MDAC to challenge use of caged beds in Czech institutions in court

The international Mental Disability Advocacy Centre (MDAC) wants to take the Czech Republic to court. The centre, an NGO promoting and protecting the interests of people with mental health problems, hopes to challenge the use of caged beds in Czech psychiatric wards and institutions. Caged beds are in use in the Czech Republic to restrain patients with mental disabilities. Although their use has been banned in Czech hospitals, they continue to be common in residential homes that are battling with low staff numbers and a severe lack of funding. Dita Asiedu reports:

The Czech Republic is the only country in the European Union where social care institutions use caged beds to restrain clients with mental disabilities. Two years ago, representatives of the Mental Disability Advocacy Centre visited Czech psychiatric wards and institutions to assess the use of netted and caged beds. Since then, the MDAC says, little has changed, despite pressure on the government. Jan Fiala, the MDAC's legal officer responsible for the Czech Republic says the centre already has a number of Czech cases on record where more humane methods of dealing with psychiatric patients should be applied. He is determined to do something about it.

"We plan to take the case to the European Court of Human Rights if we lose in domestic courts."

An estimated 700 netted and caged beds are currently being used in Czech institutions. Lucie Rybova, the vice-president of the Association for Mental Health in the Czech Republic, believes several dozen of them are still used in residential homes for the mentally disabled. This, she says, is not against the law, but many institutions may have broken regulations by violating the conditions under which caged beds are permitted:

"Caged beds in social care homes remain but the conditions for using them are very different and much more restrictive. If the reason for using caged or netted beds is a lack of trained staff or finances and this fact is exposed during the law suit, then I think that the institution and also the ministries of health and social care, which are supervising these institutions, will be in big trouble."

An example was given of one patient, who is in a social care institution in North Bohemia, and has spent most of her time in a caged bed for nine years...

"Even though I don't know the details, I think it is lawful because I don't believe that during those years there were no moments - days or months - when the patient was outside the caged bed. But there is one problem, which I feel needs to be solved. Many specialists in the health care sector and many advisors to the ministry and renowned doctors still believe that the use of netted or caged beds is less intrusive for the patient than overmedication, for example. These are the people who are being listened to, and that is why I think the pressure to ban the use of caged beds has not so strong."

But the argument that the patients are out of control and could only be handled with the help of caged beds or strong medication does not hold with the MDAC's Jan Fiala:

"Well, I think that is not the question. The question is not whether to overmedicate somebody or to place somebody into a caged bed. There simply is no reason to put someone in a caged bed or overmedicate him around the clock and during his or her entire life. We can talk about exceptional cases when someone is really dangerous. In this case we have to see whether it is better to overmedicate the person or to restrain him in that particular situation. But if we are talking about people, who are in caged beds for an entire year or for their whole life, then there is absolutely no justification for that and it's really not a question of what type of restraints to use."

The MDAC is an international NGO based in Budapest, which has been striving to protect the human rights of people with mental health problems in 28 countries across Central and Eastern Europe and Central Asia. The MDAC stresses that the use of caged or netted beds in Czech institutions is not the biggest objection it has to Czech psychiatric and social care. If this is true, then the Czech Republic can brace itself for a barrage of lawsuits challenging its entire concept of institutionalised care in the future.