-3EXECUTIVE SUMMARY
The purpose of the CPT’s April 2018 visit to Greece was to examine the situation of civil and
forensic patients in psychiatric establishments and of foreign nationals deprived of their liberty
under aliens’ legislation. With a few exceptions, the cooperation received by the Greek authorities
was very good. Concrete action should, however, be taken to implement a number of long-standing
CPT recommendations.
Psychiatric establishments
The CPT notes that the very significant reforms undertaken in the psychiatric sector in Greece since
the 1980s have come a long way. However, they remain incomplete, with persistent problems of the
inappropriate allocation of patients to understaffed and/or overcrowded in-patient services.
In general, patients met by the CPT’s delegation spoke well about staff at the establishments visited,
whereas some isolated allegations were received of ill-treatment (punches on the back, tight
restraints, verbal abuse) by staff at the private “Athina Vrilissia” Psychiatric Clinic. A small number
of allegations of violence among patients were also received at Dromokaiteio Psychiatric Hospital,
in particular in respect of periods during which the alleged victims were being restrained.
As regards living conditions, the CPT recommends that improvements be made in the
personalisation of living space and the degree of privacy afforded to patients. The most problematic
material conditions observed concerned the systemic overcrowding in the psychiatric units at the
three general hospitals visited (Evangelismos, Gennimatas and Sotiria). In particular, at
Evangelismos, patients needing greater assistance or under mechanical restraint were placed in the
corridor. On the other hand, it was positive that patients at Dromokaiteio and Sotiria benefited from
an open regime, with unrestricted access to the garden area throughout the day. However, very few
activities were offered to patients.
Understaffing was a problem, especially at Dromokaiteio Psychiatric Hospital and the Athina
Clinic. As regards treatment, high-dosage intra-muscular anti-psychotic injections were being
regularly administered during the first days after admission to Dromokaiteio Psychiatric Hospital.
At Athina Clinic, 1st-generation anti-psychotic drugs were in use in relatively high doses over long
periods, with several patients displaying clear symptoms of overmedication. The CPT recommends
that diversified and individualised treatment plans be urgently introduced. Further, medical recordkeeping should be improved.
One of the most serious findings during the visit concerned the use of mechanical restraint. The
CPT's delegation observed a lack of appropriate training on, and strict criteria for, the use of
restraints in line with internationally accepted guidelines. These factors, combined with very low
staffing levels, have resulted in a widespread practice of excessive and inappropriate use of
mechanical restraint. Shortcomings related to the criteria, duration, methods, supervision and
documentation when resorting to mechanical restraint. The CPT recommends that a range of
principles be followed, restraint guidelines and procedures introduced, and staff training
implemented in each establishment, and that a strategy be drawn up on lowering the incidence and
prolonged use of mechanical restraint.
In examining the safeguards surrounding involuntary placement procedures, the CPT recommends
that the law, currently under review, explicitly provide that: periodic re-assessment beyond six
months of placement be carried out; involuntary treatment be the subject of a separate decision; and
a clearer legal basis be established for involuntary placement in a private institution, subject to
external monitoring. Certain safeguards, although prescribed by law, were found not to benefit