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Human RightsBulgarian psychiatric hospitals, prisons, children's boarding schools and refugee centres: misery and...

Bulgarian psychiatric hospitals, prisons, children’s boarding schools and refugee centres: misery and violated rights

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The Ombudsman of the Republic of Bulgaria, Diana Kovacheva, published the Institution’s Eleventh Annual Report of the inspections in places of deprivation of liberty in 2023, carried out by the National Preventive Mechanism (NPM) – the NPM is a specialized directorate under the Ombudsman, which monitors, checks and evaluates the observance of rights of the person in prisons, detention centers, homes for medico-social care for children, family-type accommodation centers for children and persons, psychiatry, homes for adults with disabilities, mental disorders and dementia, centers for migrants and refugees, etc.

Data from the report reveal that in 2023, the NPM team carried out 50 inspections in the listed places, sent a total of 129 recommendations to various government bodies and tracked the implementation of specific measures to improve the conditions in the places of accommodation, detention or suffering of imprisonment.

The observations and conclusions in 2023 continue to identify systemic problems, for which the institution has repeatedly alerted the responsible institutions, but despite this, there are practically no real and adequate solutions to date.

The problems of underfunding and the chronic shortage of personnel to ensure quality medical care and health care for persons in all categories of inspected facilities remain permanently unresolved. There is also a lack of budget funding for social activities in the places where punishments are served – the social work and reintegration of prisoners continues to be questionable for many of the prisons;

The report summarizes that over the past two years, the ombudsman has put the topic of protecting the rights of people with mental illnesses first and with particular sharpness.

It is reported that a total of 25 unannounced inspections were carried out in psychiatric facilities and residential social service centers in the period 2022-2023.

“In the sense of the Convention Against Torture and Other Cruel, Inhuman or Degrading Treatment or Punishment of the United Nations and the European Convention for the Prevention of Torture and Inhuman or Degrading Treatment or Punishment of the Council of Europe – State psychiatric hospitals (PSHs) are places of deprivation from freedom, as some of the patients are housed with court decisions and cannot voluntarily leave them. For this reason, the ombudsman, as the NPM, monitors with particular attention the prevention of torture and other forms of inhuman or degrading treatment in these places,” the report says .

It is also noted there that in the period from 2019 to 2022, the ombudsman as NPM repeatedly alerted the responsible authorities about the presence of chronic problems in state psychiatric hospitals, humiliating material living conditions, the chronic malnutrition of patients due to a wrong financing model were found , poor quality of medical care, lack of staffing and a sustainable policy to overcome it, including lack of social services to help reintegration of patients in the PSHs.

In this regard, the Ombudsman insists that a number of urgent measures be taken to prevent any possible form of degrading treatment or torture. First of all, to distinguish the act of “torture” as an independent crime, next – to engage in practices for effective control – on the basis of Art. 127, item 4 of the Constitution of the Republic of Bulgaria that the prosecutor’s office exercise regular supervision in the implementation of criminal and other coercive measures in all state psychiatric hospitals, because they are kept places of deprivation of liberty.

The ombudsman also recommends to update the legal framework of the procedure for applying measures of temporary physical restraint to patients with established mental disorders and to draw up a protocol for applying the coercive measures “immobilization” and “isolation”, in which it should be clearly noted with what duration and how often patients may be isolated and restrained (tied) in a 24-hour period, and to specify the grounds on which these measures are applied.

The report also insists on expanding the possibilities for civil control through the mandatory inclusion of a person with a legal education and a representative of a human rights non-governmental organization in the composition of the Commission for Oversight of the Implementation of Temporary Physical Restraint Measures, as well as unifying the method of financing for all healthcare facilities for inpatient treatment, being bound by the quality of the healthcare service provided.

The report also describes the worst case of torture since the beginning of the Ombudsman’s mandate as NPM. This is the fire that occurred on October 2, 2023 in the State Psychiatric Hospital – Lovech, in which a patient died. The young man who died in a fire in the isolation ward of the Lovech psychiatric hospital, f. e. was sentenced to lie down in the isolation ward for 9 hours, 6 of them tied up. According to the ombudsman, Diana Kovacheva, this measure is torture. She insists on special supervision of the investigation by the prosecutor’s office. And also to monitor all coercive measures in psychiatry, to change the regulation on isolation.The ombudsman’s inspection there highlighted numerous weaknesses in the system for providing quality psychiatric care and protection for the mentally ill. For example – deficits in the legal framework and practices for implementing measures for temporary physical restraint of persons in the PSHs, the lack of effective mechanisms for control by state institutions, as well as chronic problems with the quality of psychiatric care provided due to insufficient funding of the activity.

Another focus of the NPM report is related to deficits regarding the rights of children in conflict with the law.

It also indicates that in every annual report of the NPM, the recommendation is invariably made to close boarding schools and introduce modern and effective measures to work with child offenders, which include restorative justice and preventive work, as well as the creation of a protective social system. with a network of services (integrated services and educational, psycho-social and protective measures and support mechanisms) regarding children in conflict with the law.

In this regard, the report describes that in 2023 teams of the ombudsman from the NPM and Children’s Rights Directorates carried out three joint inspections in Educational Boarding Schools (EBS) and Social and Pedagogical Boarding Schools (SPBS) to assess the availability or the lack of progress on the Third Thematic Report on the Rights of Children Placed in Higher Education Institutions and Higher Education Institutions.

“As a result of the systemic pressure of the ombudsman, four boarding schools were closed, such as the one in the village of Dragodanovo, municipality of Sliven. The number of children housed in the remaining three has decreased to 88 children. Most of the children are victims of circumstances in their lives – poverty , lack of normal housing conditions, separated parents and/or those who are economic emigrants abroad The material base is in a bad state, regardless of the partial repairs being carried out The investment of resources (financial, technical and human) in the system of EBSs and SPBSs is inexpedient. The efforts of the authorities should be fully focused on the rapid closure of these institutions and the creation of a protective social system including a network of services (integrated services and educational, psycho-social and protective measures and support mechanisms) in relation to children who are in conflict with the law,” the report added.

There, it is recalled that in the Third Thematic Report on the Rights of Children Placed in Higher Education Institutions and Secondary Education Institutions, a series of chronic vices were found, that Higher Education Institutions and Secondary Education Institutions do not meet international standards, because they are from the so-called “barrack type buildings” with common sleeping quarters, bathrooms, toilets. And the children housed in them not only do not have access to quality education and medical care, but also their relatives cannot visit them due to the remoteness of the institutions and the lack of funds. In addition, educational measures bear the characteristics of criminal repression, i.e. their educational effect is to impose a sanction or restriction. The absence of subsequent periodical judicial control and provision of legal assistance to the children placed in connection with the educational measures imposed on them was noted.

Among the other problems mentioned is the fact that the applicable legislation does not allow minors placed in an educational center – boarding school to apply to the judicial authorities to request a review of their detention. As well as that in the internal law of Bulgaria there is no periodic and automatic check in relation to the detention in question.

In the Eleventh Report of the Ombudsman as NPM for another year, it is emphasized that the adoption of a national policy and strategy for children’s justice with a long-term horizon is necessary. As well as that the efforts of the authorities should be fully focused on the rapid closure of institutions for children in conflict with the law and the creation of a protected social system that includes a network of services (integrated services and educational, psycho-social and protective measures and support mechanisms) in relation to these children.

“The recommendation for the need to take effective legislative actions for the transposition into the NPC of Directive 2016/800/ of the EU on procedural guarantees for children who are suspects or accused in criminal proceedings,” the ombudsman also states.

In 2023, the NPM will carry out a total of 3 planned and 11 unannounced inspections in social institutions for children and adults.

Again, the ombudsman’s recommendation is to speed up the process of deinstitutionalisation of aged care, because the long-term residence of disabled people in institutions violates basic human rights, and the homes themselves can be defined as places of deprivation of liberty.

The report points out another worrying fact – the presence of seven institutions with a capacity of more than 100 people (one with 228), located at a great distance from municipal centers and hospitals, with a lack of specialists to take care of them.

“At the moment, only 9 homes for people with mental retardation, mental disorders and dementia have been closed. Once again, it has been established that the homes do not meet any criteria for providing quality social service for people with disabilities. The attitude towards the housed people and their staying there is not only bad and humiliating, but their basic human rights are violated,” the report said. Namely, the right to free movement and contacts with the outside world; of quality psychological and medical care; of personal space and quality sanitary and living conditions, as well as the right to individual care.

The Ombudsman has once again noted the apparent lack of will and vision to move residential care services into the community. Instead, the opposite trend is observed – the material base in these institutions remains the same, they are at a great distance from the municipal center, often the accompanying infrastructure is rebuilt with minimal funds to create sheltered housing and family-type accommodation centers. This leads to the practice of new services being actually located in the same building or in the yard of the respective residential service.

The report draws attention to the fact that in 2023, the trend for a large volume of inspections in the places of serving sentences for the Ministry of Justice continues.

“At the end of October 2022, the report of the European Committee for the Prevention of Torture and Inhuman or Degrading Treatment or Punishment from its eighth visit to Bulgaria was published. The Committee points out as current and essential the problems related to violence between prisoners, the unsatisfactory conditions in prisons and detention centers in the country, the mass spread of bed bugs and cockroaches, as well as the lack of meaningful and constructive activities for those deprived of their liberty. The above findings are also confirmed by the inspections carried out by the Ombudsman in his capacity as NPM in 2023, which clearly demonstrates the continuing need to reform penal policy in the penitentiary system,” the report said.

It is emphasized that the general critical finding in this sector continues to be the lack of an effective solution to several basic problems, namely – systemic deficits in the medical care of prisoners; continuing deficits with depreciated bedding inventory; the unresolved problems with the presence of cockroaches, bedbugs and other pests in places of deprivation of liberty, etc.

Another emphasis in the report is the protection of the rights of persons detained in the accommodation facilities of the Ministry of the Interior. In 2023, a total of 2,509 such persons were covered in the inspections.

The implementation of the recommendations made in 2022 in relation to the rights of minors and persons seeking or denied international protection was checked.

In 2023, the ombudsman carried out inspections in four premises for the accommodation of detained persons in the system of the Ministry of Internal Affairs. It was found there that the material living conditions continue to be poor, with little access to daylight and a depreciated material base.

And in 2023, in his capacity as NPM, the ombudsman will carry out inspections in the centers for temporary accommodation of foreigners under the Ministry of Internal Affairs and in the centers for the accommodation of refugees under the State Agency for Refugees (SRA) under the Council of Ministers. The main focus of each inspection is an assessment of the conditions under which unaccompanied minors live and the forms of support provided.

The checks found that for 2023, according to statistics of the SRA, 5,702 applications for international protection were submitted by unaccompanied minors. Of these, 3,843 are from unaccompanied children, and 1,416 from minors. 2023 49 unaccompanied children are accommodated in social service centers.

“It is also worrying that too often unaccompanied children disappear from the SRA’s open-type accommodation centers under the Council of Ministers, within a week or two, continuing their way to Western Europe through organized and costly illegal refugee channels,” the ombudsman emphasized in the Annual report.

He draws attention to the fact that inspections in 2023 also found an increasing number of unaccompanied minors in conditions of permanently unresolved basic problems. For example – the ombudsman’s recommendation from 2022 has not been implemented and the Registration and reception center – Harmanli continues to not have a safe zone for unaccompanied minors and minors seeking international protection. The relevance of the recommendation for the introduction of a systematic policy for the protection and integration of unaccompanied minors continues. The ombudsman points out that it is necessary to evaluate the possible measures to ensure protection and support for unaccompanied minors who have received status through integration in the community and if they do not wish to be placed in residential social care.

In 2023, the ombudsman monitored the implementation of 33 coercive administrative measures on return to the country of origin, country of transit or third country and expulsion.

The monitoring teams found systemic problems when checking the personal files of foreigners – continuing the practice of under-completion of the documentation, especially regarding the appeal of orders to impose coercive administrative measures; missing evidence that the foreign citizens are aware of the content of the orders issued to them to impose coercive administrative measures, as well as their right to appeal it in accordance with the Code of Administrative Procedure; the lack of evidence that foreign nationals accommodated in the Special homes for temporary accommodation of foreigners are aware of their right to receive legal assistance and that they have met with lawyers who consulted them and informed them of their rights and legal options, etc.

Photo: Diana Kovacheva / Press center of the ombudsman

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