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26 June - International Day in Support of Victims of Torture: Welfare Facilities Lacking Proper Legal Framework

Torture and other forms of inhuman and degrading treatment could happen anywhere, but they are especially severe if happening to people with limited freedom of movement. Among those people are some of the beneficiaries of welfare facilities. The current state of affairs concerning the formal and legal framework for limiting their freedom of movement and running subsequent proceedings, esp. in situations when, due to a medically induced condition, they could harm themselves or other people, is conducive to human rights violations. 

Welfare facilities in the Republic of Serbia, aka the Autonomous Province of Vojvodina, do not have a special rulebook for implementation of physical restraint and isolation measures of beneficiaries whose health status is such that they could harm themselves or others in their immediate surroundings. In order to establish to what degree these measures are implemented under the circumstances, who decides on it, as well as whether the beneficiaries' official representatives and other institutions in charge are being informed about them, the Provincial Protector of Citizens - Ombudsman (PPCO) conducted a research survey entitled 'Implementation of Physical Restraint and Isolation Measures in Welfare Facilities in AP of Vojvodina'.

The survey has been conducted in 25 welfare facilities, aka homes housing various beneficiaries (the elderly, children, people with psychiatric conditions, as well as those with mental and sensory disabilities) in Vojvodina. Its results indicate that more restrictive measures of physical restraint and isolation of beneficiaries are used relatively rarely or only as the last instance in cases of people whose behavior could be harmful to themselves or others. The survey has also showed that the decision-making procedures and the way of implementation of these measures differ from one facility to another. 

'All this time, welfare institutions lack a clearly defined rulebook on the measures of treating agitated beneficiaries and it is a major problem. Inconsistencies in this field have led to a general feeling of insecurity of employees in immediate contact with beneficiaries,' says the general manager of one of the facilities providing inputs for the survey. Considering various needs and health conditions with elderly population, the interviewees also hold that it is justified and absolutely necessary for measures of physical restraint and isolation of people in welfare facilities to be regulated by a specific welfare-related document.

'The legislation introduces clear rules - mandatory and equal treatment according to proscribed norms. It provides for minimum mistakes,' says one of the interviewees. Lacking an adequate rulebook pertaining to welfare, the PPCO did the survey referring to the provisions of the Rulebook on Specific Conditions for Implementation of Measures of Physical Restraint and Isolation of People with Mental Disabilities Treated in Psychiatric Institutions. However, this rulebook regulates procedures in healthcare facilities and relates to only one specific category of beneficiaries, meaning that it is not entirely relevant for and applicable in welfare institutions.

Besides lacing a proper rulebook, the interviewees indicated that the question of institutional placement of people with a mental disability (of usu. moderate degree) and in need of psychiatric treatment beside it is still unresolved. Serbia has no facilities for adequate institutional housing such people, so they usually get portrayed and categorized as people with a severe degree of mental disability and placed in any of the available welfare facilities, regardless of the fact that the existing facilities are objectively not in a position to provide them with an adequate treatment.