The [European] Court [of Human Rights] has held on many occasions that the detention of a person who is ill may raise issues under Article 3 of the [European] Convention [on Human Rights, which prohibits inhuman or degrading treatment] … and that the lack of appropriate medical care may amount to treatment contrary to that provision … In particular, the assessment of whether the particular conditions of detention are incompatible with the standards of Article 3 has, in the case of mentally ill persons, to take into consideration their vulnerability and their inability, in some cases, to complain coherently or at all about how they are being affected by any particular treatment …
… [T]here are three particular elements to be considered in relation to the compatibility of an applicant’s health with his stay in detention: (a) the medical condition of the prisoner, (b) the adequacy of the medical assistance and care provided in detention, and
(c) the advisability of maintaining the detention measure in view of the state of health of an applicant …” (Sławomir Musiał v. Poland,).
Bamouhammad v. Belgium 2015 Suffering from Ganser syndrome (or “prison psychosis”), the applicant alleged that he had been subjected while in prison to inhuman and degrading treatment which had affected his mental health. He also complained about a lack of effective remedies. The Court held that there had been a violation of Article 3 (prohibition of inhuman or degrading treatment) of the Convention, finding that the level of seriousness required for treatment to be regarded as degrading, within the meaning of Article 3, had been exceeded in the applicant’s case. The Court noted in particular that the need for a psychological supervision of the applicant had been emphasised by all the medical reports. However, his endless transfers had prevented such supervision.
Murray v. the Netherlands concerned the complaint by a man convicted of murder in 1980, who consecutively served his life sentence on the islands of Curaçao and Aruba (part of the Kingdom of the Netherlands) – until being granted a pardon in 2014 due to his deteriorating health –, about his life sentence without any realistic prospect of release. The Court held that there had been a violation of Article 3 of the Convention, finding that the applicant’s life sentence had not de facto been reducible. It observed in particular that although he had been assessed, prior to being sentenced to life imprisonment, as requiring treatment, he had never been provided with any treatment for his mental condition during the time he was imprisoned.. In this case the Court also underlined that States were under an obligation to provide detainees suffering from health problems – including mental health problems – with appropriate medical care.
Sex Offenders Psychiatric Treatment
W.D. v. Belgium (application no. 73548/13)concerned a sex offender suffering from mental disorders who was detained indefinitely in a prison psychiatric wing. The applicant complained that he had been detained in a prison environment for more than nine years without any appropriate treatment for his mental condition or any realistic prospect of reintegrating into society.
The Court held that there had been a violation of Article 3 (prohibition of inhuman or degrading treatment) of the Convention, finding that the applicant had been subjected to degrading treatment by having been detained in a prison environment for more than nine years, without appropriate treatment for his mental condition and with no prospect of reintegrating into society; this had caused him particularly acute hardship and distress of an intensity exceeding the unavoidable level of suffering inherent in detention.
The Court also held that there had been a violation of Article 5 § 1 (right to liberty and security) of the Convention, finding that the applicant’s detention since 2006 in a facility ill-suited to his condition had broken the link required by Article 5 § 1 (e) between the purpose and the practical conditions of detention, noting that the reason for the applicant’s detention in a prison psychiatric wing was the structural lack of alternatives.
Rooman v. Belgium 31 January 2019 (Grand Chamber) This case concerned the question of the psychiatric treatment provided to a sex offender who had been in compulsory confinement since 2004 on account of the danger that he poses and the lawfulness of his detention. The Grand Chamber held that from the beginning of 2004 until August 2017 there had been a violation of Article 3 (prohibition of inhuman or degrading treatment) of the Convention, and that from August 2017 onwards there had been no violation of Article 3.
It found in particular that the national authorities had failed to provide treatment for the applicant’s health condition from the beginning of 2004 to August 2017, and that his continued detention without a realistic hope of change and without appropriate medical support for a period of about thirteen years had amounted to particularly acute hardship, causing him distress of an intensity exceeding the unavoidable level of suffering inherent in detention. In contrast, the Court held that since August 2017 the authorities had shown a real willingness to remedy the applicant’s situation by undertaking tangible measures, and that the threshold of severity required to bring Article 3 into play had not been reached. The Grand Chamber also held that from the beginning of 2004 until August 2017 there had been a violation of Article 5 (right to liberty and security) of the Convention and that from August 2017 onwards there had been no violation of Article 5.
Criminal Mental Health
Strazimiri v. Albania oncerned the detention of a man, who had been exempted from criminal responsibility on account of mental illness, in a prison rather than a medical institution. The applicant complained in particular that the conditions of his detention, including the provision of medical care, had been inadequate. The Court held that there had been a violation of Article 3 (prohibition of inhuman or degrading treatment) of the Convention because of inadequate living conditions in the prison hospital where the applicant was detained and insufficient psychiatric care.
It further held that there had been violations of Article 5 §§ 1, 4 and 5 (right to liberty and security/ right to have the lawfulness of detention decided speedily by a court/enforceable right to compensation), in particular because of his continued deprivation of liberty in a prison rather than a medical institution and because his appeal against his detention had been pending before the Supreme Court since 2016.
Venken and Others v. Belgium case concerned applications related to the compulsory confinement of five Belgian nationals in the psychiatric wings of ordinary prisons, and followed on from the pilot judgment W.D. v. Belgium. The Court held that there had been a violation of Articles 3 (prohibition of inhuman or degrading treatment) and 5 § 1 (right to liberty and security) of the Convention on in respect of three applicants.
Sy v. Italy concerned the fact that the applicant, who suffered from a personality disorder and bipolar disorder, had remained in detention in an ordinary prison despite domestic court decisions stating that his mental health was incompatible with such detention and ordering his transfer to a Residential Centre for the enforcement of preventive measures (REMS), and later to a prison psychiatric service.
The Court held, inter alia, that there had been a violation of Article 3 (prohibition of inhuman or degrading treatment) of the Convention in respect of the applicant. It noted, in particular, that the applicant’s mental condition had been incompatible with detention in prison and that, despite the clear and unequivocal indications by the domestic courts, he had remained in an ordinary prison for almost two years. In this regard, it noted, in particular, that, as it had emphasised on several occasions in the past, Governments should organise their prison systems in such a way as to ensure respect for the dignity of detainees, regardless of financial or logistical difficulties..
Association for the Defence of Human Rights in Romania – Helsinki Committee on behalf of Ionel Garcea v. Romania concerned access to proper medical treatment for a mentally-ill prisoner whilst in detention – on several occasions he had been taken to hospital for surgery after he had inserted a nail into his forehead and had also attempted suicide – and the difficulties faced by a non-governmental organisation to lodge an effective complaint following his death.
The Court found that the ineffectiveness of the investigation and the time it had taken the authorities to establish the circumstances of the prisoner’s death amounted to a procedural breach of Article 2 (right to life) of the Convention. It noted in particular that the court of appeal had found that the investigation had not been thorough since essential questions had not been answered by the prosecutor.
Isenc v. France 2016 This case concerned the applicant’s son’s suicide 12 days after he was admitted to prison. The applicant alleged a violation of his son’s right to life. The Court held that there had been a violation of Article 2 (right to life) of the Convention, finding that in the present case, although provided for in the domestic law, the arrangements for collaboration between the prison and medical services in supervising inmates and preventing suicides had not worked.
Prisoner Psychological Disorder
Jeanty v. Belgium The applicant, who was suffering from a psychological disorder and made several suicide attempts while in pre-trial detention in Arlon Prison (Belgium) alleged in particular that the Belgian authorities had failed in their duty to take the appropriate measures in his case to prevent the certain and immediate risk of attempted suicide from materialising.
The Court considered that Article 2 (right to life) of the Convention was applicable in the present case because the very nature of the applicant’s actions (repeated suicide attempts) had put his life at real and imminent risk. It went on, however, to find that the measures taken by the authorities had actually prevented the applicant from committing suicide and therefore held that there had been no violation of Article 2 in the applicant’s case.
The Court held, on the other hand, that there had been a violation of Article 3 (prohibition of inhuman or degrading treatment) of the Convention, finding that the applicant had suffered distress or hardship of an intensity exceeding the unavoidable level of suffering inherent in detention, particularly on account of the lack of medical supervision and treatment during his two periods of detention, combined with his placement in an isolation cell for three days as a disciplinary measure in spite of his repeated suicide attempts. Moreover, the investigation in that regard had been ineffective.