Central European psychiatrists call for more than a law banning caged beds

Growing criticism from Britain, including such celebrities as the author of the popular Harry Potter children's books JK Rowling has resulted in much discussion on psychiatric care in the Czech Republic, especially on the use of so-called caged and netted beds - beds surrounded by iron bars or nets used to control aggressive or confused patients.

So how big is the problem in the region? Dr. Jan Pfeiffer is the director of Prague's centre for Mental Health Care Development:

"Well, I think in Hungary, the laws are better developed. On the other hand, you will not find as many community alternatives as in the Czech Republic, where many children are not in institutions if there are other alternatives in the community. This is neither the case in Hungary, nor in Slovakia. However, in Slovakia, they just started taking radical steps but they are only starting so we will see how it goes. In Slovenia, which is a much wealthier country, you will not find any caged beds - maybe two or three. They are also building up some alternatives but compared to England or other rich democratic countries we still have a long way to go."

According to Czech health ministry estimates, there are currently some 100 caged beds in Czech institutions, some thirty of which are in use. Slovakia has abolished the use of caged beds but stresses the use of its 300 netted beds is not to be banned at any time in the near future. According to Pavel Cernak, founder of the independent humanitarian organisation League for Mental Health, the vast majority of psychiatrists believe the popular alternative restrictions such as tranquilizers and strapping are even worse.

This week, Czech Health Minister Jozef Kubinyi banned the use of caged beds and called on the health care institutions to stop using all netted beds by the end of the year. While Central European psychiatrists are thankful that international pressure is forcing health ministries to ban the use of caged beds, they would like to see more engagement from abroad to change the entire approach to the mentally ill. Lucie Ripova is a lawyer working for a non-governmental organisation of users of psychiatric care called Kolumbus and provides free legal help to people with mental illnesses:

"The lack of staff is a problem but I would say a bigger problem is the lack of educated staff....technique how to put the patient down. It must be a very specific way so that the patient is not hurt. But you have to be trained for that. The mental institutions are very far from their homes and there is a lack of daily crisis centres and the basic right to live and be treated in the community is denied...have to spend part of their lives in hospitals just because they have no place to go."

Most health ministries in post-Communist Central Europe have not been able to promise swift improvements in psychiatric care, admitting it will take years before the necessary measures are taken to reform the health care system. The Czech government, for example, says that 2020 is a realistic date. But psychiatrists are hopeful. International criticism has promoted discussion and their voices are finally being heard.