ECHR Article 3
Degrading treatment
Structural problems resulting in prisoner suffering from mental disorders being held for more than fifteen years in prison psychiatric wing with no hope of change or appropriate medical care: violation
Facts – In February 1978 a Criminal Court judgment ruled that the applicant, who had raped his underage sisters, was not criminally responsible for his actions. After committing a series of sexual assaults the applicant, who has an intellectual disability, was held continuously in the psychiatric wing of a prison from 1994 onwards, with the exception of a single period of twenty-two months outside prison following a decision of the Mental Health Board.
Law – Article 3: Apart from access to the prison psychiatrist or psychologist, no specific treatment or medical supervision had ever been prescribed for the applicant. Starting in 2002, he had been able to participate in the activities offered by an association and in September 2005 the prison’s psychosocial unit, backed up by the Mental Health Board, had observed an improvement in his condition and had raised the possibility of his situation being reviewed. However, he had remained in the psychiatric wing until 2009 since no facility had been found that was prepared to accept him. This long-lasting situation, which had continued since 1994, had clearly had a detrimental effect on the applicant’s psychological state. He had suffered distress owing to the lack of any prospect of having his situation reviewed; in addition, he had not come any closer to understanding his problems and required individual and intense supervision.
The Court did not underestimate the efforts made within the prison to improve the support provided to persons in compulsory confinement. Nevertheless, the applicant’s allegations were corroborated by unanimous findings at both national and international level with regard to the unsuitability of psychiatric wings for the detention of persons with mental health problems because of widespread staff shortages, the poor standard and lack of continuity of care, the dilapidated state of premises, overcrowding and a structural shortage of places in psychiatric facilities outside prison. Likewise, the Court did not underestimate the steps taken by the authorities on a regular basis from 1998 onwards to find the applicant a place in an external facility geared to dealing with his disorder. However, the applicant’s situation stemmed in reality from a structural problem. The support provided to persons detained in prison psychiatric wings was inadequate and placing them in facilities outside prison often proved impossible either because of the shortage of places in psychiatric hospitals or because the relevant legislation did not allow the mental health authorities to order their placement in external facilities. Accordingly, the national authorities had not provided the appropriate treatment for the applicant’s condition in order to prevent a situation contrary to Article 3 from arising in his case. His continued detention in the psychiatric wing without the appropriate medical care and over a significant period of time, without any realistic prospect of change, therefore constituted particularly acute hardship causing distress which went beyond the suffering inevitably associated with detention. Whatever obstacles may have been created by the applicant’s own behaviour, they did not dispense the State from its obligations in his regard by virtue of the position of inferiority and powerlessness typical of patients confined in psychiatric hospitals and even more so of those detained in a prison setting. Hence, the applicant had been subjected to degrading treatment on account of his continued detention over a significant period under the conditions referred to above.
Conclusion: violation (unanimously).
The Court further found a violation of Article 5 ss 1 (e) since the applicant’s confinement in prison in breach of Article 3 had also severed the requisite link between the aim of detention and the conditions in which it was effected. It also found a violation of Article 5 ss 4 with regard to the review of lawfulness that could be conducted by the Mental Health Board.
Article 41: EUR 16,000 in respect of non-pecuniary damage. The applicant’s transfer to an institution geared to his needs constituted the most appropriate form of redress.
Citations:
43418/09 – Legal Summary, [2013] ECHR 286
Links:
Statutes:
European Convention on Human Rights 3
Human Rights, Health
Updated: 14 November 2022; Ref: scu.472437