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Council of Europe anti-torture committee publishes new report

Sparse accommodation at the Baraboi psychoneurological social-care home near Odesa, Ukraine

The European Committee for the prevention of torture and inhuman or degrading treatment or punishment (CPT) has published today the report on its visit to Ukraine, carried out from 26 May to 6 June 2025, together with the response of the Ukrainian authorities. The report examines the treatment and conditions of detention of individuals involuntarily admitted to and treated in psychiatric hospitals, and of people accommodated in social-care homes (internats and pensions) for disabled and older people in Lviv, Kyiv, Orlivka, Vinnytsia and Odesa regions.

The 2025 visit was the second to Ukraine conducted by the CPT since the beginning of the full-scale military aggression by the Russian Federation in February 2022. The delegation visited psychiatric hospitals in Lviv (Kulparkiv Hospital), Orlivka (Sarny) and Hlevakha (Kyiv), as well as Hruskhivskyi Internat (Lviv region), Vinnytsia Pension for the elderly and disabled, and Baraboi Internat (Odesa region). Two of the establishments, those in the Lviv region and in Vinnytsa, houses significant numbers of people evacuated from the east of Ukraine after the start of the full-scale aggression.

Interpersonal conditions good, but facilities varied

The CPT received no allegations of physical ill-treatment by staff at any of the establishments visited. Overall, there was a relaxed atmosphere, and the delegation observed good staff-patient/resident relations. As for inter-patient/resident violence, conflicts did occasionally occur, but they were not of a serious nature and staff intervened promptly and adequately.

Living conditions varied in the establishments visited. Good conditions were observed in those wards which had already been refurbished, where patients/residents lived in smaller, well-furnished, decorated and personalised rooms. By contrast, the conditions in the wards which had not yet been refurbished were quite poor, with austere and cramped dormitories, and a lack of lockable storage space and privacy. Work was ongoing in the establishments visited to gradually bring the living conditions up to the standard.

Staffing and treatment

Healthcare staff numbers appeared to be generally sufficient in the psychiatric hospitals visited. By contrast, all the social-care homes examined could clearly benefit from an increased presence of doctors, nurses and orderlies. In both types of the establishments the biggest problem was the lack of therapeutic and rehabilitation staff, such as occupational therapists and physiotherapists, and of social workers.

In the psychiatric hospitals and social-care homes visited, the treatment was essentially based on pharmacotherapy, which was generally adequate, although the dosage and combination of prescribed medicines was sometimes rather high in Orlivka, where other psycho-social therapeutic activities were in short supply. The CPT has asked the Ukrainian authorities to intensify their efforts, including through the recruitment of more qualified staff, to further develop a range of therapeutic options and involve more patients and residents in rehabilitative psycho-social activities.

Seclusion was not applied in any of the psychiatric hospitals visited, while mechanical restraint (fixation) was used infrequently, only applied as a last resort and always for short periods of time. Its use was well recorded on the wards, but there were still no centralised registers. The use of chemical restraint, although employed, was not recorded. The main issue of concern at two hospitals was that patients were often fixed in view of other patients. Further, police officers could sometimes be asked by healthcare staff to help restrain a patient. Steps must be taken to eliminate these practices.

As for social-care homes, as a matter of principle, means of restraint should not be applied there. The policy should be to gradually phase out their use and replace them with alternatives such as de-escalation techniques, in which staff working in such establishments should receive adequate training.

The legislation in force concerning involuntary psychiatric hospitalisation and treatment seemed to be duly followed in practice, both as regards the “civil” and forensic patients alike. On the positive side, all patients had access to (mostly state-appointed) legal assistance and there was always a court hearing. However, the CPT has misgivings as to whether the consent provided by patients upon admission could genuinely be considered to be free and informed.

The legal framework was also duly observed overall in the three social-care establishments visited. However, residents, as a rule, received little explanation about the “contracts” signed with the establishment, including about their right of discharge, and were not given a copy of the document. The CPT is also concerned by the fact that, despite its previous repeated recommendations, many legally incapacitated residents in the three social-care establishments visited had the establishment’s director performing the functions of their legal guardian. The Ukrainian authorities must search for alternative solutions which would better guarantee the independence and impartiality of guardians, and rectify other deficiencies.

In their response, the Ukrainian authorities provide information and outline measures taken in response to the recommendations made by the CPT, including ongoing legislative and policy reforms continuing efforts to improve living conditions, staffing, and an offer of therapeutic options.

Read the report in full (read the executive summary in Ukrainian)