The Otthon Welfare Facility in Stara Moravica: Increased Mortality & Beneficiaries Behind Bars

28.08.13 St Moravica Otthon 005The last visit of the Provincial Protector of Citizens - Ombudsman (PPCO) to the Otthon Home for Persons With Mental Disabilities in Stara Moravica showed that mortality of its beneficiaries increased over the last couple of years. Some beneficiaries have been in isolation since 2011, with no prospects of change or any idea of those in charge on how to improve their position in a foreseeable future.

The beneficiaries of the Home are people with no families or have been abandoned by them. The reason for the last visit of the Deputy Ombudsman Stevan Arambasic to Otthon was to get a first-hand insight into the health status of the beneficiary M. T., who has been in permanent isolation since 2011 and is undergoing a civil capacity deprivation procedure. This beneficiary has been practically isolated in inhuman environment for five years now, in a room with no running water or lavatory, its windows and doors barred. Despite recommendations to work with M. T. intensively with a team of experts in order to socialize him and reintegrate into a group, the Home claims that a lack of staff makes it impossible to implement any individual activities with him. Considering the time he has spent in isolation and his current psychological status, the Home management holds that the only solution for his adequate treatment and protection is transferring him to another welfare facility or a hospital. 

Based on these findings, the PPCO underlines that one of the mental health protection system reform measures recommended to the Serbian Government and its Ministries by the local civil society organizations is also humanization of the housing and care facilities for persons with mental disabilities. The UN Committee against torture also holds that isolation of persons with grave or acute mental disabilities is not allowed, while the position of the UN Special Rapporteur on torture is that isolating such persons for any time is to be considered cruel, inhuman or humiliating treatment.

During this visit it turned out that, amongst others, the beneficiaries' mortality in 2014 had nearly tripled as compared to that of 2013. From 2010-2014, a total of 70 beneficiaries died in this home; 23 of them died last year, while only nine of them died in 2013. The highest mortality rate (over 60 percent) is among males aged 18-65. The staff finds this fact worrying since it cannot be justified either by the beneficiaries' age or their diagnosis, aka the nature of their illness that is the reason of their placement in the home. All deceased in 2014 were under 40 and only nine of them died in a hospital. Due to either a failure to provide the caretakers' consent or the position of the Home that there was no need for it, not a single autopsy of the deceased beneficiaries had been performed. This circumstance, as well as the general state of affairs in the Home, was the reason why the PPCO requested the Inspection Section of the Serbian Healthcare Ministry to arrange for a detailed monitoring of healthcare services provision in this Home.

Visits to the Otthon Home for Persons With Mental Disabilities in Stara Moravica are a part of the regular PPCO activities ever since its establishment. Since 2011, monitoring of the welfare and healthcare services provision falls within the mandate of the National Prevention Mechanism (NPM) for prevention of torture and other cruel, inhuman or humiliating treatment as well. This mechanism pays special attention to the so-called closed institutions, the ones not accessible to the public, such as the Home in Stara Moravica. Such visits are a chance to talk to their management, staff and beneficiaries in order to get an insight into the everyday living conditions in these facilities, the support they provide, the possibility of exercise of all rights granted to the beneficiaries, as well as their contacts with their families. Within the frame of its mandate, the PPCO institution will continue monitoring the state in this Home and offering support to its staff aimed at improving mechanisms of beneficiary protection and human rights exercise.