8(A). Workforce perspectives

MDAC investigated coercion in Czech psychiatry a decade after producing its first report because it wanted to find out whether the views of healthcare providers about reducing coercion in psychiatry had shifted during that time.

The director of Plzeň Hospital Psychiatric Department told MDAC monitors that there was a push across all psychiatric hospitals to get rid of cage beds. He referred to a report of the Ombudsperson where the use of cage beds was considered negative. In his view, media attention had influenced psychiatric hospitals and he thought that cage beds had been removed “to escape the negative attention, not because the experience of using the beds has been bad”. He was adamant that cage beds (“therapeutic beds” as he called them) were helpful: “they make sense”. Directors of psychiatric hospitals want “peace from these attacks”, so they have decided to get rid of cage beds, he said. Although two people had reportedly died in cage beds in recent years, his view was that this did not decrease their necessity. Every therapeutic procedure could have fatal complications, he explained. “The fact that an operation can be fatal does not stop the surgeons from carrying out the operation”.

Doctors at Klatovy Hospital Psychiatric Department told MDAC monitors how they had new long-term patients who were formally residents of social care institutions as a result of the 2006 ban on cage beds in these establishments.⁸² The hospital had two new cage beds from the local social care institution where their use had been banned.

Overall, the prevailing views of directors, clinicians and staff was that coercive practices were still necessary.

82 Social Services Act, Law no. 180/2006.