Annual Report on the activities of the Austrian National Preventive Mechanism (NPM) 2018 Protection & Promotion of Human Rights Annual Report 2018 on the Activities of the Austrian National Preventive Mechanism (NPM) Protection & Promotion of Human Rights Preface This report documents the activities of the National Preventive Mechanism (NPM) in 2018. More than 500 monitoring visits were carried out, most of them in public and private institutions and facilities where the freedom of individuals is restricted. The responsible ministries, supervisory authorities and the affected institutions and facilities were informed about the results of the visits in detail. The NPM also strongly advocated in the year under review that the identified deficits should be rectified as quickly as possible. A large number of presentations and information events were held with the goal of raising public awareness and placing the protection of human rights on a broad basis. International cooperation was further intensified above and beyond these nationwide activities. All of these measures have a common objective: they serve to protect persons from being treated in an inhuman or degrading manner. Human dignity is at considerable risk in places where persons’ liberty is deprived in particular, such as in correctional institutions, police detention centres or retirement and nursing homes. Persons living in such places have little chance to be heard, as they have only limited contact to the outside world. To a large extent, they are at the mercy of the staff of the respective institution or facility or they are, at least, in a dependent position. This inevitably leads to precarious situations. The essence of the preventive mandate is to detect these risks as early as possible and to help in avoiding maladministration before it occurs. The regular and mostly unannounced monitoring visits play a central role here. They are considered a particularly effective mechanism in preventing violation of human rights. All visits are made on the basis of the monitoring methodology developed by the NPM and according to harmonised standards. Special attention is paid to identifying risks. In this way, it is possible to answer the question as to which preventive measures are necessary to avert the violation of human rights or, at least, to render such violations less likely. The information gathered and observations made by the commissions are documented in comprehensive visit reports; a total of 3,134 have been drafted since 2012. The NPM has been collecting recommendations that summarise the results of the reports of the commissions since the very beginning. A total of 179 new recommendations were formulated alone in the year under review 2018. These recommendations are designed to provide orientation to the institutions and the staff working there, on which human rights standards have to be guaranteed. To this end, it is necessary to increase the awareness of all those involved for what treating persons with human dignity entails. The individual activities of the NPM are strategically aligned to interact with one another and be able to trigger a change process in the institutions and facilities, with those responsible and in society. The promotion of human rights protection is a time- consuming process. This is evident from the fact that many deficits are still observed on the monitoring visits, which was the case in 82% of the visits in 2018. The most serious and frequent deficits are covered in detail in this volume. They should not be trivialised as isolated incidents, as, in most cases, they are symptomatic for the system in which the institutions and facilities operate. This report also documents many positive developments and improvements that could be achieved. Seven years after the NPM has been granted the human rights mandate, it can be safely said that the interaction between the NPM and the institutions and facilities that it monitors has improved considerably. One indication for this is that the recommendations of the commissions are more frequently received as helpful feedback from the outside and suggestions for improvement are quickly adopted. This is attributable not only to the professionalization of the work, but also to the higher awareness level of the NPM. The preventive work also profits from the long-standing commitment to an international network. The exchange of information with similar organisations facilitates continued development and alignment with international experience, which also benefits the Austrian institutions. We would like to take this opportunity to thank the commissions for their commitment, and the Human Rights Advisory Council for their advisory support. We would also like to extend our sincere gratitude to all of our staff who make an enormous contribution to protecting human rights in Austria in their day-to-day work. This report will also be sent to the UN Subcommittee on Prevention of Torture (SPT). Günther Kräuter Gertrude Brinek Peter Fichtenbauer Vienna, June 2019 Table of Content INTRODUCTION.............................................................................................................10 1 OVERVIEW OF THE NATIONAL PREVENTIVE MECHANISM ....................................12 1.1 Mandate ............................................................................................................12 1.2 Monitoring and control visits in numbers .......................................................14 1.3 Budget ...............................................................................................................17 1.4 Human resources ..............................................................................................18 1.4.1 Personnel ............................................................................................18 1.4.2 The commissions ................................................................................18 1.4.3 Human Rights Advisory Council ........................................................19 1.5 International cooperation ................................................................................19 1.6 Report of the Human Rights Advisory Council ...............................................21 2 FINDINGS AND RECOMMENDATIONS .....................................................................24 2.1 Retirement and nursing homes ........................................................................24 2.1.1 Introduction ........................................................................................24 2.1.2 Initiatives of the Laender and reactions to recommendations .........25 2.1.3 Right to health in geritric care ...........................................................32 2.1.4 Insufficient personnel .........................................................................39 2.1.5 Ban on addictive substance depots hampers treatment of pain and palliative care ..............................................................................40 2.1.6 Support by relativess ..........................................................................42 2.1.7 Positive observations .........................................................................43 2.2 Hospitals and psychiatric institutions ..............................................................45 2.2.1 Introduction ........................................................................................45 2.2.2 Violation of human dignity through permanent video surveillance ...............................................................................49 2.2.3 Application of Nursing and Residential Homes Residence Act in hospitals .........................................................................................52 2.2.4 Caring for children and adolescents in adult psychiatry ..................53 2.2.5 Structural deficits in geriatric psychiatry at Graz Süd-West Regional Hospital .......................................................57 2.2.6 No obligation to wear institutional clothing .....................................59 2.2.7 Impermissible restriction on going outdoors .....................................60 2.2.8 Delirium prevention and treatment in hospital ................................61 2.2.9 Positive observations ..........................................................................62 2.3 Child and youth welfare facilities ....................................................................64 2.3.1 Introduction ........................................................................................64 2.3.2 Quality development in in-patient child and youth welfare ............70 2.3.3 Prevention of all forms of violence .....................................................71 2.3.4 Crisis accommodation in cases of acute endangerment of the child‘s welfare ...........................................................................73 2.3.5 Inadequate care of traumatised minors ............................................75 2.3.6 Placement in other Laender ...............................................................77 2.3.7 Poor observations on the part of the technical supervision ..............77 2.3.8 Continuation of support after reaching legal age .............................79 2.3.9 Facilities for unaccompanied minor refugees ....................................81 2.3.10 Positive observations ..........................................................................84 2.4 Institutions for persons with disabilities...........................................................86