CoE: The CoE Committee against Torture of the Council of Europe recommended that Ukraine accelerate the process of deinstitutionalization in social care, solve the lack of personnel and overcrowding. This was stated in the report of the CoE Committee on the results of inspections of three psychoneurological centers in two regions of Ukraine in 2019.
Representatives of the CoE urged the Ukrainian authorities to intensify their efforts to deinstitutionalize and develop social assistance in the community. Such community accommodation should consist of small group home living units in the community, ideally in towns, with all the relevant facilities close at hand, rather than larger units situated on the ground of long-standing social care establishments, which does not allow proper social re-integration.
The Committee has also reiterated its long-standing recommendation to allow for a regular revision by a judicial authority of the necessity for continued placement of persons to psycho-neurological “internats”; residents should be able to request such a review and explain their situation in person before the district medico-social expertise commission.
During the visit the delegation did not receive any direct and credible allegations of deliberate physical ill-treatment of residents by staff. However, inter-residence violence was clearly a problem in all the “internats” visited, due to the very low staff presence on the wards and – in Velykorybalske – the lack of appropriate psychiatric treatment which resulted in a deterioration of residents’ mental conditions. Besides, in Viktorivka some of the residents were used by staff to help maintain order, the practice the Committee found unacceptable and recommended stopping immediately.
In general, gross understaffing of healthcare staff and of personnel qualified to provide psycho-social therapy was observed in all the three establishments. The Committee recommends urgently addressing the situation. As a first step, a regular, preferably daily, presence of a psychiatrist must be ensured. Besides, urgent steps must be taken to obtain licences from the Ministry of Health for somatic and especially psychiatric treatment in all the three “internats”; and free of charge somatic examinations and treatment, including dental, as well as medications, should be ensured in these and other similar establishments in Ukraine.
Living conditions varied: while being overall acceptable at Viktorivka internat, they were rather poor because of outdated infrastructure and overcrowding in Baraboi internat, despite commendable efforts of its Director, and generally very poor at Velykorybalske Internat due to the lack of financial resources. The Committee recommended taking concrete steps to address overcrowding at Baraboi and to radically improve living conditions and eliminate the deplorable financial shortage in the Velykorybalske Internat.
The Ukrainian authorities are to provide to the CPT by end February 2020 a report on actions taken to implement the recommendations.