HRA and the German Embassy Sign Agreement on Project to Improve Conditions at “Dobrota” Hospital

Human Rights Action (HRA) and the Embassy of the Federal Republic of Germany in Montenegro have signed an agreement on a project aimed at improving treatment conditions and the protection of patients’ human rights at the Special Psychiatric Hospital “Dobrota” in Kotor.

The agreement was signed on the day marking the hospital’s 73rd anniversary. The signing ceremony was attended by Ambassador Peter Felten, hospital director Dr Jovo Đedović and HRA Executive Director Tea Gorjanc Prelević.

Treatment conditions in psychiatric institutions are not only a matter of healthcare, but also of respect for fundamental human rights. Patients have the right to a safe environment, support, privacy and treatment that does not degrade them. Physical restraint and isolation may be used only exceptionally — when necessary and lawful — and not as a substitute for a lack of support, staff, or adequate treatment conditions.

The project is a direct response to the recommendations of the European Committee for the Prevention of Torture — the CPT — which visited the hospital in November last year and pointed to serious problems. The CPT found that conditions in the hospital had not improved to an extent that ensures full respect for patients’ human dignity: patients still sleep on mattresses on the floor, cases of excessive use of physical restraint have been recorded, and the system for protection against ill-treatment remains insufficiently effective.

The broader context is also important: Montenegro has an obligation, under Chapter 23 of the negotiations for accession to the European Union, to improve the protection of the rights of vulnerable groups, and the protection of the rights of persons with mental disabilities must be one of the indicators of real progress in this area.

What the Project Envisages

The project focuses on three areas aimed at achieving concrete changes.

The renovation of the forensic ward will improve the physical conditions of patients’ stay and provide a better therapeutic environment, including a higher level of safety, privacy, and dignity. Removing inhumane and outdated arrangements will contribute to patients’ recovery and to safer working conditions for staff.

Through training, nurses, technicians, psychiatrists, and psychologists will receive additional support in identifying crisis risks, calming tense situations through conversation and an appropriate approach, preventing violence, and responding responsibly in crisis situations — with a special focus on reducing the use of physical restraint and isolation. The training will also cover the proper recording of incidents and coercive measures, because without accurate and complete data there can be no effective oversight or real reduction of coercion in practice. The training will be conducted by experts from the University Psychiatric Clinic in Ulm.

Independent monitoring carried out by HRA will include monitoring respect for patients’ human rights and the implementation of CPT recommendations.

From the Signing Ceremony

Ambassador Felten emphasized that the Special Psychiatric Hospital has a major task: to provide patients with the individually tailored therapy they need and, even more importantly, to build a bridge back to life beyond the hospital walls through appropriate treatment approaches — all in the best spirit of realizing patients’ human rights.

“In our view, this approach is very worthy of support, and that is why we decided, from the perspective of the German Embassy, to support it financially with EUR 60,000. It is especially important to us that, through this support, we are also encouraging a partnership between the Special Psychiatric Hospital in Dobrota and Montenegro’s leading human rights organization, Human Rights Action – HRA.”

HRA Executive Director Tea Gorjanc Prelević thanked the Federal Republic of Germany and the German Embassy in Montenegro for their trust and significant support, stressing the need to ensure the implementation of the CPT’s key recommendations. She particularly welcomed the openness to cooperation and professional development shown by the hospital director, doctors, and medical staff. She emphasized that the hospital was built back in 1953 and that its capacities and conditions have long been outdated.

“With this project, we will urgently help improve basic conditions where they are most problematic. However, the state must realize as soon as possible that a new Special Psychiatric Hospital is necessary — not only the one within the prison in Spuž, which we expect within the next year, but also a completely new building for the urgent and inpatient care of persons with mental illnesses, because this hospital, with its existing capacities, is not sufficient,” Gorjanc Prelević said.

Hospital director Dr Jovo Đedović thanked them, on behalf of the patients and staff who have worked in the institution for years, for their willingness to help improve the hospital’s work. He emphasized that there is significant room for improving conditions, both through urgent interventions and through longer-term, more comprehensive investment.

Đedović stressed the importance of bringing the hospital’s quality standards as close as possible to European Union standards. In this context, he particularly highlighted the importance of the contacts established so far with the staff of the University Psychiatric Clinic in Ulm, as well as European initiatives and research networks dealing with the reduction of coercion in psychiatry.

“Our intention is to apply, as much as possible in our institution, the practices for reducing coercion that have proven effective in research across the developed world,” Dr Đedović said.

Human Rights Action thanks the Federal Republic of Germany and the German Embassy in Montenegro for their trust and financial support. Their support makes it possible for the recommendations of international bodies to be translated into concrete improvements for patients and staff.