Foreign Detainee Received Treatment Against His Will: Ombudsman

In connection with a call received on the hotlines of the Human Rights Defender's office, representatives from the Ombudsman's department, which functions as a national mechanism for the prevention of torture, conducted a rapid response visit to the penitentiary institution "Hospital for Convicts" under the Ministry of Justice of Armenia. They noted that a foreign detainee registered in the psychiatric department of the penitentiary facility was held in isolation in a closed regime zone and received treatment against his will.

The Ombudsman reported violations stating that the state failed to provide adequate and sufficient detention conditions for the foreign detainee while in de facto captivity in penitentiary institutions. There was a lack of communication with relatives, proper provisions of involuntary psychiatric assistance and services, communication in a language understandable to the individual, as well as due examination and recording of injuries. As a result, the individual’s rights to health protection, personal inviolability, maintenance of contact with the external world, and protection against torture and ill-treatment were violated.

The Human Rights Defender noted that hospitalization of the detainee was carried out without his consent and without necessary legal grounds, and medical interventions were performed without proper justification, including the administration of medications for isolation and sedation. Consequently, the detainee was deprived of the opportunity to make decisions regarding medical interventions performed on his body, which led to violations of his physical and mental inviolability and right to health protection.

Both the hospitalization and the actual involuntary treatment of the detainee in the psychiatric unit of the "Hospital for Convicts" were carried out with gross violations of legislative requirements, which also resulted in a breach of the individual’s right to be free from torture and ill-treatment.

It was also revealed that after a suicide attempt in the "Armavir" penitentiary, the detainee did not receive a proper medical examination and appropriate medical assistance. A psychiatrist only examined the individual four days later. The medical staff did not assess the risk of the individual attempting suicide.

Moreover, regarding the hospitalization in the psychiatric department of the "Hospital for Convicts," the alleged risks associated with the detainee (including for his own or others' life or health) were not evaluated, as were the consequences of not organizing the detainee's treatment effectively without hospitalization, and circumstances that could pose a threat to the detainee's life, health, or surroundings.

The Ombudsman pointed out that upon hospitalization, in the absence of the detainee’s consent, he was not subjected to a psychiatric commission examination within 72 hours, and the process of starting an involuntary treatment was not initiated.

The medical history lacked justification for isolating the detainee, and there was no relevant and reasoned decision from the psychiatric commission or physician-psychiatrist. The decision was made by the acting head of the penitentiary institution to keep the detainee alone in a closed regime patient room, which was without sufficient grounds.

The Human Rights Defender also documented that the foreign detainee was not informed in a language he understands, through an appropriate translator, about his rights, freedoms, limitations, the nature of his mental disorder, the goals, methods, duration, as well as side effects and anticipated results of the proposed treatment, and the consequences of refusing psychiatric assistance and services.

During the detainee's stay in penitentiary institutions, communication with relatives was not ensured, which also resulted in a breach of his right to maintain contact with the outside world.

In the "Hospital for Convicts," appropriate detention conditions were not provided; bedding materials and utensils were not supplied. Only upon the intervention of the Defender’s representatives were bedding materials and utensils provided to the detainee.

The ongoing monitoring conducted as part of the national prevention mechanism by the office of the Human Rights Defender indicates that such cases are widespread. The analysis shows that these stem from the failure to adhere to procedures for hospitalization, involuntary treatment, application of restraint measures, lack of recording of injuries, failure to provide communication in a language understandable to the individual, contact with the outside world, and proper detention conditions, a low level of awareness regarding these issues, as well as the lack of proper oversight by the Ministry of Justice of Armenia.

The Human Rights Defender documented violations in the actions of the respective entities of the administration of penitentiary institutions and the Penitentiary Medical Center. In this context, the Minister of Justice of Armenia has been suggested to: 1) immediately conduct an investigation regarding the violations of the rights of the detainee to address the accountability of the pertinent officers of the administration of penitentiary institutions and the Penitentiary Medical Center; 2) eliminate the practice of involuntary hospitalization without written consent and in the absence of sufficient grounds; 3) eliminate violations concerning the protocols for involuntary treatment of individuals deprived of liberty with mental health issues where sufficient grounds exist; 4) inform the relevant medical staff of the Penitentiary Medical Center on the grounds, procedures, duration, and justification of applying restraint measures to individuals deprived of liberty with mental health issues; 5) regularly conduct awareness-raising activities and periodic training courses on the legal grounds and procedures for voluntary and involuntary treatment for the staff of the penitentiary administrations and the Penitentiary Medical Center to prevent violations of the rights of individuals with mental health issues; 6) decisions to isolate individuals deprived of liberty shall be taken only in cases where there are sufficient and necessary grounds; 7) ensure proper medical supervision of individuals deprived of liberty after incidents and suicide attempts, including medical examinations, properly record any injuries sustained by detainees, and provide the necessary volume of medical assistance; 8) take measures to organize the realization of rights for individuals deprived of liberty, especially regarding medical assistance and services, involving a translator in a language understandable to them; 9) enforce strict supervision over the provision of bedding materials and utensils to individuals deprived of liberty in the "Hospital for Convicts." This decision was also sent to the Prosecutor General of Armenia and the Migration Service of the Ministry of Territorial Administration and Infrastructure of Armenia for information.