. It has taken note of the information supplied by the Greek
authorities in their replies and encourages them to continue their efforts in this direction.
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