Mentally ill patients in four central European countries are being kept in padlocked, caged beds despite condemnation of the practice by the European parliament and the United Nations, a patients' organisation said this week.
In some cases patients are locked in such cages for months or years and sometimes not even let out to use the toilet, says the Budapest based Mental Disability Advocacy Centre, which promotes the rights of people with mental health problems.
The countries concerned—Slovenia, Hungary, Slovakia, and the Czech Republic—are due to join the European Union next May. In the Czech Republic some of the patients concerned are children.
Figure 1.
Patients are sometimes locked in cages like the ones above for months or years, say s the Budapest based Mental Disability Advocacy Centre
Credit: MDAC
Three people have died while being kept in caged beds; in one case last year a 14 year old Czech girl was fatally injured by a metal bar that fell on her.
“Not only is this practice inhuman and degrading—with some patients locked up day and night—but it's dangerous too. It is also a real abuse of human rights. We were shocked at the scale of the problem and the justification often given by staff,” Oliver Lewis, legal director at the Mental Disability Advocacy Centre, told the BMJ.
Mr Lewis said the widespread use of such beds surrounded by a metal cage, or sometimes enclosed in net, was symptomatic of the wider problems in the provision of mental health care in central Europe, where there is an overemphasis on institutional care and a problem of severe understaffing. It was easier for staff to look after patients if they were locked up than to provide proper, community orientated care, he said.
At a conference to discuss the findings in Prague, one 29 year old former patient, Michal, told how he had admitted himself to a psychiatric hospital and was immediately drugged and placed in a caged bed for one week without being let out at all. “Instead of helping, my treatment at the hands of people I had trusted made me much worse,” he said.
But some Czech doctors and government officials defend the use of caged beds in certain circumstances.
Pavel Boudis, secretary general of the Czech Psychiatrists' Association, said eliminating the beds in the near future “would bring many more problems than advantages.”
He highlighted severe understaffing in mental health care, with the staffing level in the Czech Republic at a third the level in other countries.
John Bowis, a European parliament spokesman on health and a former British health minister, called on the four countries to begin eliminating such use as they were about to join the European Union, where the practice was “unacceptable and totally unnecessary.”