Juvenile Educational-Correctional Facility, Kruševac
Some improvements were noted since the CPT's visit in 2023, including better material conditions and reduced recorded incidents of use of force. However, the institution retained an excessively punitive culture, outweighing its educational purpose. In particular, the Closed Regime Block was marked by long lock-up times and a lack of purposeful regime for the children. The Committee remained seriously concerned about children's safety specifically the continued use of batons by staff (at times causing serious injury) and frequent, severe inter-juvenile violence, including sexual violence. The Serbian authorities should prohibit batons as a legitimate means of force in educational-correctional facilities, ensure prompt forensic medical examination and psychological support when sexual abuse is alleged, and implement a comprehensive programme of structured activities for children on the Closed Regime Block.
Special Prison Hospital
The delegation received some allegations of ill-treatment by staff from the patients, including incidents involving the use of force with batons and excessive use of means of restraint, as well as several allegations of verbal abuse. The CPT noted one recorded disciplinary case in which a patient was punched by a staff member, resulting in a sanction. Despite refurbishments to some areas, overall conditions in the hospital had not significantly improved since the CPT's previous visit in 2021. Severe overcrowding had reached saturation point. Living conditions on the fourth floor remained appalling, including for children held there. Treatment still consisted mainly of pharmacotherapy, with individual plans not systematically updated. Mechanical restraint (fixation) was used frequently and for extended periods, with patients routinely placed in incontinence pads. In the view of the Committee this practice may well be considered degrading. The Serbian authorities should improve procedures for the reporting of injuries and ensure that medical examinations follow any violent incident. They should also establish a multi-sectoral forensic treatment strategy based on the least-restrictive care, invest in step-down facilities, urgently develop psycho-social activities and occupational therapy for all patients, and increase the number of healthcare staff.
The Committee considers that, unlike current practice, children must never be admitted to the Prison Hospital, which is unsuitable as it cannot adequately meet their specific needs.
Adult psychiatric facilities (Laza Lazarević Clinic and Kovin Hospital)
Although most patients spoke positively about staff, several ill-treatment allegations were received at the Laza Lazarević Intensive Care Unit 1 Ward and Kovin's Male Acute Ward. Certain improvements to living conditions had been undertaken in both establishments but most notably at Kovin Hospital premises, which were largely renovated and in good condition. Material conditions at the Laza Lazarević Clinic were deteriorating. The absence of outdoor access at Laza Lazarević's Belgrade site, flagged since 2004, persisted. Treatment remained overwhelmingly pharmacological, with cursory individual plans. Mechanical restraint (fixation) was used frequently, including in the presence of other patients, with instances of long-term fixation undocumented in restraint registers. The Serbian authorities should strengthen forensic treatment programmes within the civil hospitals, increase staffing, and comply with national restraint guidelines aligning with international standards.
Child psychiatry (Laza Lazarević Adolescent Unit and Clinic for Children and Adolescents, Belgrade)
No ill-treatment allegations were received. However, the CPT was particularly concerned by the absence of outdoor access, over-reliance on pharmacotherapy, and frequent fixation of children shortly after admission - sometimes overnight - often applied in the presence and view of other patients, and sometimes not properly recorded. The Serbian authorities should revise existing practices and procedures concerning the use of means of restraint on child patients in psychiatric institutions.
The CPT has serious misgivings about cases of long-term placement of children in acute psychiatric facilities in Serbia, in certain cases lacking medical justification and an independent review of the need for continued placement. Certain children were isolated from other patients, had limited meaningful human contact, no direct contact with their families and the outside world, no access to the outdoors and their regime was critically limited. The Committee considers that such treatment may be considered inhuman or degrading. The Serbian authorities should transfer these children to an appropriate non-medical setting where they can be afforded the appropriate support and care. Pending these arrangements, the living conditions and regime in the psychiatric clinics in which the children are placed should be immediately improved. The children should be provided with meaningful daily human interaction, daily access to age-appropriate activities, education, and an access to an outdoor area, as well as contact with their families and other persons of trust.
- Read the report in English
- Read the executive summary and observations in English, in Serbian
- Read the response in English
- Read the visit newsflashes (November) (December)
- The CPT and Serbia
