On August
6, the representatives of the subdivision exercising the Human Rights Defender's
functions as National Preventive Mechanism (NPM) and NPM experts made an
unannounced visit to the National Center for Mental Health Care CJSC of the RA
Ministry of Health (Nubarashen psychiatric establishment).
Within the
visit, the issues on ensuring the rights of persons with mental health issues, the
organization of preventive activities due to new coronavirus pandemic
(Covid-19), the sanitary-hygienic conditions and their compliance with the
required standards, the working conditions of the staff and other issues were examined.
The
following main issues have been recorded:
• A number
of issues from the perspective of preventing the new coronavirus pandemic
(Covid-19) were recorded. In particular, the procedure for measuring
temperature during the entry of visitors to the psychiatric establishment is
carried out improperly, the patients and medical personnel do not comply with
social distancing rules, the personnel does not comply with the rules on
wearing a mask and etc.
• the
14-day isolation period for preventing the spread of the new coronavirus
pandemic (Covid-19) is not implemented with regard to the patients admitted to
the Center,
•
hand-sanitizers and garbage cans are only located near the hospital wards and
are not accessible for the patients: during the visit, the latter also did not
wear mask,
• the
Center works in an overloaded regime, the personal space of patients is not
ensured, which may be problematic from the perspective of the new coronavirus
pandemic (Covid-19),
• there is
a necessity for major renovation of hospital wards, as well as hospital rooms,
bathrooms, canteens and kitchens: this issue has been raised for a long period
of time,
• breaches
of procedure for applying restraint measures: the relevant records are not
properly maintained, the information on the injuries suffered by the patient
and the person applying restraint measure. as well as information on the
effectiveness of a restraint measure are not recorded properly, in hospital
rooms, physical restraint measures are sometimes applied in the presence of
other patients, etc.,
• some
patients are unable to receive their pension due to various organizational
uses,
• there is
mostly no individualization of clothing and is distributed randomly after
washing,
• the
medical records are not maintained properly,
• issues
with regard to management of hunger-strike and force-feeding were recorded,
• issues
with regard to informed consent were recorded: the patients do not provide
informed consent and are not properly informed of their rights,
• there is
an urgent need to ensure occupational activities for patients, while the
television in hospital ward halls is the main leisure activity;
• there is
no accessible transportation to the Center, while the Center accommodates 407
patients.
The
following positive changes were observed as a result of the visit and carried
out examinations:
• from the
perspective of preventing the new coronavirus pandemic (Covid-19), the
psychiatric establishment was equipped with adequate protective equipment and
disinfectants,
• payphones
were installed in hospital wards,
• following
the previous visit, the positions for a neurologist and therapist were filled,
• within
the Center, an internal internet network was established,
• within
the Center, document circulation and registry was mostly digitalized,
• different
internal regulations were prepared.
Decent work
conditions and social guarantees of the psychiatric establishment's employees,
including their salary, need to be continuously improved.
The visit
was carried out by a special methodology and in conformity with preventive
rules and the "do no harm principle". The monitoring was conducted
with the participation of lawyers, doctors, including a psychiatrist and a
sociologist.
The issues
raised during the visit were discussed with the administration of the
psychiatric establishment. The recorded issues will be summarized and will be
submitted to the competent authorities, together with recommendations for their
solution.
During the
monitoring visit, the personnel and the administration of the Center
effectively cooperated with the Human Rights Defender's representatives and did
not create any obstacle for their work.
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