4(A). To the Minister of Health
25 June 2014
English
- Cage beds (including those that the Czech government refers to as ‘net beds’) should be immediately removed from all psychiatric institutions in the country.
- Other forms of restraint including strapping, chemical restraints and seclusion should immediately be ended as standard practices in Czech psychiatry. The removal of one form of restraint must never be used to justify an alternative coercive measure.
- Conduct a rapid assessment of all psychiatric medications used in hospitals, with a view to avoiding medication as punishment, and reducing preventable side effects. This includes ensuring that clozapine is never given without ongoing blood tests.
- Issue guidance that all forms of restraint or seclusion, including chemical restraint, must be recorded and centrally monitored in all cases, whether or not ‘consent’ is given by patients in any psychiatric facility. This information should be made available to independent bodies, including the Public Defender of Rights (Ombudsperson) and civil society upon request.
- Establish a programme of workforce development to train all staff of psychiatric services about human rights standards and how each person’s practice needs to change as a result (from the management of mental health facilities, to clinicians, nurses, auxiliary nurses, cleaners, receptionists and anyone else who comes into contact with patients).
- Ensure all mental health services comply with the provisions of the UN Convention on the Rights of Persons with Disabilities (CRPD), particularly in relation to informed consent.
- Progress towards achieving the above should be submitted to the UN Committee on the Rights of Persons with Disabilities in an annex to the Czech Republic’s report. This report should be made public.