GREEK HELSINKI MONITOR (GHM)
Address: P.O. Box 60820, GR-15304 Glyka Nera
Tel.: (+30) 2103472259 Fax: (+30) 2106018760
e-mail: firstname.lastname@example.org website: https://greekhelsinki.wordpress.com
Parallel Report on Greece’s compliance
with the Convention on the Rights of Persons with Disabilities
11 February 2019
This report was prepared for submission to the United Nations’ Committee on the Rights of Persons with Disabilities (CRPD) for the compilation of a list of issues on Greece during its 11th Pre-Sessional Working Group (8-11 April 2019). It contains comments on Greece’s Initial Report (CRPD/C/GRC/1) submitted on 1 June 2015.
Greek Helsinki Monitor (GHM), founded in 1993, monitors, publishes, lobbies, and litigates on human and minority rights and anti-discrimination issues in Greece and, from time to time, in the Balkans. It also monitors Greek and, when opportunity arises, Balkan media for stereotypes and hate speech. It issues press releases and prepares (usually jointly with other NGOs) detailed annual reports; parallel reports to UN Treaty Bodies; and specialized reports on ill-treatment and on ethno-national, ethno-linguistic, religious and immigrant communities, in Greece and in other Balkan countries. It operates a general web site (http://greekhelsinki.worldpress.com), a specialized website on racist crimes in Greece (https://racistcrimeswatch.wordpress.com) and a Facebook page (https://www.facebook.com/panayote) covering human rights issues and comprehensive and comparable presentations of minorities in the Balkan region. GHM is a member of the European Implementation Network (EIN); GHM’s Spokesperson Panayote Dimitras has been a member of EIN’s Board since 2018; GHM is a member too of the World Organization Against Torture (OMCT) Network and GHM’s Spokesperson Panayote Dimitras is an OMCT General Assembly member. GHM is also member of the Justicia European Rights Network, the International Detention Coalition (IDC), the International Network Against Cyber Hate (INACH), the Network Against the Extreme Right, the Campaign for the access to asylum, and the Greek Network for the Right to Housing. Panayote Dimitras is the correspondent of Hope not hate in Greece.
Greece mentions that its country report “was prepared in cooperation with … the National Confederation of Disabled People (ESAMEA)”. Yet, on the ESAMEA website, very rich in information about all ESAMEA activities, meetings, reports, etc., there is no reference to such a contribution, nor is Greece’s report available there. In fact, Greece’s report does not seem to be available on line anywhere. Moreover, unlike for all other reports to UN Treaty Bodies, the Greek National Commission for Human Rights (NCHR) was not asked to comment on the draft before its submission to CRPD.
The report was prepared by the Directorate of International Relations of the Ministry of Labor, Social Security and Social Solidarity, which was at the time the focal point for Greece, but on the Ministry’s website, neither is the report available, nor is there any reference to its focal point role.
Since 2017, with Law 4488/2017, the central focal point is the General Secretariat for Human Rights at the Ministry of Justice. Yet on its website there is no reference to its focal point role or to any related action it may have taken, nor is the report available. On the personal website of the General Secretary Maria Yannakaki there is only one statement on the 2017 National and International Day for Persons with Disabilities which is declaratory of its intentions. It was not repeated in 2018. Additionally, hundreds of focal points have been established: one in every Ministry (that must inter alia publish an annual report), plus all Mayors and Regional Governors themselves (no obligation for annual reports). In no Ministry website as well as in no Municipality or Region website is information about such responsibility or related action available, although occasionally some action related to the rights of persons with disabilities may be listed.
Since 2017 as well, the Coordination Mechanism is the Minister of State who appointed in June 2018 on of his assistants as Director for the Operation of the Coordination Mechanism. On the Ministry’s website one will find two broad declaratory statements from 2016 and 2017 on the implementation of the CRPD and a Statement on the 2018 National and International Day for Persons with Disabilities. There is also a webpage with actions taken through 2018. There is however a very rich and active Facebook page that informs about several related activities including new related legislation. Yet the report is not there either.
Finally, since 2017 there is also a Framework for the Promotion of the Implementation of the CRPD who is the Greek Ombudsman. This Independent Authority has mediated in several individual cases following complaints related to the rights of persons with disabilities. However, its first comprehensive annual report that is mandated to evaluate also legislation and policies is due for publication in March 2019. Also, the report is not available on its website either, as it appears to be “Greece’s best kept secret!”
It is worth mentioning that, soon after the adoption of the CRPD by Greece, then City of Athens Ombudsperson issued a legal advice on the 2013 National and International Day for Persons with Disabilities. The table of contents is indicative of everyday problems faced by people with diability: “Priority in cases of people with disabilities pending before the services of the Municipality of Athens and not yet processed – Documents requested when submitting applications for the provision of parking spaces even though not provided for in the relevant Municipal Council Act – Discontinuation of financial aid to persons with disabilities only after issuing of a relative social worker’s report – From the beginning, inform the person concerned of the possibility to pay any overpayments in installments – Consultation with organizations representing people with disabilities, to review the City Council Act for parking facilities and the overall institutional framework for conducting audits on behalf of municipal services when targeting acts of disabled people for the exercise of the right of accessibility – Forwarding of requests to third party services, outside the City of Athens – Collection of all information on the rights of people with disability that can be exercised through the City of Athens Portal more easily accessible website with a clear mark on the home page.” The Mayor of Athens (who was before the Greek Ombudsman) never replied to that report, nor did he implement the recommendations, not even the one to introduce a clear mark in the homepages of the Municipality and of the Municipal Multi-Purpose Centers linking to related information.
Greece should therefore be asked to provide:
- “Αn explanation of the procedure used to consult [for the drafting of the report] with civil society and in particular with representative organizations of persons with disabilities and the measures taken to ensure that this process was fully accessible,” as well as on the availability (if any) of the report in Greek and in English on state websites.
- Comprehensive summary reports of the actions of the Central and other Focal Points, the Coordination Mechanism and the Framework for the effective implementation of the Convention and the transparency of their activities through easily accessible websites; and in particular the first forthcoming report of the Greek Ombudsman in its role as Framework.
- Information as to whether focal points in all Ministries, Municipalities and Regions have been appointed and if so where is a list of all of them available as well as where is information oν their work available on line.
- Exhaustive list of all new legislated developments since 2015, as well as of their implementation along with a critical evaluation and an impact assessment.
- Information on the implementation of the 2013 recommendations of the City of Athens Ombudsperson.
In paragraph 9 of the report it is correctly stated that “disability is not treated as a medical problem through the assignment to it of a specific percentage of disability, but as a result of the interaction between people with disabilities and behavioural disorders and obstacles, which derive from their physical environment and from existing social prejudices and can prevent their equal access to and participation in society.” Except that this is not applied in Greece. The criteria for the assignment of a percentage of disability are established by Decision Φ. 80000/45219/1864 and are exclusively medical. There is no assessment of possible “interaction with various barriers.”
Additionally, the report reports that most complaints received by the Greek Ombudsman concern “reasonable accommodation.” Yet, the Ombudsman’s conclusions and recommendations are not reported.
Greece should therefore be asked to explain why in Decision Φ. 80000/45219/1864 the assessment of disability is strictly made as a medical problem; as well as to provide at least a comprehensive summary of the Ombudsman’s recommendations on the basis of the complaints it has received.
Article 5 – Equality and non-discrimination
There is indeed antiracism Law 927/79 applicable since 2014 also to cases with persons with disabilities as victims. There is also Article 81A of the Criminal Code on racist crimes that includes disability in the criteria to discern racist motive. However, there has never been any training of prosecutors and judges and/or lawyers on the treatment of disability as a concept, the persons with disabilities as subjects who turn to justice for the defense of their rights. The result is that there is a widespread impression that the related case law is very thin and there is no known conviction to date.
Greek Helsinki Monitor, on 1 October 2018, monitored a trial, before an Athens Three-Member Misdemeanors Court, of a taxi driver accused of “illegal violence motivated by the disability of the victim” because on 25 May 2015 he had used violence to refuse a ride to a person with spastic tetraplegia, who also happened to be an activist for the rights of persons with disabilities. It is noteworthy that at the time the taxi company who had sent the driver to the client offered her apologies and dismissed the driver. In the hearing, the evidence was compelling and the prosecutor, who happened to be also the special Athens Prosecutor for Racist Crimes but also OSCE’s Contact Point in Greece for Racist Crimes, asked for the conviction of the defendant delivering an eloquent explanation why there was such a crime. Yet the court, with judgment AT2573/2018, acquitted the defendant fully subscribing to the defendant’s version of the event, not corroborated by any eyewitness, who stated that he thought that the victim was drunk… It is commendable that the Prosecutor’s Office appealed the acquittal and a trial before an Athens Three-Member Appeals Court will be held on 18 September 2019, but the judges who delivered the acquittal are not known to have been the subsect of any disciplinary procedure.
Moreover, anti-discrimination Law 3304/2005 was abolished in 2016 and was replaced with Law 4443/2016. Greece fails to provide any statistical data on the implementation of Law 3304/2005 and information on the administrative or criminal sanctions it may have led to, let alone any impact assessment.
Yet an important deficiency of the Greek legal system is that sanctions against those who park in special parking places for persons with disabilities, or in ramps for persons with disabilities, or in pathways for the blind are only administrative and can only be imposed by police officers present to record them. There is repeated experience of reluctance of police to respond to such calls promptly or sometimes not at all, usually because of the severity of the sanction, i.e. removal for 60 days of the car license plates and license permit as well as the driver’s license, but only for the parking places and the ramps. So this is a regular scene in related public spaces in Greece (pictures from January 2019 GHM complaints; they were taken in Greater Athens suburbs Kallithea and Glyka Nera – when the emergency police number 100 was called for the Glyka Nera violation they refused to send anyone).
There is no special sanction for those parking in pathways for the blind, which is treated as mere parking οn pedestrian walks with a fine of 40 euros. Let alone that most pathways for the blind are unusable. So this is a regular scene in related public spaces in Greece, namely of a police bus parked in the Athens Appeals Court (on the left – the Athens Appeals Court is around the corner from the Supreme Court) and from the very center of Athens (by the National Theater) on the right where the pathway for the blind is interrupted by water and electricity metal constructions giving access to underground instruments, let alone that it is in terrible shape (GHM pictures from a complaint filed in December 2018 on the left and a not yet public report to the City of Athens in January 2019 on the right – GHM has on file scores of similar pictures and has filed half a dozen complaints for the police abuse at the Athens Appeals Court all ignored by the Prosecutor for Racist Crimes!).
In its complaints, GHM has argued that the antiracism legislation is applicable as those parking in these places deliberately and publicly cause an actual discrimination against persons with disabilities as they deny those persons the right to circulate in the respective places without discrimination since in effect they hinder the accessibility to those places.
Greece should therefore be asked to provide statistics from the use of Laws 927/79 and 3304/2005 and its replacement 4443/2106 with administrative and criminal sanctions imposed; explain why the administrative sanctions imposed for parking in ramps and in parking places for persons with disabilities are not also applicable for parking in pathways for the blind; also explain the acquittal in the October 2018 trial and inform is after the appeal sanctions were imposed on the judges and provide information on training of judicial and law enforcement officials on how to treat complaints from persons with disabilities; and inform if it considers introducing criminal legislation to punish parking in places or pathways reserved for person with disabilities and why no sanctions have been imposed in several cases reported by GHM and other organizations or individuals.
Article 6 – Women with disabilities
Greece does not keep statistics for women with disabilities, related to criminality, victimization, employment, participation in political life, etc. Several campaigns and informational social spots do not meet the standards of accessibility, e.g. the spot for the eradication of violence against women. Information, particularly of those who are highly vulnerable, like women with intellectual or mental disabilities, is inadequate if not non-existent. Shelters for victimized women are not accessible. Policies for women with disabilities are not included in mainstream policies. No initiatives have been taken to support women with disabilities during pregnancy. Medical staff should properly inform disabled women about the versions of prenatal screening and decision-making regarding serious operations like abortion, sterilization, etc. The information should be fully accessible so as to be understood. Women with mental disabilities are highly vulnerable to sterilization. Modern technology is a help and can improve the daily living of women with disabilities. There is no evidence that medical staff is systematically informed about all these issues.
Greece should therefore be asked to provide if available statistical data on women with disabilities in relation to criminality, victimization, employment, participation in political life; also inform on accessibility of information for women with disabilities through campaigns or other material, as well as accessibility of shelters for victimized women; and finally inform on support to and information for women with disabilities during pregnancy.
Article 8 – Awareness-raising
The public television program does not provide programs with an acoustic description for the Blind. Newscasts in sign language to the deaf after the 2018 Ministerial Decision are only 7 minutes a day … Accessible decoders for people with disabilities were never given in 2008-2009 although announced. There is no adaptation of subtitling to a very simple text for People with Intellectual Disabilities. All that apply to the private television stations as well.
Greece in the report mentions that the text of the UN Convention on the Rights of Persons with Disabilities is now available in various accessible formats, including in Greek Sign Language and Greek Braille writing, but does not mention where: neither is the original form nor in these formats is the Convention available in the websites of the three governments agencies referred to above, or of the NCHR or –for the accessible formats- of the ESAMEA.
Greece should therefore be asked to provide detailed information on the relevant programs available on public and on private television, including newscasts and of the availability of accessible decoders; as well as on the availability of the Convention in all formats in public websites as well as in the ESAMEA one.
Article 9 – Accessibility
The legal provisions on accessibility submitted by Greece are to a large extent satisfactory. Yet, there is no information as to their implementation, including most crucially which qualified body assesses the effective accessibility of all facilities that are supposed to have adapted to the regulations. As already stated above, in a large number of cases, pathways for the blind are totally inadequate, and the same is true with many ramps for persons with disabilities that are two steep or too rough to be able to be used effectively. There are no effective remedies against such inappropriate constructions, which is why none is reported by Greece.
Let alone the fact that, as mentioned above, these facilities are often abused by persons without disabilities with very rare to be efficient control and sanctions by police.
While indeed the Athens Metro and the main airports are accessible, the trains and most ships including ferries and most ports are not.
Ramps in buses often do not operate because of lack of adequate maintenance. Additionally although guide dogs are allowed in public transports, many drivers are not informed let alone trained and there are frequently reported incidents of refusals to allow those dogs aboard buses. Again, even when reported including with complaints, GHM experience shows that authorities often fail to impose administrative or criminal sanctions.
The portal www.prosvasi-amea.gov.gr was launched in 2013 in the framework of an EU-funded project but as it is no longer available nor are traces of it available in the Internet Archive one can assume that is was discontinued soon after its launch when the project ended.
Greece should therefore be asked to provide concrete information on state agencies that inspect and evaluate the accessibility of all facilities provided by law, including with statistics on inspections, conclusions, possible rejections, sanctions etc.; as well as on effective accessibility of buses, trains, ships including ferries, and ports, and on training of drivers to accept if not facilitate access of guide dogs and sanctions when they refuse; and finally, as to the fate of the portal www.prosvasi-amea.gov.gr and any replacement.
Article 13 – Access to justice
Access to justice for people with disabilities as well as for judicial officials with disabilities including lawyers is extremely difficult, as most courts or court buildings –including in Greece’s largest court house, the Athens First Instance Court- lack accessibility.
Moreover, there is a lack of training of police officers on the treatment of persons with disabilities in detention of any kind. For example, it has been reported that they wear handcuffs to the deaf and do not remove them so that they can sense or use the sign language in the investigative and other processes that require communication.
Greece should therefore be asked to provide information as to the accessibility of all court houses; as well as to the training of police officers on how to treat persons with disabilities in detention especially the deaf.
Article 21 – Freedom of expression and opinion, and access to information
The “Guide for the Disabled Citizen” (paragraph 182) is indeed a very good practice except that it dates from 2007 and therefore needs updating.
Article 24 – Education
As ActionAid Greece stated based on their 2014 research, “the most shameful element of our survey is that only 15% of the children with disabilities in Greece go to school! Only 15%! The remaining 85%, that is some 170,000 children remain invisible to the education community, limiting their chances to become visible in the future to our society.” “According to head ActionAid researcher Pelagia Papanikolaou, a PhD [in criminology] at Athens Law School, the main obstacles keeping disabled children from receiving an education are shortages in transportation, infrastructure such as ramps, audio-visual aids, staff and regular funding.”
In the survey it was also highlighted that there is no national database of children with disabilities or of persons with disabilities in general. Additionally, data is provided to the effect that for the school year 2014-2015, according to an ESAMEA – General Confederation of Workers in Greece (GSEE) comprehensive study, only 1,740 out of some 4,000 applications for provision of parallel support to children with disabilities to attend general schools were approved, while it is not known if and where the remaining approximately 2,300 children attended school in that school year. The limited number of applications approved is attributed to the lack of funds as a result of the crisis. Moreover, there is no updated database and evaluation of the functioning and the needs of special education schools especially at the time of financial crisis and the effects of the latter on those schools. There was a general promise by the Ministry of Education that such data bases will be created in 2015-2016 but it was not materialized, which was confirmed by the fact that there is no such reference in Greece’s report.
In 2015, GHM submitted this information to the UN CESCR and UN HRCttee requesting them to reiterate the UN CRC’s 2012 recommendations to Greece on children with disabilities GHM included in the reports:
Disability, basic health and welfare (arts. 6, 18 (para. 3), 23, 24, 26, 27 (paras. 1-3) of the Convention)
Children with disabilities
- The Committee notes that the State party has adopted laws and established services and institutions with the aim of supporting children with disabilities, promoting their social participation, including joint learning in schools, and developing their independence. However, the Committee remains concerned that deep-rooted discrimination still exists and that measures for children with disabilities are not carefully monitored, as well as the unavailability of the statistical data on children with disabilities in the State party. It is deeply concerned at the widespread use of institutionalization, mainly because of lack of day care and community services for children with the most serious forms of disabilities. The Committee is further deeply concerned about the recently reported case of Children’s Care Centre in Lechaina of children with disabilities living under inhumane and unacceptable conditions including being systematically sedated and subject to practices such as being tied to their beds, and the use of cage beds due to shortage of staff.
- The Committee recommends that the State party, in accordance with its General comment No.9 (2006) on the rights of children with disabilities:
(a) Revise and adopt specific legislation in order to fully protect all children with disabilities, and establish a monitoring system, which carefully records progress made and identifies shortcomings in implementation;
(b) Provide community-based services that focus on enhancing the quality of life of children with disabilities, meeting their basic needs and ensuring their inclusion and participation;
(c) Make every effort to provide programmes and services for children with disabilities with adequate human and financial resources and periodic monitoring of placement of children with disabilities and to adopt, as a matter of priority, measures to ensure that no children with disabilities are placed under such inhumane conditions. Furthermore, placement in residential institutions should be the last resort, depending on the needs of the child;
(d) Equip schools with the necessary facilities for the inclusive education of children with disabilities and ensure that they can choose their preferred school or move between regular schools and special needs schools according to their best interests;
(e) Provide assistance to non-governmental organizations (NGOs) working for and with children with disabilities; and
(f) Ensure that residential centres for children and persons with disabilities are adequately staffed and that training is provided for professional staff working with children with disabilities, such as teachers, social workers, health, medical, therapeutic and care personnel.
The two UN Committees issued the following related concluding observations and recommendations:
Inclusive education for children with disabilities (CESCR – 27 October 2015)
- Despite measures taken by the State party, including Law 4115/2013 which facilitates integration of students with special education needs in mainstream schools, the Committee is concerned at reports indicating extremely low rate of enrolment of children with disabilities in schools, indicating that only 15% of the children with disabilities go to school (arts. 13 and 2, para. 2).
- The Committee recommends that the State party collect disaggregated data on school enrolment and drop-out rates at various levels of education of children with disabilities, disaggregated by sex and national or ethnic origin, to identify obstacles to accessing and continuing education and to devise appropriate strategies. The State party should also ensure that all children with disabilities have access to quality and inclusive education.
Persons with disabilities (HRCttee – 3 December 2015)
- The Committee notes with concern the discrimination faced by persons with disabilities, in particular with regard to access to education, employment and health services and further regrets the impact of the economic crises and austerity measures on their situation. While noting the information provided by the State party that physical restraints on mental health patients are only used as a measure of last resort, the Committee is concerned at reports indicating the continuing widespread use of such measures, including the use of enclosed restraint beds (cages/net beds) and systematic sedation as a means to restrain patients with intellectual disabilities, including children, in institutions. (arts. 2, 7, 9, 10 and 24)
- The State party should strengthen the measures taken to protect persons with disabilities from discrimination, particularly with regard to access to education, employment and health services. The State party should take immediate measures to abolish the use of enclosed restraint beds and systematic sedation in psychiatric and related institutions. Furthermore, the State party should establish an independent monitoring and reporting system, and ensure that abuses are effectively investigated and prosecuted and that redress is provided to the victims and their families.
Greece should therefore be asked to provide detailed and documented in transparent way information on how it implemented the recommendations of UN CRC, UN CESCR and UN HRCttee including whether a comprehensive and transparent data base on children with disabilities’ school attendance and provision to them of parallel support (as well as applications for such support) has been or is being established.
Article 25 – Health
On 17 August 2016, the Council of Europe Commissioner for Human Rights (CHR) sent a letter to the Greek government with concerns on “the human rights of persons with intellectual and psychosocial disabilities and their de-institutionalization” following his visit to Greece. We reproduce below in facsimile his grave concerns, mainly on the extensive use of sedatives and restraints including cages, as well as on very high rates of compulsory psychiatric confinement, often in violation of national legislation as confirmed by two ECtHR judgments in 2011. Greece for the first time in the history of CHR visits and ensuing letters or reports on Greece did not provide any replies! Moreover, Greece has also failed for more than six years to provide the Council of Europe Committee of Ministers, supervising the execution of the two judgments, with “an action plan on the measures taken to address all the shortcomings identified by the Court regarding the procedure of involuntary placement for psychiatric examination” (see summery below).
Commissioner for Human Rights letter to the Greek government (excerpts)
Committee of Ministers summary of the state of execution of
Venios & Karamanof judgments (2019)
Case Description: Involuntary placement for psychiatric examination in breach of domestic law (violation of Article 5 §1 e). More specifically the Court found that competent authorities did not comply with the timeframe set in domestic law for the involuntary placement of the applicants for psychiatric examination.
General measures: action plan received on 23/04/2012. Up-dated action plan/report is awaited on the measures taken to address all the shortcomings identified by the Court regarding the procedure of involuntary placement for psychiatric examination (see in particular par. 48 of the Karamanof judgment).
Moreover, the CHR made reference to the mental health facility (KEPEP) in Lechaina (Pleoponnese). Its case became widely known in Greece from 16 February 2011 onwards with a series of almost daily articles by in the daily “Eleftherotypia.” The articles were based on a report “Working with people with compromised development and their rights to access a full and rewarding life. Report about the children’s human rights inside ΚΕΡΕΡ Lechainon, IIlias Prefecture, Greece” written in November 2009 by a group of five volunteers who worked for a period of seven months in Greece as part of the Youth in Action Program – European Voluntary Service. The articles include pictures of children tied all day to their cages or beds (see one here). The summary impressions of those volunteers were:
“We have reached the conclusion that ΚΕΡΕΡ, Lechainon does not manage to promote basic human rights that ensure that these children with disabilities can live a worthy life in optimum conditions, developing their own abilities and some amount of self-care. We would like to think that the subhuman conditions that these children live currently in will change someday. At the same time, we feel a great ethical responsibility to bring their plight to the attention of somebody who has the ability to make changes. We are calling for a commitment and strategic action from the Greek state with respect to the population with special needs and in particular to Greek children with disabilities. At present (November 2009) there is no psychological therapy available and it has been like this since December (2008) .The physiotherapists do not have a specific room within ΚΕΡΕΡ, so even though there are 2 hired and paid physiotherapists they do not actively work and provide this service. The therapy sessions are mainly lead by the Occupational therapist but she has to work with little resources and motivation. From what we have seen of the sessions, there is little production and the small tasks that take place are simple for even an unqualified person to administer. There is only one doctor present in ΚΕΡΕΡ to diagnoses and administer prescriptions. She is newly qualified and has little experience in such an extreme care centre. When the passage refers to the ‘inmates’ receiving therapy, in actuality only a very small percentage really do. Αll the inmates have some form of disability and therefore should be eligible for therapy. Only 14 get the opportunity to attend therapy, and unfortunately these are not the children most in need of this service. Calling the children ‘Inmates’ doesn’t promote an image of free, happy, life full people that a care centre should promote, but instead images of criminals in cages, looked away in prison. Therefore this observation may actually me the only truth in the whole passage, because in fact the children and young people are treated like criminals; being deprived of their luxuries and freedom of choice. In fact there are many cages that these children have to live in day in day out, and in fact the place feels like a prison, with a life sentence for all, but only for the crime that these children where born disabled with unfortunate social situations. We ask the law and state is this fair and justified?”
On 23 March 2010, the Ombudsman, based on this information, alerted the Ministry of Health but nothing changed through the time of the revelations. Such conditions exist in similar institutions, as documented in 2016 CHR report.
Finally, in April 2018, the Council of Europe Committee for the Prevention of Torture (CPT) visited inter alia several psychiatric establishments. Soon after it published its preliminary observations and subsequently submitted its comprehensive report, which though for the first time in Greece’s history of reviews by the CPT, has not be published as Greece has not authorized its publication! Yet, the preliminary conclusions reprinted below are telling:
Preliminary observations made by Georg HØYER, Head of Delegation, and Jari PIRJOLA, Head of Sub-delegation, of the European Committee for the Prevention of Torture and Inhuman or Degrading Treatment or Punishment (CPT) at the end of the CPT’s ad hoc visit to Greece (10 to 19 April 2018)
- The focus of the ad hoc visit was two-fold: on the one hand, the delegation looked into the treatment, living conditions and safeguards offered to civil and forensic patients in psychiatric establishments; on the other hand, it examined the situation of foreign nationals deprived of their liberty under aliens’ legislation. A list of the establishments visited is attached. (…)
- The delegation notes positively that, in most of the establishments visited, patients spoke well of staff, and that hardly any allegations of ill-treatment of patients by staff were received. In general, the delegation observed a caring attitude towards patients and a relaxed atmosphere, especially in those establishments in which patients generally enjoy a less confined environment. Nevertheless, the delegation received some isolated allegations of verbal abuse and disrespectful behaviour by staff. A clear message should be communicated to staff that such behaviour is unacceptable.
- Most of the establishments visited by the delegation are seriously understaffed. Given the strain that they are under, it is impressive to see the level of motivation and caring attitude demonstrated by staff during the visit. Careful consideration must be given to the management of resources in the current context of austerity: essential services, such as providing for vulnerable patients, cannot be taken care of properly given the current low staffing levels.
- One of the most serious findings during the visit concerns the widespread practice of excessive use of mechanical restraints. A combination of factors has converged to result in a situation which needs to be urgently reviewed. These factors include low staffing levels, a lack of appropriate training on restraints, a lack of strict criteria for the use of restraints in line with international standards, inappropriate restraints methods and inadequate or absent recording of the use of restraints. The delegation found no properly kept, dedicated register on restraints in use at the establishments visited. The delegation urges the Greek authorities to carry out a review of the use of mechanical restraints in all psychiatric establishments, including private institutions, with a view to bringing the policy and practice in line with the specific standards of the CPT. The delegation would like to be informed of the steps taken to review and improve the situation.
- Any review of the policy and practice regarding restraints should not come at the expense of the open regime conditions, which are one of the most positive aspects of the situation observed in a number of the establishments visited, particularly at Dromokaiteio Psychiatric Hospital and at the Psychiatric Unit at Sotiria General Hospital. In contrast, the absence of outdoor exercise for patients placed at the Psychiatric Unit in Evangelismos General Hospital, some of them there for months or even years, is unacceptable. The delegation requests that this situation be remedied as a matter of urgency.
- As regards material conditions, overcrowding at all three psychiatric units of general hospitals visited meant that patients’ beds are regularly placed in the corridor for extended periods. In particular, at Evangelismos Psychiatric Unit certain bedridden and/or restrained patients are accommodated in the corridor, some in diapers which are changed by staff in full view of others. This unacceptable situation must be urgently addressed. The delegation invokes Article 8, paragraph 5, of the European Convention for the Prevention of Inhuman or Degrading Treatment or Punishment (the Convention) and calls upon the Greek authorities to put an immediate stop to the practice, at the Psychiatric Unit of Evangelismos General Hospital, of placing people in need of intensive care and supervision in the corridor. Patients in need of restraint or requiring assistance as regards their hygiene needs should be cared for in hospital rooms, under close monitoring by staff, and under conditions which respect their privacy and dignity.
- Transfers of individuals by the police to an establishment for psychiatric assessment remain a problem, which the CPT has already pointed out previously. The police should not be the default transportation option for such cases. Persons with health-care needs should, primarily, be transported by health-care staff. As is borne out by interviews with patients, health-care staff and police officers themselves, the police are not the appropriate service to carry out such transfers. The delegation heard of the frequent use of tight, painful handcuffs, sometimes for extended transfers, lasting many hours, from remote locations. It also heard one allegation of excessive use of force by the police during such a transfer. In the delegation’s view, it is for the Ministry of Health to lead efforts to find a humane solution to this problem as a matter of priority.
- At the time of the visit, Korydallos Prison Psychiatric Hospital was still entirely under the responsibility of the Ministry of Justice, in spite of the 2009 law (n. 3772, Article 13) providing for its integration into the Greek national health services. The delegation would like to be informed of the timeline for completion of the transfer of responsibility for medical services at this establishment.
- In the delegation’s view, the practice concerning the use of the so-called “blue” or protective cells is totally unacceptable and must cease immediately. These basement cells are unfit for holding persons for any longer than the shortest time necessary to address an acute situation to prevent self-harm or harm to others. The delegation observed, however, that patients are placed in these cells for periods of several days, stripped naked, and left unattended for hours, which resulted in them defecating and urinating in the cell. The delegation invokes Article 8, paragraph 5, of the Convention and urges the Greek authorities to immediately put an end to the current practice regarding the use of the “blue” or protective cells at Korydallos Prison Psychiatric Hospital. It is totally unacceptable to place people naked, without supervision, and for extended periods, in these cells. In accordance with the standards applicable for a proper psychiatric hospital, if there is a need to seclude patients for protective purposes, this should be done for the shortest possible time necessary to resolve the acute situation and during that time the person should be permanently monitored by staff.
Greece should therefore be asked to provide its comments and replies to the above CHR and CPT documents, as well as the long overdue action plan on the execution of the ECtHR judgments, including in particular whether it has substantially decreased the use of sedatives and restraints, has stopped the compulsory confinement in violation of national legislation, the placing of people in need of intensive care and supervision in corridors, and the use of “blue cells.” Greece should also be asked to provide a copy of the final CPT report, preferably also after asking for its publication by CPT.
APPENDIX: A RECENT ARTICLE THAT SAYS IT ALL
Athens, a city to live … if you are not a person with disabilities.
An inhospitable capital that does not respect people with disabilities
[translated by Greek Helsinki Monitor from the original in Greek available at https://www.in.gr/2019/02/08/apopsi/athina-poli-gia-na-zeis-den-eisai-amea/]
8 February 2019
Athens is a city for you to walk and enjoy, it is sunny, with beautiful buildings, and bitter orange trees. In spring your heart opens in its streets. Unless you are a person with disabilities. If you are a person with disabilities, you will stay home.
The city is inhospitable for people with disabilities. A simple ride with the eyes of a a person with disabilities will convince you: The sidewalks are broken and do not help the cane or the wheelchair, the ramps on one sidewalk are not available in the next sidewalk and which satanic mind thought on a fifty centimeter sidewalk to put α flowerbed to plant a bitter orange tree?
And this is the scenario that concerns those who are mobility impaired (and the reality of the elderly and the parents with pushchairs, too). When we talk now about people with visual impairments, then we learn that they are faced with the same problems (especially poles and bitter orange trees), plus the private initiative.
In the special lanes for visually impaired people, on their way, one can find a lot of things. You can into a pole. Or into a tree. You can, more often than not, bump into a restaurant table that has never been removed from the municipal police, which is usually too busy as it is chasing street vendors.
Athens – A city to park in parking for persons with disabilities
Inhospitable Athens. Indicatively, 11% of parking violations for 2017 were for parking in ramps for the disabled. But the problem with the ramps is not the only one. Athens is a city with almost no awareness for people with disabilities. Infrastructures are few or blocked or damaged and do not have full accessibility paths to help people with disabilities. Infrastructure is either scarce or blocked or damaged and has no pathways fully accessible that will help persons with disabilities to move around.
Buildings for the few and … upright
The problem is not only the streets, but also the buildings of the city. Even public buildings. Very rarely, admittedly, but even nowadays, you will still find public buildings that have not followed the instructions for accessibility for the persons with disabilities or have not repaired damages that prevent the circulation of citizens with disabilities. As for private buildings, no question. The entrances to restaurants, businesses and, above all, multi-apartment buildings are often prohibitive for people with disabilities. And especially in apartment buildings, it is prohibitive for everything: if someone cannot go down the stairs of the entrance, how is he supposed to be able to get out of his home?
City for living in only with help
If you are a person with disabilities, you cannot live in Athens. At least, not easily. You cannot go out on the road alone and even if you do, you cannot move. Of course, in the life of the city the absence of persons with disabilities has no cost, as it has not learned to integrate people in wheelchairs or with walking sticks. It is, however, a matter of dignity of the city itself towards its citizens. It has, if anything, an obligation to allow them to leave their home.
 The report and the pictures are on file with GHM and can become available on request.
[Report in word format: submission to crpd february 2019]