On World Mental Health Day, observed every year on 10 October, Human Rights Action (HRA) calls on the Government to ensure better treatment conditions in psychiatric institutions in line with the recommendations of the European Committee for the Prevention of Torture (CPT), as well as significantly stronger support for the realisation of the human right to mental health in the community. The state’s commitment to the right to the highest attainable standard of mental health is measured by the conditions in which people receive treatment and the quality of support available to them every day in the community, enabling them to live independently.

HRA recently organised training on reducing the use of coercion against patients for 144 participants, in cooperation with the Special Psychiatric Hospital in Dobrota and with the support of the Embassy of the Federal Republic of Germany. However, putting the knowledge gained into practice requires adequate space and sufficient staff, both of which the Hospital lacks. At the same time, there has been no progress in developing services that would enable patients who no longer need hospital treatment to live outside the institution.

HRA also expresses serious concern over the announcement that Montenegro’s Mental Health Festival will not take place this year, although in previous years it enabled people in several cities to learn about mental health and available support, which is essential for preventing illness and more serious outcomes.

For years, HRA has warned that inadequate conditions at the Special Hospital in Dobrota undermine patients’ rights and make the work of staff more difficult. In March, we again highlighted the CPT’s findings: overcrowding, poor conditions in certain wards, staff shortages and excessive use of restrictive measures. The Committee also found a shortage of beds, which forced patients to sleep on mattresses on the floor. We requested a public discussion on the implementation of the CPT’s recommendations, but received no response from the Government. The Minister of Health has also failed to respond to our invitation to organise a meeting with the directors of the Special Hospital in Dobrota and the Psychiatry Clinic in Podgorica to discuss the problems and possible solutions. Ignoring these problems is unacceptable. Protecting patients’ dignity is an obligation of the state, and implementing the CPT’s recommendations is one of the closing benchmarks for Chapter 23 in the EU accession negotiations.

Participants in the training at the Hospital also highlighted the lack of space, staff and support. Under such conditions, staff struggle to devote enough time to each patient, recognise signs of distress promptly and prevent escalation. We call on the Ministry of Health, in cooperation with the Hospital, to publish concrete measures and deadlines for addressing the shortage of beds and staff and improving treatment conditions.

Addressing overcrowding at the Hospital also requires the development of community services, which is one of the objectives of the Deinstitutionalisation Strategy for 2025–2028, adopted by the Government in December 2024. Patients who no longer need hospital treatment should not remain in the institution because accommodation and appropriate support outside it are unavailable. We call on the Government to ensure that implementation of the Strategy also delivers concrete results for patients at the Hospital in Dobrota, through the development of supported housing and other services that enable them to live more independently and participate in community life. This requires funding, clearly defined responsibilities of the relevant ministries and published deadlines for establishing these services.

Mental health care must also be available outside hospitals, through education, efforts to combat stigma and connecting people with professionals and support services. Particular attention should be given to suicide prevention through early recognition of risk, accessible professional help and continuous support for people in crisis and their families.

The Mental Health Festival also helped inform the public and encourage open discussion about mental health. Since 2023, it has been organised by the Institute of Public Health of Montenegro and the Clinical Centre of Montenegro to mark World Mental Health Day. Last year, the Festival included more than 40 free workshops, lectures, public activities and arts programmes in six cities: Podgorica, Cetinje, Kotor, Risan, Herceg Novi and Bar. According to a public statement by one of its organisers, the Festival will not take place this year, despite bringing together around 30 organisations and attracting more than a thousand visitors.

HRA expects the Ministry of Health, the Clinical Centre of Montenegro and the Institute of Public Health to explain why the Festival is not taking place and announce what they will do to ensure its continuation. At a time when mental health support needs to be strengthened, losing a space for dialogue, learning and solidarity is a step backwards.

More About the Training

The five-day training took place from 21 to 25 September at the Special Psychiatric Hospital in Dobrota, as part of the project “Strengthening Human Rights in Psychiatric Treatment”, with financial support from the Embassy of the Federal Republic of Germany in Montenegro. It was accredited by the Medical Chamber of Montenegro and brought together 144 participants from various professional backgrounds, including security staff.

The training was led by Dr Sophie Hirsch, a psychiatrist from the Centre for Psychiatry South Württemberg (ZfP Südwürttemberg), and Sascha Mesic, a nurse, PAIR trainer and deputy head of the Heidenheim Clinic. Both institutions are located in the German federal state of Baden-Württemberg.

Participants discussed how aggression develops, how to recognise the first signs of tension and how to respond before a situation escalates. The German S3 guidelines for preventing coercion were presented, along with research findings on their implementation. Through practical exercises, participants learned communication and response techniques that help defuse tense situations.

Participants were also introduced to two tools used in psychiatric practice. The Brøset Violence Checklist (BVC) is used to assess the short-term risk of violent behaviour, while the Staff Observation Aggression Scale – Revised (SOAS-R) is used to record and analyse aggressive incidents and staff responses in order to improve future practice.