On February 5, 2020, the Office of Human Rights was informed on the subject that medical personnel at the Republican Specialized Psychiatric Hospital (hereinafter - RSPB) appealed to the relatives of the patients suffering from mental disorders, who were undergoing inpatient care, with a request to take them home for an undefined period due to lack of funding over the past three months. The chief physician of the RSPB is G.I. Kortava confirms the information regarding the lack of funding over the period mentioned, while at the same time denying any cases of the medical stuff addressing the relatives with requests to take the patients home due to lack of budget for the maintenance and treatment in the RSPB. This is not the first time the psychiatric hospital is left without funding. In 2019, the state did not finance the hospital for five months, during which the patients were not provided with drugs essential for their treatment. The Ombudsman became aware of this on 03.10.2019 during a visit to the hospital aimed at checking the facility services and treatment regimes of individuals suffering from mental illnesses. By this time, funding for the hospital had already been resumed. Unstable funding had a negative impact not only on the supply of certain essential drugs, but also on the overall quality of patient care services, including nutrition.

People suffering from chronic mental conditions fall under the category of highly vulnerable population due to the restrictions in their ability to exercise their will. Therefore, a medical facility designed and intended to treat people with mental health conditions is highly responsible for the quality of the medical help provided. Thus, a psychiatric institution must be supplied with all the necessary resources, including: a) diagnostic and therapeutic equipment, b) drugs required for regular and comprehensive treatment; c) qualified medical personnel to ensure the proper treatment of patients.

It is unacceptable that, due to the lack of essential diagnostic and therapeutic equipment or the untimely provision of medical supplies for the hospital, the patients of the psychiatric unit would be exposed to unreasonable risks.

We consider it our duty to state that violation of the rights of citizens in receiving quality medical care in mental health facility is often directly related to the lack of adequate funding. In this regard, drawing up a budget for a medical institution and ensuring timely financing of its full-fledged activities is a prerequisite for providing quality medical care to patients. In order for this to be achieved it is necessary to allocate the salaries for employees in advance while ensuring that they are adequate to the difficulty of their duties, considering the amount of work and moral burden associated with the provision of services to patients suffering from acute psychotic disorders.

A mental health unit is a community-based and secure institution, inaccessible to the public. People undergoing treatment there must be under the close scrutiny of the state in order to avoid discrimination of their rights.

The state, demonstrating its adherence to the principles of humanity, respect for the inherent dignity of the person, should strive to ensure that the environment and living conditions of patients in a psychiatric hospital are as close to the conditions of normal life as possible, especially since the length of stay for certain patients in the hospital varies from months to years. It is categorically unacceptable to interrupt inpatient treatment due to funding problems.

Based on the above, we consider it necessary to conduct a comprehensive assessment of the activities of the Republican Specialized Psychiatric Hospital, including an analysis of resources, hospital needs, funding, staffing, work schedule in order to identify the causes of the reoccurring crisis in the RSPH that poses a threat to the health of patients. Another objective for such assessment is to prevent similar situations in the future.

We appeal to the Prime Minister of the Republic of Abkhazia with a request to take appropriate actions aimed at ensuring the effective functioning of the RSPB as well as at protecting the rights of patients in a psychiatric facility.

High Commissioner for Human Rights

Asida Shakril