In two of Moldova’s three psychiatric hospitals, there are no special wards for patients who committed crimes while legally insane. Such patients are blended with others, including with self-admitted patients, and so the doors must always stay locked. This was found by the Moldovan Human Rights Institute (IDOM) following a monitoring of the human rights situation in three psychiatric in-patient establishments and six temporary placement centers for people with disabilities.
IDOM executive director Vanu Jereghi told a press conference that the situation is improving, but there is still much work to do to uproot human rights violations. A person may be legally forced into treatment only if there is a court decision, but this is not always the case, IDOM experts believe. Last year there were about seven thousand admissions at the Chisinau Psychiatric Hospital. And this despite the fact that only about 50 forced treatment orders were issued in the entire country. “We are meant to believe that the rest of admissions are voluntary, but we doubt that, because when we visit those institutions, everybody says they want to go home,” said Vanu Jereghi.
At the temporary placement centers, formerly known as psycho-neurological residential institutions, there are closed wards or whole floors where patients are confined for various periods of times. “Often they are left at their own devices. Moreover, per the accounts of patients, they are given psychotropic drugs while in confinement, and not always on the prescription of the center’s psychiatrist”, said Doina Ioana Străisteanu, a human rights expert and practicing lawyer. She added that the patients complain of being treated with aggression and that the staff often fails to intervene to quench conflicts among patients.
Nelea Panfil, project coordinator at Keystone Moldova, said one prevailing issue is the lumping of different patients together, whether it’s intellectual disability, physical disability or geriatric condition. Carers are not skilled or trained to cope with challenging situations, and as a result restrictive measures have become the norm.
Another issue is that patients have limited employment opportunities. “Some beneficiaries, who have the will and ability, go out to work. But they often face abuse, because these people are not very good at calculating money, there is no specialized training for them and some of them don’t have any formal education at all”, said Nelea Panfil.
The monitoring also found patients with incomplete files and missing IDs. “We saw autistic children being admitted to psychiatric wards, where they are held under strict supervision, with no access to education, or leisure activities, or alternative forms of therapy”, added Nelea Panfil.
Psychotherapist Arcadie Astrahan, program director at the Botanica Mental Health Community Center, complained of a shortage of specialists in the entire sector, in both hospitals and residential institutions.