SECRETARIAT GENERAL SECRETARIAT OF THE COMMITTEE OF MINISTERS SECRETARIAT DU COMITE DES MINISTRES Contact: Clare Ovey Tel: 03 88 41 36 45 Date: 03/05/2016 DH-DD(2016)564 Documents distributed at the request of a Representative shall be under the sole responsibility of the said Representative, without prejudice to the legal or political position of the Committee of Ministers. Meeting: 1259 meeting (7-9 June 2016) (DH) Item reference: Communication from a NGO (Association for the Defense of Human Rights in Romania – the Helsinki Committee) (20/04/2016) in the Țicu group of cases against Romania (Application No. 24575/10) and reply from the authorities (28/04/2016) Information made available under Rule 9.2 of the Rules of the Committee of Ministers for the supervision of the execution of judgments and of the terms of friendly settlements. * * * * * * * * * * * Les documents distribués à la demande d’un/e Représentant/e le sont sous la seule responsabilité dudit/de ladite Représentant/e, sans préjuger de la position juridique ou politique du Comité des Ministres. Réunion : 1259 réunion (7-9 juin 2016) (DH) Référence du point : Communication d’une ONG (Association for the Defense of Human Rights in Romania – the Helsinki Committee) (20/04/2016) dans le groupe d’affaires Țicu contre Roumanie (Requête no 24575/10) et réponse des autorités (28/04/2016) (anglais uniquement) Informations mises à disposition en vertu de la Règle 9.2 des Règles du Comité des Ministres pour la surveillance de l’exécution des arrêts et des termes des règlements amiables. April 2016 Submission before the Committee of Ministers on the implementation of general measures in respect to the cases of Ţicu v. Romania and Predescu v. Romania The cases of Ţicu v. Romania (24575/10) and Predescu v. Romania (19696/10), placed under enhanced supervision before the Committee of Ministers of the Council of Europe, concern the treatment of people with mental health problems in Romanian prisons. These cases raise issues in respect to a general lack of services for people with mental health problems in Romanian prisons and the damaging effects that detention conditions have on the mental health of prisoners. In respect of these cases Romania submitted an action plan on the 2nd of July 2014 in which, in relation to the general measures envisioned, the Romanian Government stated: - That detainees with mental health problems received specialized care and medication, and they receive daily assessments by medical personnel; - That there is a new Law on the execution of prison sentences as of 1st of February 2014 which provides additional guarantees for people with mental health problems, including setting up specialized psychiatry wards in prisons. Through the present submission we would like to provide the Committee of Ministers with additional information on these issues in the hope that the Committee will consider them in negotiating with the Romanian Government more ample and substantive improvements in terms of how people with mental health problems are treated in Romanian prisons. We would argue that, contrary to the Government’s communication, no significant improvements have been made and that the way people with mental health problems are treated in Romanian prisons still falls short of ECHR and CPT standards. 1 About the Organization The Association for the Defense of Human Rights in Romania – the Helsinki Committee (APADOR-CH) is a non-governmental organization. It was established in 1990 and ever since it has been working on increasing awareness and respect towards human rights standards and the rule of law in Romania and in the region. One of the specific activities that APADOR-CH employs in reaching its goals is carrying out fact- findings visits in penitentiaries (since 1995) and police lock-ups (since 1993). Since 2013 we visited over 30 criminal justice detention facilities throughout Romania. During these visits APADOR-CH experts asses to what extent the rights prescribed by law regarding detention conditions are met in practice, they talk to inmates, staff members and look at relevant documents. They also seek to identify any cases of miss-treatment and brutality and provide legal counseling to victims of such acts. Detainees with mental health problems in Romanian prisons In Romania there are 40 prisons of which 6 are Prison Hospitals.1 On the 29th of March 2016 these facilities housed 28075 people in 34551 beds and at a capacity of 19910 places, considering the 4sq.m requirement for prisons and 7 s.qm for prison hospitals.2 In all of these 40 prisons, on the 16th of March 2016, there were: 3 - 6 employed physiatrists (3 at Jilava Prison Hospital, 1 at Colibași Prison-Hospital, 1 at Poarta Albă Prison-Hospital, and 1 at Craiova Prison); - 70 psychologists; - 5 psychiatry wards (Jilava Prison-Hospital- one ward for acute patients, Colibași Prison- Hospital- a ward for chronical patients, Rahova Prison-Hospital- a detox ward and Poarta Albă Prison-Hospital, where there are 2 wards one for acute patients and one for chronical patients); - 150 beds housing 2628 patients in these 5 psychiatry wards in 2015 alone. 1 According to the National prison Administration 2015 annual report, p 12, available at: http://anp.gov.ro/documents/10180/7602375/bilant+Administratia+Nationala+a+Penitenciarelor+eng.pdf/7 97b7159-5c96-4d76-89ae-d3e08bffe61b 2 According to figures available on the website of the National Prison Administration for the 23rd of April 2016, available at: http://www.anp.gov.ro/documents/10180/8041712/Capacitatea+de+cazare+a+unitatilor+si+efectivele+ace stora+la+data+de+29.03.2016.pdf/6ef1873f-3a3d-41a5-a6c7-14abbd649abe 3 According to figures provided by the National Prison Administration on the 21st of March 2016 in response to a FOI request sent by APADOR-CH 2 On the 1st of June 2015 in Romanian prisons there were 2990 prisoners (approximately 11% of prisoners) who had a diagnosed mental health problem and 160 pre-trial detainees (approximately 7% of pre-trial detainees) with a diagnosed mental health problem. 4 However, unofficial sources indicate that between 30-40% of those deprived of their liberty suffer from a mental health problem. 5 Doctors would even say that all of the detainees suffer from mental health problem which is aggravated by the deprivation of liberty and realities of prison life.6 We consider that these numbers clearly indicate that Romanian prisons are not able to provide the services required by prisoners with mental health problems, there services are too few, in very few scattered places, they are severely understaffed and simply unable to cope with the large number of people in need of these services. This has been reflected in both our own monitoring visits as well as in reports made by other entities. In our detention monitoring experience what we see is that when a psychiatrist is required prisons often must refer the patient to a psychiatrist based at another penitentiary7 or an external psychiatrist.8 For example in Baia Mare prisoners who require psychiatric assistance must be transferred to Bucharest Jilava Prison, which is approximately 600 km away and naturally severely hinders detainees’ access to psychiatric services.9 Furthermore, we found that on 12 May 2014 Iasi prison held 120 detainees with diagnosed mental health problems despite no onsite psychiatrist.10 In Tirgu Ocna prison, on 17 July 2014, there was no onsite psychiatrist or general medical practitioner, except an external doctor who would visit the prison twice a week.11 4 Figure obtained on 23 November 2015 by APADOR-CH from the Romanian National Prison Administration (Administrația Natională a Penitenciarelor) through an FOI request. 5 Figuers reflected in interviews with medial staff from Romanina prisons, held by representatives of APADOR-CH during monitoring visits, as explained in an interview with N.A., executive director of APADOR-CH on 20 November 2015 6 Interview with N. A., executive director of APADOR-CH on 20 November 2015 7According to APADOR-CH report on the Rahova penitenciary of July 17, 2013, available in English at: http://www.apador.org/en/show_report.php?id=180 8 This is the practice in the case of the Tirgu Mures Penitentiary for Juveniles, where there were 70 juvenile prisoners diagnosed with mental health problems in 2013. According to APADOR-CH report on the Tirgu Mures Penitentiary for Juveniles, of 23 August 2013, available in Romanian at: http://apador.org/show_report_nf.php?id=310 9 According to a monitoring report written by APADOR-CH, available at: http://www.apador.org/raport- asupra-vizitei-la-penitenciarul-baia-mare-3/ 10 According to a monitoring report written by APADOR-CH, available at: http://www.apador.org/raport- asupra-vizitei-in-penitenciarul-iasi/ 11 According to a monitoring report written by APADOR-CH, available at: http://www.apador.org/raport- asupra-vizitei-de-verificare-a-evolutiei-situatiei-din-centrul-educativ-targu-ocna/ 3 These observations are also supported by other reports, for instance in Giurgiu the Romanian Ombudsman found that detainees with mental health problems were not evaluated by a specialist to determine the severity of their disability and the prison did not have a on staff psychiatrist which meant that prisoners had to see doctors from psychiatrist from the local hospital who would give indications to nurses in the prison on how to administer treatment.12 Also, the Council of Europe's Committee for the Prevention of Torture and Inhuman or Degrading Treatment or Punishment (CPT) report on Romania following a visit from June 2014 shows that there were no psychiatric consultations in the prisons from Arad and Oradea, despite the fact that in Arad there were 146 detainees with mental health problems and for example detainees from Târgşor had to go for annual consultations at Bucharest –Jilava prison (approximately 100 km away) where they had a psychiatrist.13 This clearly indicates that despite the statements made by the Romanian Government it is highly unlikely that prisoners benefit from the mental health services they are in need of.