During the visit, the CPT delegation focused on the treatment of persons detained in police custody, in several prisons, in the Judicial Observation and Psychiatric Institute (IMEI) and patients of two civil psychiatric facilities.
The visit also provided an opportunity to discuss with the Hungarian authorities several immigration related issues. In this respect, it is regrettable that there is still no legal procedure offering effective protection against informal forcible removals of foreign nationals (pushbacks) and refoulement, including chain refoulement.
Regarding the police, the majority of persons interviewed by the delegation made no complaints about their treatment by police officers. Nevertheless, a number of credible allegations of physical
ill-treatment of detained persons were received. The CPT also heard several allegations of excessively tight handcuffing, sexual harassment of female detainees by male police officers, verbal abuse, including of a racist nature, of detained persons by police officers, and of humiliating remarks in respect of transgender persons and those who were being strip searched.
In general, material conditions in police detention facilities were adequate for short periods of police custody (of up to 72 hours). However, according to the relevant legislation, persons remanded in custody may still be held in such facilities for longer periods, up to 60 days. Although it would appear that this rarely happens in practice, the conditions of detention in police holding facilities remain unsuitable for extended stays.
As regards the situation in prisons, the CPT received no allegations of physical ill-treatment by staff at Székesfehérvár Prison and a few isolated allegations of physical ill-treatment by staff at Nyíregyháza Prison. In contrast, at Tiszalök Prison, numerous credible allegations of physical ill treatment by staff were received, such as slaps, punches, kicks and truncheon blows to the head and body. In some instances, such treatment was meted out while the detained person was hand- and ankle-cuffed. The alleged ill-treatment took place in areas not covered by CCTV cameras, notably in the storage room on the disciplinary/security block, in the medical consultation room, in communal showers and in cells.
While reports to the prosecutor’s office were made swiftly by the management of Tiszalök Prison when allegations of ill-treatment were brought to their attention, the investigations which followed did not appear to be prompt and effective. Moreover, the recording of injuries by the prison’s healthcare service, which is crucial for combating ill-treatment, was deficient.
Inter-prisoner violence appeared to be particularly problematic at Tiszalök Prison. Not only do the findings of the visit suggest that staff did not always intervene promptly, but the delegation also heard credible allegations that certain prisoners were allowed or even instructed by staff to mistreat their cellmates.
Overcrowding and limited resources continued to affect the prison regime adversely, with most prisoners, in particular remand and high security prisoners, having no or limited access to work, education or other out-of-cell activities.
Persons held at IMEI who were interviewed made no allegations of recent physical ill-treatment by staff.
Material conditions in the establishment were adequate in many respects. However, most premises remained austere and impersonal. It continued to be the case that dormitories accommodated up to 16 persons. Further, the CPT considers that IMEI is unsuitable for holding underaged patients and urgent steps should be taken by the Hungarian authorities to end the policy of placing this age category of patient in the establishment.
Positively, the treatment of patients was provided by multidisciplinary teams and, in addition to pharmacotherapy, a range of individual and group therapeutic sessions and activities was offered. However, there were a number of patients who were not involved in any organised activities. Further, there were no staff to provide psychosocial activities tailored to the specific needs of patients with intellectual disabilities.
As for the use of means of restraint, patients were strapped to their beds in view of other patients and there was no continuous supervision by staff. Moreover, restrained patients were provided with adult nappies to comply with the needs of nature. The CPT considers that putting patients in adult nappies or having them use a bedpan in view of other patients may amount to degrading treatment.
Legal safeguards surrounding the court-imposed measure of compulsory psychiatric treatment and its review were generally followed in practice. However, it is a matter of particular concern that patients placed in the IMEI under this measure who no longer required psychiatric treatment could not be discharged as they were unable to cater for their own needs and there was no place for them in social welfare establishments.
In the two civil psychiatric establishments visited, that is, the psychiatric departments of Flór Ferenc Hospital in Kistarcsa and of Gróf Tisza István Hospital in Berettyóújfalu, the delegation received no allegations of physical ill treatment of patients by staff.
Material conditions in both establishments were adequate in many respects. However, the premises were generally austere, impersonal and unwelcoming, lacking in colour and decoration. Further, patients’ rooms at Gróf Tisza István Hospital in Berettyóújfalu were accommodating up to nine patients, which compromised their privacy and prevented the creation of a therapeutic and caring environment. In both establishments, patients accommodated on closed wards had in practice virtually no access to outdoor areas, which is unacceptable. The CPT underlines that the aim should be that all patients benefit from unrestricted access to outdoor exercise during the day unless scheduled activities require them to be present on the ward.
Patients accommodated on the open ward of Flór Ferenc Hospital were provided, in addition to pharmacotherapy, with a wide range of therapeutic and psychosocial rehabilitative activities. However, despite efforts made by staff, the majority of patients from the open wards at Gróf Tisza István Hospital did not participate in any organised activity. The situation was even more problematic on closed wards in both establishments, where treatment was largely limited to pharmacotherapy and patients spent their days in idleness, with TV watching and walking along the corridors being their only activity. The CPT considers that the treatment of psychiatric patients should involve, in addition to appropriate medication and medical care, a wide range of therapeutic, rehabilitative and recreational activities. It should also be based on an individualised approach, which implies the drawing up of a treatment plan for each patient.
The number of nursing staff was low in both establishments, which negatively impacted on several areas of their functioning, most notably the staff’s inability to intervene in all episodes of inter-patient violence, the lack of access to outdoor exercise, the involvement of patients in the provision of care to other patients, and the frequent use of means of restraint.
As regards safeguards, the involuntary placement of patients in Flór Ferenc Hospital was, in principle, compliant with the relevant legal provisions. However, at Gróf Tisza István Hospital, formally voluntary patients were routinely placed on closed wards, which they were prevented from leaving of their own volition if staff considered that their condition required hospitalisation. The CPT considers that these patients were de facto deprived of their liberty, without benefiting from the legal safeguards accompanying involuntary admission into a psychiatric establishment and its regular review.
The Hungarian authorities should take steps to ensure that, if the provision of in patient care to a voluntary patient who wishes to leave the psychiatric establishment is considered necessary, the appropriate involuntary placement procedure provided by the relevant legislation is fully applied.
In their response, the Hungarian authorities provide additional clarifications and outline certain measures taken in response to the recommendations made by the CPT.
The CPT report and the response of the authorities have been made public at the request of the Hungarian authorities.
