[psych-hr] Hungary: Ban on use of cage beds within psychiatric and social care facilities

P R E S S R E L E A S E

12 July 2004, Budapest. The Hungarian Mental Health Interest Forum (PIF)
and the Mental Disability Advocacy Center (MDAC) welcome a ministerial
decree banning the use of cage beds within psychiatric and social care
facilities in Hungary.

Cage beds - hospital beds with a metal or netted cage placed on top of
them to enclose a person within their confines - currently exist
throughout the Hungarian psychiatric system. The Hungarian government has
been under pressure for a number of years to end the use of this medieval
practice. On 6th July 2004 The Hungarian Minister for Health, Social and
Family Affairs, Mr Mihaly Kvkiny, issued a legally-binding ministerial
decree making the use of cage beds unlawful, something which was promised
to happen by the end of 2003.

Gabor Gombos, the chair of PIF, said, "We are glad that cage beds will
finally be consigned to the dustbin of history. However, the decree fails
to address one of our central concerns, namely that staff of psychiatric
institutions be trained in de-escalation techniques and safe restraint
use, as mandated in the standards of the European Committee for the
Prevention of Torture and Inhuman or Degrading Treatment or Punishment
(CPT). There is no doubt that the lack of training will directly endanger
the safety of both patients and staff."

MDAC's Legal Director Oliver Lewis commented, "As the decree does not
include a mechanism to monitor the implementation of the decree, we ask
the Hungarian government to allow unrestricted access to non-governmental
organizations to perform human rights monitoring. A failure to do so will
reinforce an environment in which psychiatric staff may continue to abuse
the rights of patients with impunity."

Commenting on the European situation, John Bowis, Member of the European
Parliament from the UK, added, "The Hungarian abolition of cage-bed use is
an important step in Europe, and one which the governments of the Czech
Republic, Slovakia and Slovenia should urgently follow. These countries
should also follow the sensitive way in which the Hungarian Minister
engaged with the civil society and professional organizations while
formulating the decree."

The decree also states that restraints cannot be used to restrict a
patient's right to refuse treatment, especially in relation to medical
research and testing of medicines. Another positive development is that
the decree allows for the elimination of cage bed use in long-stay "social
care homes" with an absolute ban coming into force on 1 January 2005. This
is important since many of the victims of cage bed abuse have been subject
to cage beds for many years and therefore require appropriate
rehabilitative measures prior to implementation of the ban.

Both PIF and MDAC remain concerned about certain aspects of the decree.
Problems pointed out by PIF and MDAC during the consultation phase (but
not addressed in the decree) are:

* The Ministry's failure to invest in training of healthcare staff
questions its commitment to take human rights seriously."
* The decree fails to specify a maximum length of time for which
restraints can be used. Instead, this is to be determined by internal
rules of each hospital, leaving patients inadequately protected by the
law.
* The decree fails to establish a system for the central collection of
statistics on restraint and seclusion-contrary to CPT standards-making it
impossible to assess the frequency of restraint use.
* The decree fails to establish any system of monitoring the
implementation of the Decree or of human rights practices in general. In
the absence of such monitoring, it is impossible to know whether the
Decree will be followed.
* If a patient's behaviour is considered "dangerous", the decree allows
for only one review per week of the patient's freedom of movement within
the territory of the hospital.
* The decree regulates restraints within institutions, but is silent about
the degrading and sometimes dangerous way in which people are brought in
to psychiatric institutions by police and emergency services.


The Mental Health Interest Forum (PIF)
H-1437 Budapest, PO Box 287, Hungary
tel: (+361) 341-0521
fax: (+361) 268-9917
email: pef@hu.inter.net
http://www.pef.fw.hu

Mental Disability Advocacy Center
H-1241 Budapest, PO Box 263, Hungary
tel: (+361) 413-2730
fax: (+361) 413-2739
email: mdac@mdac.info
http://www.mdac.info



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