Ivan Šelih, Deputy Ombudsman and Head of the Slovenian National Preventive Mechanism (NPM), spoke about the situation of older people living in retirement homes and prisons at the conference entitled Monitoring the rights of specific groups of people deprived of their liberty. He highlighted the problems the retirement homes are experiencing due to the lack of capacities and staff. He also pointed out that the institution of the Human Rights Ombudsman of the Republic of Slovenia has been striving for some time to improve the situation of prisoners who, due to their age, illness or disability, require additional assistance to meet their basic needs in the form of care or social care during imprisonment in order to ensure respect for their personality and dignity.

The conference took place between 5 and 6 October 2022 in Strasbourg in France and was attended by the representatives of several national preventive mechanisms (NPMs), experts and representatives of international organisations and civil society from the region of the Council of Europe. The purpose of the conference was to provide help to NPMs in dealing with key issues encountered when implementing their mandate with the emphasis on particularities of monitoring the conditions of detention and treatment of especially vulnerable persons who are deprived of their liberty. These persons include children and adolescents, the elderly, women, migrants and minorities.

The attendees also discussed the work methods of NPMs during preventive visits. They particularly focused on various problems that occur in this regard, institutional mechanisms of monitoring the realisation of rights of special groups in various countries and possible special approaches when drafting recommendations for NPMs.

The conference was an excellent opportunity for the representatives of NPMs, international and non-governmental organisations to exchange views and good practices in order to improve the living conditions of vulnerable persons deprived of liberty or whose liberty is restricted. The prevention of torture and inhuman or degrading treatment or punishment, which is the key task of NPMs, requires a comprehensive, interdisciplinary and long-term approach.

„Im österreichischen Gesundheitssystem hat die psychische Gesundheit noch immer nicht den gleichen Stellenwert wie die körperliche“, sagt Volksanwalt Bernhard Achitz anlässlich des Welttags für psychische Gesundheit (10. Oktober): „Beim Zugang zu Psychotherapie herrscht Zweiklassenmedizin, die Kinder- und Jugendpsychiatrie ist eine Dauerbaustelle. Und wie im gesamten Care-Bereich ist auch an den Psychiatrien der Personalmangel ein wesentlicher Risikofaktor für Menschenrechtsverletzungen.“

Zweiklassenmedizin bei psychotherapeutischer Versorgung

Beim Zugang zur psychotherapeutischen Versorgung gibt es immer noch das Problem, dass die Zahl der Behandlungen kontingentiert ist. Achitz: „Das wäre bei körperlichen Erkrankungen oder Unfällen unvorstellbar. Da sagt niemand: Brechen Sie sich den Fuß erst im nächsten Jahr, heuer haben wir schon genug gegipst." Auch beim NGO-Forum 2022 der Volksanwaltschaft zum Thema „Soziale Grundrechte in die Verfassung“ war das ein Thema. Die Arbeitsgruppe Gesundheit ergab, der Zugang sei „sowohl für Erwachsene als auch für Kinder unzureichend, weil nach wie vor keine bundesweiten Verträge mit den niedergelassenen Psychotherapeutinnen und Psychotherapeuten abgeschlossen wurden, sondern länderweise sogenannte Vereinslösungen bestehen, im Rahmen derer nur ein bestimmtes Kontingent an Therapiestunden angeboten wird. Das führt zu langen Wartezeiten, weshalb die Betroffenen letztlich gezwungen sind, Wahltherapeutinnen und Wahltherapeuten in Anspruch zu nehmen, für die die Krankenversicherungsträger nur einen geringen Kostenzuschuss leisten.“ Volksanwalt Achitz: „Das können sich nur die Wenigsten leisten. Das ist Zweiklassenmedizin und untragbar.“

Dauerbaustelle Kinder- und Jugendpsychiatrie

Seit 2012 ist die Volksanwaltschaft für die Präventive Menschenrechtskontrolle zuständig, ihre Kommissionen besuchen unter anderem psychiatrische Krankenanstalten und Abteilungen in ganz Österreich. Achitz: „Seit Jahren weist die Volksanwaltschaft auf das unzureichende Versorgungsangebot in der stationären Kinder- und Jugendpsychiatrie (KJP) hin. Immer wieder müssen Kinder mangels geeigneter Plätze in der Erwachsenenpsychiatrie untergebracht werden. Solche Fehlunterbringungen können aber großen Schaden anrichten.“

Zwar wurde dem Mangel an Fachärztinnen bzw. Fachärzten im Bereich der Kinder- und Jugendpsychiatrie durch die Erklärung zum Mangelfach begegnet, wodurch einige zusätzliche Ausbildungsstellen geschaffen wurden. Das allein reicht jedoch nicht, um dem steigenden Bedarf an fachärztlichem Personal gerecht zu werden und den Ausbau der Kinder- und Jugendpsychiatrie adäquat voranzutreiben.

Mehr Personal ist der Schlüssel, um Menschenrechtsverletzungen zu verhindern

Im Rahmen der Präventiven Menschenrechtskontrolle haben die Kontrollkommissionen der Volksanwaltschaft in den psychiatrischen Krankenanstalten und Abteilungen einen Schwerpunkt auf Gewaltprävention und Freiheitsentziehung gesetzt. Die Sonderprüfung ergab, dass freiheitsbeschränkende Maßnahmen wie Fixierungen in einem Viertel der Einrichtungen nicht ausschließlich durch qualifiziertes ärztliches und pflegerisches Personal durchgeführt werden. „Hier besteht enormer Handlungsbedarf, denn Fixierungen sind ein gravierender Einschnitt in die Menschenrechte, sie dürfen nur als allerletztes Mittel eingesetzt werden, um Gefahr für Leben oder Gesundheit abzuwenden“, sagt Achitz: „Sonst handelt es sich um Folter.“

„Eines der Probleme ist der Personalmangel. Mehr Personal ist der Schlüssel, um Menschenrechtsverletzungen zu verhindern“, sagt Achitz. „Um Unterbringungen in der Psychiatrie zu vermeiden, müssen niederschwellige Behandlungsangebote wie etwa Krisendienste und aufsuchende ambulante Versorgung ausgebaut werden.“

The operation of the National Mechanism for the Investigation of Arbitrary Inci­dents (EMIDIPA) is provided for under Article 1 of L 3938/2011 (Α’ 61), as origi­nally replaced by Article 56 of L 4443/2016 and then by Article 188 of L 4662/2020. The report for 2021 is structured similarly to the reports of the previous three years, to facilitate the comparative and systematic review of the degree of com­pliance of the internal disciplinary bodies with the recommendations and findings of the Ombudsman’s Mechanism. At the same time, the report aims to enhance transparency and focuses on groups of cases or independent incidents that have raised public concern. During 2021, the assignment of special duties to enforce­ment agencies aiming at monitoring compliance with the measures against the spread of COVID-19, accounted for a series of complaints concerning violence and arbitrary conduct from the uniformed staff, culminating in the widespread incidents that took place in Nea Smyrni in March. The report makes special refer­ence to the progress of these investigations. You may download the report HERE.

Justice, victims’ rights and judicial cooperation Children, youth and older people Victims’ rights Defendants’ rights

When 14 October 2022

Where Brussels, Belgium

External event

FRA will take part in the first annual seminar of the EU-funded EU Child-friendly Justice Network.

VISIT NETWORK SITE

Taking a 360° view, professionals, academics, civil society representatives and authorities will meet in Brussels on 14 October to exchange views on how to best make justice more child-friendly across the EU.

Specific workshops will span the whole range of roles when children are involved in judicial proceedings: administrative, civil, and criminal. They will address questions of intersectionality and digital justice.

FRA will be part of a high-level panel setting the scene. It will specifically address the needs of children, in particularly vulnerable situations, such as LGBTI children, and present its newest research on child-friendly justice focussing on procedural safeguards for children in criminal proceedings.

The week in review 

NHS Scotland’s first Speak Up Week has been a great opportunity for boards to highlight the benefits of speaking up. We hope that you got as much out of it as we did! We’ve been delighted by the engagement we have seen from boards during the week on social media and if you missed anything you can catch up on Twitter by viewing #SpeakUpWeek.

The week started with an inspiring conversation between Dr Jayne Chidgey-Clark, the National Guardian and Rosemary Agnew, the Independent National Whistleblowing Officer. It was great to have the leaders of these organisations taking time to share their experiences and thoughts about speaking up and the benefits a strong speak up culture can bring. The video is really worth a watch and at the end both leaders shared their top tips for organisations, individuals and managers:

• For NHS management: move your mind-set to a growth mind-set; remember that people are giving you a gift of information when they speak up; and be as courageous yourself as you would like other people to be in speaking up when things aren’t right.
• For individuals, people who need advice should speak to their FTSU guardian (England) or a Confidential Contact/Whistleblowing Ambassador (Scotland) so they can be supported through it. Also people in Scotland can pick up the phone and speak to the INWO team who will help with realistic and meaningful advice (for more details, see below).
• For managers receiving concerns, be curious about what the information is telling you (and not defensive). Be open, and put the person speaking to you as much at their ease as you can, without forming any judgements until the issue is fully explored.

On Tuesday our Spotlight on Confidential Contacts blog talked about the value of the Scottish Speak Up Network in supporting isolated colleagues, and the development and standardisation of the role.

The Spotlight on Whistleblowing Champions blog on Wednesday highlighted the Champions’ position as the guardians of the whistleblowing process in Scotland’s NHS. We also looked at how the Champions have come together to understand and develop their roles, and share learning from their experiences so far.

Our panel session with Niki Maclean (SPSO), Simon Watson (Healthcare Improvement Scotland), Stewart Hughes (SSE) and Sean Parker (Civil Aviation Authority) showed how building trust and transparency is vital for staff to have confidence in raising concerns. That involves treating speaking up as a onetime event and handling it right the first time, or people are unlikely to come back. From a management point of view, it is about seeing the purpose of your speak up process as a way for employees to tell you where the problems are, and not just a functional way to manage people who have concerns. Providing feedback is also very important so that people know that processes are working and that speaking up is worthwhile. Building trust also takes in the aftercare that people get when they speak up, so that they are assured that they won’t experience detriment. Our speakers noted that trust and transparency does not happen overnight. It takes years to build and moments to destroy. Watch the discussion here.

What happens next?

Speak Up Week has been a really positive campaign for raising awareness amongst staff about the benefits of speaking up and who to speak to. But the ideas and activity generated are just part of an ongoing process. We know that some boards are doing well at encouraging people to speak up, listening to them and acting on the concerns, and their reports reflect this. But others have work to do to get staff to feel comfortable raising concerns. This is where senior leaders and people responsible for whistleblowing governance have an opportunity to take the lead and demonstrate that speaking up is welcomed and valued. Talking about speaking up should continue throughout the year and should be a regular focus of communications with staff.

Thank you to everyone who has taken part in Speak Up Week. We were extremely encouraged by the enthusiastic response of NHS organisations, and we appreciate all the work that has been put into it. We would love to hear about what you did, please send your feedback to INWO@spso.gov.scot. We look forward to working with everyone again next year on Speak Up Week 2023!