CEDH · CASELAW;CLIN;ENG — 20 janvier 2009

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Poland - 28300/06 Judgment 20.1.2009 [Section IV] Article 3 Degrading treatment Inhuman treatment Inadequate medical care and conditions of detention of remand prisoner suffering from serious mental disorders: violation   Article 46 Article 46-2 Execution of judgment State required to secure applicant's transfer to a specialised institution and, generally, to secure appropriate conditions of detention for prisoners in need of special care   Facts : The applicant had suffered from epilepsy since early childhood and had also been diagnosed with schizophrenia and other serious mental disorders. He had attempted suicide and received in-patient treatment in a psychiatric hospital. In 2005 he was arrested on suspicion of robbery and battery and was thereafter detained in various remand centres without psychiatric facilities. His condition continued to require psychiatric supervision. On several occasions he was taken to a psychiatric hospital for emergency treatment following hallucinations and suicide attempts. He was twice admitted to psychiatric units for periods of several weeks for observation. In his application to the European Court, he made various complaints about the detention facilities, including of overcrowding, insanitary conditions, infestation and a lack of recreational facilities. The Government contested most of his allegations, but acknowledged problems of overcrowding. The applicant further complained of inadequate medical care and treatment for someone in his condition and submitted that he should have been held in a proper psychiatric institution instead of a detention facility. In two recommendations (R(98)7 and Rec(2006)2) the Committee of Ministers of the Council of Europe stressed the need for prisoners whose mental health is incompatible with detention in prison to be held in suitably equipped facilities. While the recommendations are not binding on member States, the European Court has in recent judgments ( Rivière v. France , 11 July 2006, Information note no. 88; and Dybeku v.   Albania , 18 December 2007, Information note no. 103) drawn attention to the importance of complying with them. Law : Article 3 – (a)     Admissibility (exhaustion of domestic remedies) : The applicant's psychiatric problems were such that he could not be expected or required to follow the procedures scrupulously. Even though he had not lodged formal complaints under the relevant provisions, the penitentiary authorities had been aware of his situation as he had raised the matter of his medical care and detention conditions in each of his numerous applications to the courts for release and in a separate application to the Ombudsman, all of which had been dismissed as unfounded. The applicant had thus made sufficient attempts to bring his situation to the attention of the authorities. In any event, a formal complaint would not have had sufficient prospects of success as overcrowding had been identified by the Constitutional Court as a structural problem affecting a large part of the prison population and the prison governors, while acknowledging the existence of the problem, had nevertheless decided to reduce the minimum space requirement. An action in the civil courts could only have afforded a financial remedy and would not have changed the applicant's situation. Lastly, a complaint to the Constitutional Court would not have been effective as, although that court had recently ruled that it was unconstitutional for prisoners to be held indefinitely in cramped conditions, the applicant's main complaint was of inadequate medical care and of the need for a transfer to a specialised psychiatric institution. Only a remedy able to address his complaint in its entirety, not just selected aspects thereof, could offer realistic redress. Conclusion : objection dismissed (unanimously). (b)     Merits : The conditions – overcrowding, limited access to exercise and recreation, poor hygiene and sanitary facilities – were not appropriate for ordinary prisoners, still less for a person with a history of mental disorder and in need of specialised treatment. Detained persons suffering from a mental disorder were more susceptible to a feeling of inferiority and powerlessness. Accordingly, increased vigilance was called for when reviewing compliance with the Convention in such cases. The very nature of the applicant's psychological condition had made him more vulnerable than the average detainee and his distress, anguish and fear may have been exacerbated by his detention in unsatisfactory conditions. Above all, the authorities' failure during most of the applicant's time in detention to hold him in a suitable psychiatric hospital or a detention facility with a specialised psychiatric ward had unnecessarily exposed him to a risk to his health and must have resulted in stress and anxiety. It also ignored the Committee of Ministers recommendations in respect of prisoners suffering from serious mental-health problems. In sum, the inadequate medical care and inappropriate conditions in which the applicant was held had clearly had a detrimental effect on his health and well-being. Owing to its nature, duration and severity, the treatment to which he was subjected had to be qualified as inhuman and degrading. Conclusion : violation (unanimously). Article 41 – EUR 10,000 in respect of non-pecuniary damage. Article 46 – General measures : In view of the seriousness and structural nature of the problem of overcrowding and resultant inadequate living and sanitary conditions in Polish detention facilities, the necessary legislative and administrative measures were to be taken rapidly in order to secure appropriate conditions of detention, in particular, for prisoners in need of special care because of their state of health. Individual measures : Poland was required to secure at the earliest possible date the applicant's transfer to a specialised institution capable of providing him with the necessary psychiatric treatment and constant medical supervision.   © Council of Europe/European Court of Human Rights This summary by the Registry does not bind the Court. Click here for the Case-Law Information Notes