For the first time, the European Court of Human Rights has found that the Czech Republic violated a young man’s right to life due to wrong and violent interventions by the staff of a locked psychiatric hospital and police, tragically resulting in his death. The judgment sets an important precedent, challenging the common restraint practices that are often deployed against people detained in the country’s abusive psychiatric hospitals.
The victim, P.Z., was a 30-year-old man who had a long history of health issues and who had become aggressive the night before being taken to hospital. His condition was known to the hospital staff long before the night of 5 November 2015 when he was compulsorily admitted to the Psychiatric Clinic of Olomouc University Hospital, and thereafter was administered anti-psychotic medication without his consent and placed in an ordinary room. The situation deteriorated early the next morning when the young man became restless and the medical staff had decided to transfer him to a so-called “intensive care room” where he would have been mechanically restrained behind a solid metal door. His sister – who also brought the case to the European Court – emphasised that it was precisely the fear of being placed in seclusion that caused her brother’s restlessness. He reacted in self-defence against this measure to which he was vehemently opposed but against which he had no means to defend himself.
As the standoff continued inside the locked psychiatric ward, clinic staff sought police intervention. After two police officers put P.Z. in a prone position, another police officer tasered him three times, and a nurse administered him with two injections of antipsychotic drugs. P.Z. died one hour later, presumably as a result of cardiac arrest. In ensuing investigations, no criminal liability was found either in relation to the hospital staff or the police.
Since 2016, Forum for Human Rights and the Validity Foundation have been seeking justice for P.Z. and his family who were left devastated by his death. Such sad cases highlight the powerlessness with which persons with disabilities are faced when subjected to unreformed psychiatric systems that maintain high levels of coercion and control in violation of modern human rights standards. With its judgment, the European Court of Human Rights has found that persons in such situations of vulnerability are subjected to serious human rights violations through maintaining abusive restraint practices. The Court acknowledged that it is not unusual for people forcibly admitted to closed acute care units becoming agitated or violent. Instead of using physical, mechanical and chemical force, the Court found that healthcare facilities should take appropriate de-escalation measures. Moreover, police intervention should not be sought out on a routine basis –hospital staff should primarily be responsible to provide adequate care.
Both Šárka Duškova, Validity’s Litigation Director, and Maroš Matiaško from Forum for Human Rights, who represented the victim’s sister, welcomed the Court’s findings. Šárka Duškova highlighted:
“This was an entirely preventable death of a young man who was killed in a psychiatric hospital to which his desperate family turned for help. The family called for assistance from mental health professionals weeks before the situation escalated. But the Czech psychiatric system was entirely unprepared. No services with well-trained multidisciplinary crisis teams were available, as they would be in other countries. The implementation of the judgment will require heightened efforts on the part of the Czech Ministry of Health to invest in quality, community-based services capable of safely preventing similar situations.”
Maroš Matiaško, the attorney representing the applicant also emphasised:
“The case of V. v. Czech Republic highlights a systemic problem in the approach to people with psychosocial disabilities who face intervention by police officers. The failure to use de-escalation techniques, the absence of education and the unnecessary use of weapons is a cocktail that can easily lead to disproportionate violence and death. In these regards, it is therefore critical that the state significantly increases the professionalism and competence of medical personnel and police officers. Moreover, there is a deeper problem of high levels of institutionalisation. It is often in institutions where this violence can occur, so the state must take much more active steps to transform the institutional system of mental health care, in conformity with its obligations under international human rights law.”
The victim’s sister who had to live with the trauma resulting from her brother’s death and for whom the judgment today represents a small recognition of the suffering her brother went through, declared:
“I am very glad that the Court stood up for me and I would very much like this situation not to happen again. In particular, I hope that the training of police officers will be significantly strengthened so that any possible intervention with persons with mental illness will be without the use of a Taser.”
Such situations are by no means unique, and indeed are likely to continue in the absence of systemic measures to end involuntary detention, treatment, and the use of seclusion and restraints in psychiatric care. Indeed, such reforms are necessary in accordance with Czechia’s obligations under the UN Convention on the Rights of Persons with Disabilities, which requires an end to detention and involuntary treatment on the basis of disability. Forum for Human Rights and Validity will continue to strive for recognition of the rights of persons with disabilities and we hope that the judgment today will be taken seriously not only by the Czech Government, but also more widely across the Council of Europe.