This document is a visit report following a visit paid by the National Preventive Mechanism of Georgia to Bediani Psychiatric Hospital on September 26-28, 2018. The technical reports1 of members of the Special Preventive Group participating in the visit were used during the preparation of the report, along with other material. The documentation obtained during the visit, as well as the reports of the members of the monitoring team, are kept in the Public Defender's Office of Georgia. The report contains the main findings of the monitoring team and excludes the possibility of identifying the respondent patients, given the confidential nature of interviews with them. During the visit, members of the monitoring team were able to move around the facility without obstacles and there has not been any hindrance by the administration.

According to the Public Defender, like previous years, overcrowded bedrooms is still a problem at Bediani Psychiatric Hospital, as well as the lack of patients' private space and privacy, non-adapted environment, poor sanitary norms and personal hygiene, practice of application of physical and chemical restraints, lack of access to timely and adequate treatment of somatic diseases, absence of relevant psychosocial rehabilitation and support services, prolonged hospitalization due to negligence and involuntary medical intervention. The Public Defender termed all of the above in the 2015 Annual Report as inhuman and degrading treatment of patients and issued a number of recommendations for the protection of patients’ rights at Bediani Psychiatric Hospital. The recommendations have not been implemented and the situation has not been substantially changed in the institution.

It is worth noting that patients, who do not need active treatment, have remained at Bediani psychiatric institution for many years; they cannot leave the hospital against their wish, because of the lack of services in the community. The Public Defender emphasizes that placement of people with mental health problems in large institutions cannot be considered as a high quality of protection of their rights.

Therefore, the Public Defender calls on the agencies in charge of determining the state policy to take effective steps to facilitate the deinstitutionalization process and the development of community-based services in the shortest possible time. Inter alia, active steps should be taken to build group homes in order to facilitate the integration of beneficiaries into the community. In addition, until the end of the deinstitutionalization process, the Government of Georgia should take immediate steps to ensure a minimal therapeutic environment for patients at Bediani Psychiatric Hospital.

The European Committee for the Prevention of Torture, in a report issued following a visit to Georgia in 2018, called on the State to make every effort to fully implement the obligations under the mental health development strategy and action plan for 2015-2020 and, in this context, substantially develop psychiatric care in the community in order to improve the quality of life of patients and reduce the risk of ill-treatment. The Committee also said that community accommodation should be provided in small living units, ideally located in towns, with all the relevant facilities close at hand.

For detailed observations identified by the Special Preventive Group as a result of monitoring, see the chapters below.