8(C). Removal of cage beds at Opařany Children’s Psychiatric Hospital

With the exception of the director at Opařany Children’s Psychiatric Hospital, few clinicians engaged with the possibility of a coercion-free environment in psychiatric institutions. She spoke about how JK Rowling had criticised cage beds and had caused perspectives on the use of cage beds to change. She said that she had always been opposed to cage beds, but had not known how to deal with “difficult cases”. Seclusion rooms had been installed when the cage beds were taken out of use, and had apparently been inspired by a visit to the UK and a discussion of employee injuries.

To the surprise of medical and nursing staff at the institution, there had been a reduction in incidents which previously would have justified the use of cage beds. It should be noted that this supports global evidence of how alternatives to coercion are intuitively sought by staff when coercive measures are removed, as discussed in the next section.

In Prague Bohnice Psychiatric Hospital, where all but one cage bed had been removed, a doctor told the monitoring team that he did not miss the cage beds. They “could be used for patients that are strapped now, but there is a greater risk of excessive use [when compared to other restraints].” He explained that without the possibility of resorting to cage beds, doctors paid more attention to the residents: “The wards are smaller and more specified, the supervision is more intensive”, he said.

In general, however, MDAC monitors found little empathy amongst professionals for patients subjected to coercive practices.