Czechia: UN Anti-Torture Experts Express Concern Regarding Ongoing Use of Cage Beds in Psychiatry

The United Nations Committee against Torture has expressed concern about the continued restraint of people with mental disabilities in so-called ‘net beds’ in Czech psychiatric facilities. The comments came following a wide-ranging review of the country’s progress in stamping out torture by the UN’s top expert body, who pointed out to Czech representatives that involuntary treatment, physical and chemical restraints breach international human rights law.

Representatives of the Government of Czechia said there were proposals to ban such forms of restraint in psychiatric facilities, yet the Committee expressed grave misgivings about the slow pace of change and the lack of legal safeguards for persons with mental disabilities in the country.

Expressing particular concern that restrictive practices are also applied to children with disabilities, the Committee urged Czechia to “prohibit, in practice, the use of cage beds in all psychiatric institutions and social care institutions in which children with mental disabilities are held.”

The Committee called on the country to adopt a legal prohibition on the use of “net beds” in all psychiatric facilities.

Czechia has often maintained that the use of net beds are ‘less abusive’ than metal-barred cage beds. The Committee’s comments, however, underline that the practice breaches core human rights standards, and rejected the country’s proposals to issue ‘guidelines’ as insufficient.

The UN’s special rapporteur on torture has said that there can be “no therapeutic justification” for the use of seclusion or cage beds in psychiatry, which can amount to torture or ill-treatment and should be prohibited.

Metal-barred cage beds were banned in Czechia after Validity (then MDAC) and partners documented the widespread use of the practice across central and eastern Europe in 2003. The publication caused an international outcry during the country’s negotiations to join the European Union.

A follow-up investigation published in 2014 found that the netted variant of cage beds continued to be used in many of the country’s psychiatric facilities, often in conjunction with other physical or chemical restraint techniques such as strapping and sedation by drugs.

Tereza Bártová, Lawyer for the Forum for Human Rights which represents victims of human rights violations in Czechia said: “Despite the numerous explicit recommendations of international human rights bodies, the Czech Government still has not taken any steps to ban the practice of placing individuals with mental disabilities in netted cage-beds. It is time for the Czech Government to fulfil its obligations and stop justifying the use of restraints which may amount to ill-treatment or torture.”

Steven Allen, Campaigns Director for Validity said: “It is unsustainable for Czech psychiatrists to continue to defend the caging of adults and children with disabilities under the guise of ‘treatment’. Coercion and institutionalisation remain the default options in the country, an outdated approach which breaches human rights standards and subjects people to abuse and segregation. Czech psychiatry needs to come into the twenty-first century. The Government should invest in community mental health services rather than institutions and must respect the right of persons with mental disabilities to consent to treatment.”

Forum and Validity submitted a report to the Committee against Torture in preparation for the review, setting out deficiencies in national legal standards, the ongoing institutionalisation of children with mental disabilities and the use of tasers in psychiatric hospitals.