§71, Alm.del - 2014-15 (1. samling) - Bilag 47: Orientering om Danmarks samlede besvarelse på Torturkomitens rapport, fra ministeren for sundhed og forebyggelse

Tilsynet i henhold til grundlovens § 71 2014-15 (1. samling)
§71 Alm.del Bilag 47
Offentligt

Response of the Danish Government to the report of the European

Committee for the Prevention of Torture and Inhuman or Degrading

Treatment or Punishment (CPT) on its visit to Denmark from 4 to 13

February 2014. [Danish response in

italic]

I.C.

Co-operation

Paragraph 5

in CPT’s report

CPT’s

observation concerning paragraph 5:

The CPT trusts that the Danish authorities will make continued efforts to improve the

situation in the light of the Committee’s recommendations, in accordance with the

principle of co-operation which lies at the heart of the Convention.

Please be assured that the Danish Government is continuously striving to ensure that no

persons deprived of their liberty by Danish authorities are treated in a way that may be

characterised as torture or inhuman or degrading treatment or punishment, cf. Article 3 of the

Convention for the Protection of Human Rights and Fundamental Freedoms.

In this respect the Government thoroughly examines the recommendations of inter alia the

CPT for the purpose of working towards a better protection of persons deprived of their liberty

against torture or inhuman or degrading treatment or punishment.

In order to further strengthen the coordination of the Danish Government’s overall human

rights reporting commitments please be informed that in October 2014, the Government

decided to establish a permanent cross-ministerial human rights committee under the Ministry

of Foreign Affairs. The Committee is also expected to map the follow-up to recommendations

received by the Government from international human rights monitoring bodies and

mechanisms, among others.

Concerning the specific reference to the CPT’s concerns

as regards the imposition of judicial

restrictions on remand prisoners, the practice of the use of fixation in prisons and the

prolonged application of mechanical restraints on psychiatric patients, reference is made to the

Ministry of Justice’s responses to paragraphs 33, 35, 72 and 111 (judicial restrictions on

remand prisoners) and to paragraphs 67, 68 and 71 (fixation in prisons), and to the Ministry of

Health’s responses to paragraph 115, 121, 122 and 125 (mechanical restraints on psychiatric

patients) in the CPT’s report below.

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II.A. Law enforcement agencies

Paragraph 8

in CPT’s report

CPT’s

request for information concerning paragraph 8:

The CPT would like to be informed of the steps taken by the Danish authorities to ensure

that all persons preventively detained by the police are held in appropriate conditions.

On 11 June 2014, the Danish National Police

–

at the request of the Danish Minister for Justice

–

issued guidelines to all police districts on the use of administrative detentions under the

Danish Police Act and the management of large demonstrations.

The guidelines contain, inter alia, provisions on the treatment of detainees during large

demonstrations. These provisions were drafted in the light of the outcome of the court cases

regarding the administrative detentions during the 2009 conference and aim to prevent similar

episodes in the future.

Paragraph 9

in CPT’s report

CPT’s

recommendation concerning paragraph 9:

The CPT recommends that the Danish authorities remind police officers that they should

use no more force than is strictly necessary when carrying out an arrest and that where it

is deemed essential to handcuff a person, the handcuffs are under no circumstances

excessively tight and are applied only for as long as is strictly necessary.

The Danish Police Act of 9 June 2004 regulates the use of force by police officers and stipulates

that they may use force only if necessary and justified and only by such means and to such an

extent as is reasonable with regards to the interest which the police are seeking to protect.

Infringement of the provisions on the use of force in the Police Act can make the police liable

to pay compensation for damages and any police officer can receive disciplinary or even penal

punishment, if he or she does not observe the provisions in concern.

The Danish Police College, which is part of the Danish National Police, has issued guidelines on

the instruction of police trainees in the use of handcuffs.

The guidelines stipulate, inter alia, that handcuffs

–

for security reasons

–

are always to be

applied while the person is holding his hands behind his back. It must be ensured that the

handcuffs have not been applied to tightly. During transportation, it must be ensured that the

handcuffs cause as little inconvenience to the person as possible. In case of longer transports,

a fixation belt may be applied, which

restrains the person’s hands in front instead of behind

the back.

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Paragraph 10

in CPT’s report

CPT’s

recommendation concerning paragraph 10:

The CPT recommends that the Danish authorities incorporate torture as a specific offence

under national criminal law.

The United Nations Convention against Torture or Other Cruel, Inhuman or Degrading

Treatment or Punishment article 4 requires each participating state to “ensure that all acts of

torture are offences under its criminal law”. The convention does

not require the parties to

adopt a specific criminal offence provision in national legislation concerning torture.

The question of adopting a provision on torture as a specific offence in the Danish Criminal

Code was thoroughly assessed by the Committee on Criminal Law (Straffelovrådet) in its

report no. 1494/2008 from January 2008.

The Committee on Criminal Law did not recommend adopting such a provision. The Committee

pointed out that all acts covered by the definition of torture in the United Nations Convention

against Torture or Other Cruel, Inhuman or Degrading Treatment or Punishment article 1 were

already covered by existing provisions of Danish criminal law, including acts where mental pain

and suffering were inflicted on the victim.

The Danish Government agreed with the assessment of the Committee on Criminal Law and

followed its recommendations by adopting the current provision in the Danish Criminal Code

and the Military Criminal Code in Act no. 494 of 17 June 2008.

Instead, the Committee on Criminal Law recommended adopting a special provision in the

Danish Criminal Code making torture an aggravating circumstance in the determination of the

penalty for violation of the Danish Criminal Code.

The Committee considered this alternative to emphasize the gravity of the crime of torture in

the same manner as a specific provision on torture would. In addition the exact character and

gravity of the specific crime would be clearly reflected in connection with the criminal case.

Thus, instead of being convicted

of the general crime of ”torture”, a wide concept, the

perpetrator would be convicted in accordance with the relevant specific provisions with

reference to the fact that the criminal act was committed by the use of torture (e.g. ”assault of

a particularly

dangerous nature by the use of torture” or ”confinement by the use of torture”).

It should be noted that the provision in the Danish Criminal Code regarding the use of torture

as an aggravating circumstance on this background has been defined in accordance with the

United Nations Convention against Torture or Other Cruel, Inhuman or Degrading Treatment or

Punishment article 1. The Ministry of Justice refers to the travaux préparatoires to Act no. 494

of 17 June 2008.

Furthermore, the amendments to the Danish Criminal Code and the Military Criminal Code by

Act no. 494 of 17 June 2008 established that violations of the Criminal Code and the Military

Criminal Code, including attempts and complicity, cannot be subject to the statute of

limitations if the violation is committed by the use of torture.

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Consequently, the Danish Government considers the current legislation to be a sufficient and

adequate response to the need for criminalizing the crime of torture as well as emphasizing the

specific gravity of the crime.

Paragraph 11

in CPT’s report

CPT’s

recommendation concerning paragraph 11:

The CPT recommends that all police officers wear an identity number or name badge for

identification purposes.

By letter of 30 October 2014, the Minister for Justice asked the National Police to introduce

individual identity numbers on all police uniforms as soon as possible. Numbers will be

composed of a single letter and four digits.

Paragraph 13

in CPT’s report

CPT’s

recommendation concerning paragraph 13:

At present, the power to delay notification of custody is neither clearly defined nor strictly

limited in time, and resort to that power does not appear to be accompanied by the

above-mentioned safeguards. The CPT recommends that appropriate measures be

adopted to remedy these deficiencies.

Pursuant to Section 2(2) of Circular no. 9155 of 18 March 2010, all persons detained by the

police have the right to inform relatives or other relevant persons about the arrest. Hence, the

police must without undue delay give the detainee the opportunity to inform his closest

relatives or other relevant persons about the arrest.

However, pursuant to the Section 2(3) of the Circular, the detainee can be denied this right

temporarily or definitively, if, due to the specific circumstances of the case, information about

the arrest in itself may compromise the investigation. The police must make this decision

without undue delay. If the detainee is denied notification due to certain steps of the

investigation, these steps must be completed as soon as possible.

If the detainee is denied this right, the police must, as a general rule, notify his/her relatives

or other relevant persons, if the detainee so wishes, cf. Section 2(4). Such notification must be

made without undue delay. The police must notify the detainee about the result of the

notification.

However, the police may refrain from doing so, if due to the circumstances of the case there

are specific reasons to presume that information about the arrest in itself would interfere with

the investigation of the case and this is crucial for reasons of the investigation.

The decision to deny or delay the detained person his/her right to inform or to have his/her

relatives or other relevant persons informed of the arrest is made by the officer on duty or by

the officer in charge of the investigation, cf. Section 2(6).

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Furthermore the Circular stipulates that compliance with the said procedures must be recorded

in the detention report or protocol. If notification is denied the reason for this must

furthermore be noted.

The Circular is issued by the Ministry of Justice to the police and the Prosecution Service and is

as such binding upon the individual police officer.

The Ministry of Justice has not found that additional regulation is needed.

Paragraph 14

in CPT’s report

CPT’s

recommendation concerning paragraph 14:

The CPT reiterates its recommendation that the Danish authorities ensure that all persons

detained by the police are able, in practice, to enjoy the right to inform a relative or a

third party of their choice, of their situation as from the very outset of their deprivation of

liberty. Further, such notification should be properly recorded and detained persons

provided with feedback on whether a member of their family or third person was

contacted.

Reference is made to the Ministry of Justice’s response to paragraph 13 of the CPT’s report

above.

Paragraph 16

in CPT’s report

CPT’s

recommendation concerning paragraph 16:

The CPT recommends that the Danish authorities take the necessary steps to ensure that

the right of all detained persons to have access to a lawyer is effective

in practice

as from

the very outset of custody. Further, it recommends that, in association with the Bar

Association, a list of ex officio lawyers which detained persons can consult be compiled for

each police station. In addition, a record should be maintained of any request by a

detained person to see a lawyer and whether such a request was granted.

Pursuant to Section 3(1) of Circular no. 9155 of 18 March 2010, the police must without undue

delay give all detainees the opportunity to contact an attorney, who can serve as

representation in the detainee’s case. Access to such contact should be given in immediate

connection to the detainee being brought in to the police station.

The attorney shall in accordance with the rules in Chapter 67 of the Danish Administration of

Justice Act be given access to be present during police interrogations of the detainee, cf.

Section 3(3) of said Circular.

Pursuant to the Administration of Justice Act, Chapter 66, the court can in certain

circumstances deny chosen representation. If the police wishes to oppose to certain

representation chosen by the detainee the police can temporarily deny said representation.

The question of whether the detainee should have access to that particular representative

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must afterwards be presented before the court in correspondence with the rules in the

Administration of Justice Act. The detainee must in such cases without undue delay be given

access to other representation.

According to Section 3(5) of the Circular compliance with the abovementioned rules must in all

cases be noted in for example the detention report.

In order to ensure that all persons detained receive sufficient guidance about their rights, the

Danish National Police has issued a leaflet that outlines the most important rights for detainees

including the right to have an attorney. The document is translated into six languages besides

Danish including English, Arabic and French and is presented to the detainee by the police in

addition to oral guidance.

The rules set out in the Circular apply equally in relation to detainees under the age of 18.

Furthermore, the Circular states that due respect must be given to the special needs and

conditions of the detainee due to his/her young age.

Furthermore, Order no. 467 of 26 September 1978 stipulates that when the police charges a

person with a criminal offence which under the law can result in a more severe penalty than a

fine, the police is obliged to guide the person about his/her right to an attorney. To make sure

that all persons charged and detained are aware of their right to be assisted by an attorney

during the police interrogation, the guidance must be given no later than the guidance about

the right not to give a statement.

If a person, who is charged with a criminal offence which under the law can result in a more

severe penalty than a fine, has not requested an attorney in connection with an interrogation,

the person is assigned an attorney at the latest when he/she is brought before the court for a

preliminary examination with the purpose of detention on remand or upholding of the arrest.

The person and the attorney will always be given the possibility to discuss the charge and the

evidence before the court’s preliminary examination.

The court’s preliminary examination must take place within 24 hours after the arrest of a

person. Therefore, a person detained will at the latest be assigned and given the possibility to

speak to an attorney about the charges against him within 24 hours from the arrest.

In each of the twelve police districts in Denmark a list of the districts endowed attorneys is

compiled. Furthermore, such lists are available on the website of the Danish Courts. A

compiled list of all attorneys in Denmark is available on the Danish Bar and Law Society’s

website.

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Paragraph 17

in CPT’s report

CPT’s

request for comments concerning paragraph 17:

The CPT’s delegation received no complaints regarding access to a doctor

in the context

of detention by the police. However, it was informed about a survey carried out by The

Street Lawyers

of 50 drug users who had been detained by the police and who alleged

that they had been denied access to medical care while in police custody. It is alleged that

the lack of treatment for their withdrawal symptoms had a negative impact on the way in

which they answered questions during police interviews, including false confessions. The

CPT would appreciate the comments of the Danish authorities on this matter.

Pursuant to Circular no. 9155 of 18 March 2010, all detainees will receive medical attention if

needed. When a detainee is in need of medical attention the police must

–

dependant on the

circumstances

–

without undue delay bring the detainee to the hospital, send for a doctor or

give the detainee access to contact a doctor, cf. Section 4(1) of said circular.

According to Section 4(4) of the Circular it must be noted in for example the detention report if

the detainee has requested to get in contact with a doctor.

It occurs that the police must postpone an interrogation in situations where a detainee under

the influence of alcohol, narcotics or medication is not deemed suited for interrogation, cf.

Section 5(1) of said Circular.

CPT’s

recommendation concerning paragraph 17:

The CPT recommends that steps be taken to put in place a proper reporting system for all

such injuries recorded by doctors of persons in police custody. [On injuries consistent with

allegations on excessive use of force or ill-treatment.]

Apart from suspicious deaths doctors are not obliged to report possible criminal offences to the

police. This is partly due to the fact that doctors are subject to confidentiality.

Complaints concerning the conduct of police personnel and reports of criminal offences

committed by police personnel while on duty must be submitted to the Independent Police

Complaints Authority.

Pursuant to Sections 1019(1) and 1020 of the Administration of Justice Act a complaint or

report will immediately be forwarded to the Authority if it is submitted to the police or

prosecuting authority.

Furthermore, the Authority initiates an investigation on its own initiative where a person has

died or been seriously injured as a result of police intervention or if the person in question was

in police custody.

A non-governmental organisation that provides legal aid services to vulnerable and marginalised groups

in Denmark such as drug users, street-based sex workers, homeless and undocumented migrants.

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Paragraph 18

in CPT’s report

CPT’s

recommendation concerning paragraph 18:

The CPT recommends that steps be taken to ensure that all persons detained by the

police are systematically informed of their rights, orally at time of deprivation liberty and

through the provision of an information sheet, in a language they can understand, upon

detention at the police station. Further, consideration should be given to a specific record

being maintained of the fact that detained persons have been provided with information

on their rights; detained persons should be asked to certify with their signature that such

information has been provided and, if necessary, the absence of a signature in a given

case should be explained.

According to Section 1(2) of Circular no. 9155 of 18 March 2010, persons detained by the

police must be informed of their rights as set out in the Circular. The information must be

given in a language, the detainee can understand.

In order to ensure that all persons detained receive sufficient guidance about their rights, the

Danish National Police has issued a leaflet that outlines the most important rights for detainees

including the right to have an attorney. The information sheet is available in Danish, English,

German, French, Spanish, Turkish and Arabic and is presented to the detainee by the police in

addition to oral guidance.

If the detainee does not understand any of these languages, the police must ensure that the

information is given in an understandable way as soon as possible

–

possibly by an interpreter.

In exceptional cases, where it is not possible to guide the detainee before release, e.g.

because an interpreter is not available, the information sheet must be handed out in English.

Observance of these requirements must be reported in for example the detention report or

protocol, cf. Section 1(3) of the Circular.

The Ministry of Justice has not found that additional regulation is needed.

Paragraph 19

in CPT’s report

CPT’s

recommendation concerning paragraph 19:

The main deficiency observed was a lack of access to natural light and insufficient artificial

lighting in the cells in the stations visited, which made reading difficult. The delegation,

also received complaints from persons recently detained in police stations who had not

been offered anything to eat despite being held there for several hours. Indeed, at the

Copenhagen City Police Station and Roskilde Police Station, the delegation was informed

that detained persons were only offered a meal after having been detained for eight

hours. The CPT considers that all detained persons should be offered something to eat at

appropriate times during the day. The CPT recommends that steps be taken to remedy

these deficiencies.

Detention cells and holding cells at the Danish police stations are designed according to the

guidelines for new police buildings of August 1992 given by the Ministry of Justice. Detention

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cells and holding cells constructed before 1992 have also been altered to meet the standards

in the guidelines.

According to the guidelines, there must be access to natural light in detention cells, and the

window area must be equivalent to at least 10% of the floor area. Access to daylight is not

required in holding cells, which are often used only for short stays.

Naturally, there are requirements for the artificial lighting in the cells but not for the luminosity

or the conditions for reading.

The provision of meals for detained persons is subject to local decisions in the police districts.

It is in that connection taken into consideration when the detainee is brought in to the station,

normal mealtimes, the expected extend of the detention etc.

Paragraph 21

in CPT’s report

CPT’s

request for information concerning paragraph 21:

The CPT would be interested to learn more about the Independent Police Complaints

Authority’s plans to recruit and train young professionals as investigators.

The Independent Police Complaints Authority contemplates at the moment the possibility of

also recruiting qualified investigators, who does not have a background in the police. The

Independent Police Complaints Authority has in July 2014

–

i.e. with a view to these

considerations

–

set up a working group, who will make a draft for an actual recruitment

policy. When the working group has completed the draft for such recruitment policy, it will be

given to the Independent Police Complaints Authority, who will consider the matter.

It is noted that the Independent Police Complaints Authority’s legal

workers to some extent are

taking part in the investigation of the police complaint cases. The legal workers in the

Authority have different backgrounds and more of them have not previously been employed

with the police or prosecuting authority. Recently the Independent Police Complaints Authority

has engaged a new deputy manager as from 1 December 2014, who has been working as a

barrister-of-law.

Paragraph 24

in CPT’s report

CPT’s

observation and request for information concerning paragraph 24:

The CPT trusts that the Danish authorities will continue to provide the Independent Police

Complaints Authority with the necessary resources to carry out its functions effectively. It

would like to be informed about the nature and, in due course, the outcome of the above-

mentioned review into the Authority.

During the negotiations of the bill establishing the Police Complaints Authority it was agreed

that the new system should be evaluated 3 years after its commencement, i.e. in January

2015.

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The Ministry of Justice will inform the CPT as soon as the outcome of the evaluation is

available.

II.B. Prison establishments

Paragraph 25

in CPT’s report

CPT’s

recommendation concerning paragraph 25:

The CPT recommends that the Danish authorities take the necessary steps to ensure that

all prisons operate within their design capacity and that they pursue their efforts to

manage the prison population, taking due account of the relevant Recommendations of

the Committee of Ministers of the Council of Europe in this area, in particular:

Recommendation No. R(99)22 concerning prison overcrowding and prison population

inflation; and Recommendation Rec(2006)13 on the use of remand in custody.

The CPT has recommended that the Danish authorities pursue their efforts to manage the

prison population, taking due account of the relevant Recommendations of the Committee of

Ministers of the Council of Europe in this area, in particular e.g. Recommendation Rec (2006)

13 on the use of remand in custody.

In 2012 the Director of Public Prosecutions launched a project focused on reducing the length

of remand in custody.

In this connection a Lean project was implemented in two selected police districts in order to

identify the most efficient workflows in relation to dealing with cases of remand prisoners.

Using the experience from the Lean project a new management concept for investigation in

cases of remand prisoners was developed, with the particular intention to shorten the length of

the remand in custody. The new management concept has now been introduced in all police

districts, and the districts have started using the concept.

The Director of Public Prosecutions is closely monitoring the experiences with the use of the

concept.

With the political multi-year agreement on the appropriation for the Danish Prison and

Probation Service for 2013-2016, a long term and solid solution was found for managing the

prison population and avoiding overcrowding.

A total of 200 new places are to be established. One hundred of these places have already

been established, and one hundred more are expected to be ready throughout 2015. The new

places will contribute significantly to reducing the occupancy level of Danish state or local

prisons on a permanent basis to avoid that the population of some prisons exceeds the

approved number of places for long periods of time.

In addition to the establishment of new places, the multi-year agreement also includes a

number of initiatives, which have already contributed to a reduction in the occupancy level of

the institutions of the Danish Prison and Probation Service, including the increased use of

community service and electronic tagging.

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In 2014 (January-August), the total average occupancy level of the state and local prisons of

the Danish Prison and Probation Service was 93.5 per cent, broken down into 92.2 per cent for

places in open state prisons, 95.8 per cent for places in closed state prisons and 93.2 per cent

for places in local prisons.

As a consequence of a relatively low occupancy level in 2014, the Danish Prison and Probation

Service has regularly closed down excess capacity on a temporary basis. In mid-September

2014, more than 300 places had therefore been closed down. These places are expected to be

reopened when the occupancy level increases.

Consequently, 2014 has not been characterised by overcrowding. According to the multi-year

agreement, the average occupancy level of state and local prisons must be 94 per cent as from

2016.

In 2011, the Parliamentary Ombudsman launched a general investigation of the overcrowding

problems at the institutions of the Danish Prison and Probation Service on his own initiative,

and the Department of Prisons and Probation therefore consulted the state and local prisons to

identify any consequences of the periods with overcrowding. On the basis of the consultation

responses, the Parliamentary Ombudsman was informed that, in the opinion of the Department

of Prisons and Probation, the periods in 2010 and the first half of 2011 with high occupancy

levels had not resulted in any inmates not being accorded their statutory rights and that the

periodical overcrowding had been handled with maximum consideration for the inmates.

On the basis of this information, the Parliamentary Ombudsman decided not to take further

steps in relation

to any consequences for the inmates’ rights under the sentence enforcement

legislation.

Paragraph 27

in CPT’s report

CPT’s

recommendation concerning paragraph 27:

The CPT recommends that prison officers at Western Prison and Copenhagen Police

Headquarters Prison be reminded that no more force than is strictly necessary should be

used to control prisoners and that there can be no justification for striking a prisoner after

he or she has been brought under control or for physically assaulting a prisoner who

refuses to obey an order.

The CPT has referred to a foreign national inmate who had told the delegation that he had

been hit by a prison officer in the left side of his chest for not taking off his clothes when

requested.

Copenhagen Prisons have informed the Department of Prisons and Probation that it has not

been possible to identify and investigate the specific case referred to.

Copenhagen Prisons have also stated that naturally they agree that force may be used only to

the extent permitted by the applicable

rules and that, on the basis of the CPT’s

recommendation, they have issued a reminder to joint consultative committee of the prisons,

which consists of representatives of the staff and management. Minutes of meetings of the

joint consultative committee are made available to all employees of Copenhagen Prisons.

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Copenhagen Prisons have informed the Department of Prisons and Probation that they will

immediately launch an investigation in case of suspicion of violence against an inmate.

If an inmate wishes to report violence to the police, the prison will always assist the inmate. If

the inmate does not wish to report the matter to the police, Copenhagen Prisons will

nevertheless report the matter to the police if, based on the prison’s investigation, there

are

reasonable grounds for suspecting that the inmate has been subjected to violence.

The Department of Prisons and Probation refers to the above information.

Paragraph 30

in CPT’s report

CPT’s

recommendation concerning paragraph 30:

The CPT nevertheless recommends that further steps be taken to put into place a

comprehensive anti-bullying strategy to reduce the incidence of inter-prisoner violence

and intimidation at Ringe State Prison, taking into consideration the above remarks.

Ringe State Prison has informed the Department of Prisons and Probation

that, after the CPT’s

visit, the prison has taken the following initiatives to reduce the incidence of inter-prisoner

bullying and violence:

(1)

Focused allocation of new inmates to units, work places and school where

safety is a significant factor.



From January 2015, a new reception procedure will be introduced, and the Department of

Prisons and Probation and Ringe State Prison will cooperate to develop a more refined tool

for deciding the unit in which the inmate should be placed and the occupation he or she

should be given.

(2)

Increased sectioning



In 2014, fences have been erected at the end of the courtyards to allow the inmates to be

in the courtyards without fearing that they will meet the inmates of other units.

Only a limited number of inmates are allowed to participate in common leisure time

activities and only subject to prior registration.

The inmates attend work/school with the other inmates of their unit. Previously all

inmates attended work/school together. This means that the maximum number of

inmates being together is 16, and that they are only together with inmates from their own

unit when they are working or attending school. Previously the number could be much

higher.

Prohibitions against more than two inmates in one room are issued more frequently than

previously.

The measure of transferring inmates to the prison’s special unit (unit 1 for inmates who

threaten other inmates) is used much more frequently than previously.



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

If there are grounds for transferring an inmate to a closed prison or the police

headquarters, this measure will be used.

(3)

Skills development for staff and inmates

Staff



The staff have been ordered to react more proactively towards unacceptable behaviour. In

practice, this means that the staff are expected to intervene if they see or hear inmates

being bullied and that, by being present and by focusing on safety, the staff may prevent

incidents of unacceptable behaviour.

The prison unit managers have been instructed to discuss the proactive approach with the

staff and support this approach on a continuous basis.

The new prison staff conflict management programme which started in November 2014 is

expected to upgrade the conflict management tools of staff.

A training course for the entire staff in the use of force has been initiated. The purpose of

the course is to brush up the use of locks and holds, etc. and to make the staff feel safe

when intervening. The courses have been completed for almost all employees, and the

few remaining will attend the course in January 2015.



Inmates



At present, the prison is in the process of developing a three-day conflict management

course (to be included in the adult vocational training scheme (AMU)) which will be

offered to all new inmates. Three local instructors have been educated and have been

certified by AMU. The first two courses will be launched in February 2015.

Together with the prison, the Department of Prisons and Probation will monitor the

development closely to ensure that the initiatives taken have the necessary effect of reducing

inter-prisoner violence and intimidation.

Paragraph 31

in CPT’s report

CPT’s

recommendation concerning paragraph 31:

The CPT recommends that the Danish authorities take proactive measures to prevent

sexual exploitation of prisoners at Ringe Prison, notably as concerns those prisoners

allocated to the mixed male and female wing.

In recent years, a number of initiatives have been taken to improve conditions for female

inmates. One of the initiatives of the Danish Prison and Probation Service is a cognitive

programme tailored to women, and, on the basis of the current multi-year agreement, female

inmates have been offered better employment and leisure time activities at Møgelkær State

Prison.

In general, the Danish Prison and Probation Service has a strong focus on the conditions of

female inmates, both as regards their safety and their rehabilitation. This area is closely

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monitored through annual, general user surveys of the inmates’ well-being.

It should also be

mentioned that policy makers are currently discussing whether it will be a good idea to place

all female inmates in a separate institution.

As regards the conditions of female inmates in Ringe State Prison, the prison has informed the

Department of Prisons and Probation that the suitability of each woman is assessed individually

before she is assigned to unit 5 which also holds male inmates. It is also a requirement that

the relevant female inmate is drug-free. The suitability of male inmates is also assessed

individually before they are assigned to the unit.

The prison finds it essential to maintain the possibility of placing women in unit 5 since these

more well-functioning

women are offered an alternative to the women’s section, which may

have a conflictual and unstable environment with highly stressed women who react violently.

For the purpose of further reducing the risk of harassment of women by male inmates of unit

5, the prison has introduced a rule providing that men and women (married couples

exempted) are only allowed association in the cell if the cell door is open. This enables staff to

assess the situation visually and intervene if it seems that this privilege is being abused.

Generally, the prison is aware of the risk existing when men and women associate in the same

unit. Special attention is paid to the possibility of using toilet facilities as private rooms, and

therefore inmates are allowed to use toilets upon request at one of the prison workshops only

as the access to the toilets is difficult to monitor. The toilets are closed during church services,

and in case of subsequent social interaction between inmates, supervision is intensified.

The Department of Prisons and Probation agrees with the information provided by the prison.

Paragraph 32

in CPT’s report

CPT’s

comment and recommendation concerning paragraph 32:

More generally, the CPT considers that the Danish authorities need to put in place a more

rigorous reporting system of all incidents of inter-prisoner violence as at present it would

appear that prison officers and health-care staff are not noting down all occurrences.

Consequently, there is also a lack of action to identify and address acts of violence,

intimidation and bullying. It also means that the statistics on inter-prisoner violence

produced by the Department of Prisons and Probation are most likely not an accurate

reflection of the situation in prisons.

The CPT recommends that a more rigorous approach towards combating inter-prisoner

violence in prisons be put in place, which should include a systematic recording and

reporting of all such incidents. Reference should also be made to an effective complaints

system.

On 20 March 2013, the Department of Prisons and Probation sent a letter to all prisons and to

Copenhagen Prisons concerning the procedure for handling cases relating to inter-prisoner

violence and intimidation. The following was emphasised:

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all cases must be registered in the Client System of the Danish Probation and Prison

Service,

the registration must be made

in the victim’s case file,

the registration must be made regardless of whether the victim wishes to report the

matter to the police,

the registration must be made when it has been established through interrogation that

the case involves violence or intimidation,

the registration must be made regardless of the sanction imposed based on the

outcome of the interrogation, e.g. transfer, a disciplinary sanction or exclusion from

association with other inmates, and

the registration must be made no later than seven days after the interrogation.

In that connection, the Department of Prisons and Probation sent a list of registered reports of

inter-prisoner violence or intimidation in 2011 and 2012, respectively, and the institutions

experiencing significant deviations for one year to the next were ordered to assess the reasons

for the deviation.

As a result, the Department of Prisons and Probation believes that a procedure for handling

such cases has already been developed and that this procedure is satisfactory. The institutions

assist inmates in reporting matters, and in special cases an institution may report a matter

against the wish of an inmate. However, it is usually the inmate who decides since the

inmate’s cooperation is normally required for prosecution of

an offence.

Inmates may file a complaint with the management of the institution if assaulted and they may

request, e.g., a transfer to another institution. A decision of that nature may be appealed to

the Department of Prisons and Probation. The Department believes that the inmates are well-

informed of this right of appeal, and that the staff provide guidance in that respect.

It should also be mentioned that the Department of Prisons and Probation has

set up a working

group to conduct a detailed analysis of specific incidents of violence during a particular period

to gather knowledge. Consequently, the group will seek to ensure uniformity in the registration

practice of the institutions relating to incidents of violence and intimidation and to make

specific proposals for effective measures which may reduce the extent of incidents of violence

and intimidation for both inmates and the staff, both in the short term and the long term. The

group consists of employees with knowledge of statistic and dynamic security, relational work

and user-driven innovation. The working group is expected to complete its work during spring

2015.

See also the response to paragraph 73 below concerning procedures for filing of written

complaints in sealed envelopes.

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Paragraph 33 in

CPT’s report

CPT’s

recommendations concerning paragraph 33:

The CPT welcomes the continued progress made by the Danish authorities and

recommends that they pursue their efforts to ensure that remand prisoners are only

placed in solitary confinement in exceptional circumstances which are strictly limited to

the actual requirements of the case and last no longer than is absolutely necessary.

Further, the Committee recommends that the authorities pursue their efforts to

counteract the negative effects of remand prisoners placed in judicially-imposed solitary

confinement.

The Administration of Justice Act chapter 70 provides strict rules for the use of solitary

confinement. As a general principle in section 770 remand prisoners are only subject to those

restrictions, which are necessary to ensure the purpose of the remand in custody or the

maintenance of order and security in the remand centre.

Furthermore, section 770 b stipulates that solitary confinement may only be used during

remand in custody when the aim of the solitary confinement cannot be attained by less

invasive measures, when the solitary confinement is not disproportionate to the importance of

the case and the expected legal ramifications if the defendant is convicted, and the

investigation of the suspected criminal offence is carried out with the speed which is required

in such cases.

The prerequisites for the use of solitary confinement are generally increased with the duration

of the solitary confinement. Thus, it follows from section 770 d(3) that the use of solitary

confinement beyond 8 weeks in relation to a person over the age of 18 and the use of solitary

confinement beyond 4 weeks in relation to a person under the age of 18 must be approved by

the Director of Public Prosecutions before such a request can be made to the courts.

Since 2001 the Director of Public Prosecutions has been closely monitoring the use of solitary

confinement of remand prisoners in order to ensure that remand prisoners are only placed in

solitary confinement when it is necessary to ensure the purpose of the remand in custody. The

Director of Public Prosecutions submits a yearly report on the use of solitary confinement to

the Minister for Justice.

In this context it should be noted, that the Director of Public Prosecutions has implemented a

new system for collecting data regarding remand in custody and solitary confinement. The

system can also be used by the regional state prosecutors in their supervision with the police

districts. The regional state prosecutors are expected in their yearly report to the Director of

Public Prosecutions to account for the development in the amount of solitary confinements as

well as the duration of these in order to decrease the use of solitary confinement and to point

out any regional or local differences in the use of solitary confinement.

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Paragraph 35

in CPT’s report

CPT’s

recommendation concerning paragraph 35:

The CPT reiterates its recommendation that the Danish authorities reinforce the

safeguards surrounding the application of

judicial restrictions on remand prisoners’

contacts with the outside world, namely:

that the police be given detailed instructions as regards recourse to

prohibitions/restrictions concerning prisoners’ correspondence and visits;

that there be an obligation to state the reasons in writing for any such measure;

that, in the context of each periodic review by a court of the necessity to continue

remand in custody, the question of the necessity for the police to continue to

impose particular restrictions upon

a remand prisoner’s visits, telephone calls and

letters be considered as a separate issue.

The Administration of Justice Act and the Remand Custody Order provide regulation on remand

prisoners’ right to receive visits and to send and receive letters.

Pursuant to Section 770 of the Administration of Justice Act, a remand prisoner is only subject

to those restrictions, which are necessary to secure the purpose of the remand or the

maintenance of order and security in the detention center.

Pursuant to Section 771 of the Administration of Justice Act, a remand prisoner can receive

visits to the extent that the maintenance of order and security in the detention centre permits

it. The police can, due to the purpose of the remand, oppose that the remand prisoner receives

visits, or insist that visits take place under supervision. The remand prisoner can demand that

a decision to deny visits or require supervision is submitted to the court for review.

A remand prisoner always has the right to unsupervised visits by his defence attorney.

Pursuant to Section 772 of the Administration of Justice Act, the police can inspect letters

before they are received or sent. The police shall as soon as possible hand over or send the

letter unless the content is harmful to the investigation or to the maintenance of order and

security in the detention centre.

If a letter is withheld by the police, the question whether the suppression should be upheld

shall immediately be submitted to the court for decision. If the suppression is upheld the

sender shall be notified immediately, unless the judge, due to considerations to the

investigation, makes a different decision.

A remand prisoner always has the right to unsupervised exchanges of letters with the court,

the defence attorney, the Minister for Justice, the Director of the Prison and Probation Service

and with the Parliamentary Ombudsman.

According to the Administration of Justice Act section 773 the police can impose other

restrictions such as restrictions on telephone calls. The remand prisoner can require that such

restrictions be submitted to the court.

In practice, the decision whether or not to impose restrictions in the right to receive visits or

mail (B&B) is taken by the prosecutor at the time when the decision on remand (or the

prolonging thereof) is taken by the court.

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The prosecutor may only make a decision to impose restrictions that are deemed necessary in

accordance with section 770 of the Administration of Justice Act. “B&B” judicial restrictions are

therefore as a general rule only imposed, when the purpose of the remand is to prevent the

detainee from obstructing the course of the proceedings, in particular by removing traces or

warn or influence others.

The decision to impose restrictions in the right to receive visits or mail will usually not be

communicated in writing to the remand prisoner. However, should this be requested by the

remand prisoner, the prosecutor may produce a written justification. Furthermore, if the

remand prisoner demands that police denials of visits or requirements of supervision are

submitted to the court for review, the court’s decision on the application of “B&B” judicial

restrictions will be made in writing.

In addition to the Administration of Justice Act and the Remand Custody Order, Judicial

Guidance number 36 of 12 April 2012 regarding the Remand Custody Order gives detailed

instructions as regards restrictions concerning remand prisoners’ right to receive visits and

correspondence.

The Danish Ministry of Justice has recently taken steps

to examine the use of “B&B” judicial

restrictions in Denmark. A project involving the Danish Prison and Probation Service, the

Danish National Police and the Director of Public Prosecutions is to address a number of issues

regarding the use of “B&B”, e.g. to what extent “B&B” judicial restrictions are being applied,

any demerits of “B&B” judicial restrictions in relation to remand prisoners' ability to maintain

contact with family and the possibility of targeting the use of “B&B” judicial restrictions.

As such, the restrictions imposed by the police are not part of the periodic review by the court

regarding the continued need for remand in custody. However, the question can be brought

before the court for review. Accordingly, the restrictions are subject to judiciary control and

the Administration of Justice Act is considered to provide sufficient safeguards in relation to

remand prisoners’ rights to receive visits and to send and receive letters.

Paragraph 36

in CPT’s report

CPT’s

recommendation concerning paragraph 36:

The CPT recommends that greater efforts be made to ensure that all prisoners are offered

the possibility to associate or to be involved in activities requiring human contact for

several hours every day.

First, it should be noted that, as a paramount rule, detention in Copenhagen Police

Headquarters Prison is only temporary.

Copenhagen Prisons have stated that the inmate composition at Copenhagen Police

Headquarters Prison is complex. In general, inmates are members of four or five different biker

gangs or other gangs, and often the number is higher. For security reasons, inmates from

different gangs cannot associate with other inmates from other gangs while at Copenhagen

Police Headquarters Prison due to their socially dominant behaviour.

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There may also be other reasons why it is difficult to find a suitable fellow inmate for some

inmates to associate with. In those cases, the difficulties will often be caused by matters

relating to security.

However, the staff make a great effort to ensure that all inmates associate with other inmates,

and this issue is monitored on a continuous basis, e.g. at the monthly meetings with the prison

management at which the individual inmates are discussed.

Copenhagen Prisons have also stated that an inmate who is in fact excluded from association

because he or she has no association with other inmates enjoys the same rights to measures

which may alleviate the feeling of isolation as inmates excluded from association through a

decision.

Finally, Copenhagen Prisons have indicated that they will consider whether, within the existing

framework, more can be done to ensure that as many of the inmates at Copenhagen Police

Headquarters Prison as possible are able to associate with others.

The Department of Prisons and Probation refers to the information provided by the prison and

adds that, in connection with the monthly reports on the length of stays at Copenhagen Police

Headquarters Prison, the Department monitors the development closely.

Paragraph 37

in CPT’s report

CPT’s

comments and recommendation concerning paragraph 37:

If the Danish Prison and Probation Service intends to accommodate prisoners at this

facility who do not fulfil the requirements of a “negatively strong” prisoner, efforts should

be made to provide a more meaningful regime for them. More generally, the CPT

continues to believe that the placement criteria should be rendered more transparent.

The CPT recommends that the Danish authorities review the situation at the Copenhagen

Police Headquarters Prison, in the light of the above remarks.

There are five described categories of inmates who may be placed at Copenhagen Police

Headquarters Prison. Categories 1-4 only comprise inmates meeting the criteria of being

negatively strong inmates. Also inmates falling within category 5 are placed there. In the

instruction letter from the Department of Prisons and Probation to the institutions dated 28

August 2006, category 5 inmates are defined as follows:

Remand prisoners from Copenhagen Prison

a) who are excluded from association with other inmates under section 63 of the Sentence

Enforcement Act (see also comments to paragraph 38),

b) who wish to be excluded from association with other inmates, or

c) who are kept in solitary confinement as ordered by the court.

This list is not exhaustive since also other categories of inmates may also be placed there,

such as inmates needing particularly strong protection and secrecy as to the prison in which

they are placed.

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Categories 5(a)-(c) are characterised by the inmates being excluded from normal association

with other inmates because of their legal status or a decision made by the prison. As a result,

the basic right to association with other inmates is not restricted when the inmates are placed

–

usually for a short period of time

–

in Copenhagen Police Headquarters Prison instead of in

an ordinary local prison unit, such as in Western Prison. To these inmates, the solitary

confinement ordered by the court or the exclusion from association decided by the prison is

the primary and fundamental decision, and placement in Copenhagen Police Headquarters

Prison is merely a secondary decision which is made for operational reasons. The length of

solitary confinement and exclusion from association with other inmates are covered by the

ordinary due process protection, decision-making procedures and restrictions set out in the

Danish Administration of Justice Act and the Danish Sentence Enforcement Act. However, it is

not possible already on the first day to decide and tell the inmate how long e.g. the period of

exclusion from association imposed by the prison is going to last and when he or she will be

returned to an ordinary local prison unit, as such exclusion is naturally decided to prevent a

particular future behaviour, which will be discontinued when it is considered advisable to allow

the inmate to associate with other inmates again, e.g. because the inmate has reflected on his

behaviour and made a positive change to the behaviour which gave rise to the exclusion.

Copenhagen Prisons have informed the Department of Prisons and Probation that, on the basis

of the information from the CPT, it has not been possible to identify the specific case, and it is

therefore impossible to make further comments in that respect.

The Department of Prisons and Probation still finds that it must also be possible to place

category 5 inmates at Copenhagen Police Headquarters Prison according to the existing

practice.

The Sentence Enforcement Act and the Administration of Justice Act and any administrative

rules laid down in pursuance of those Acts describe and provide guidance on the various

options for placement, transfer and exclusion of inmates. With regard to Copenhagen Police

Headquarters Prison, the Department of Prisons and Probation has in fact issued a special

circular dated 12 October 2012 which describes the concept of negatively strong inmates in

detail and deals with various case management requirements relating to placement in

Copenhagen Police Headquarters Prison. As stated above, the Department of Prisons and

Probation has also defined categories for placement there and e.g. specifically described the

persons who may be placed as category 5 inmates. It should be noted that a decision of

whether to place an inmate in Copenhagen Police Headquarters Prison must be based on an

individual assessment. Prior to the prison’s decision to exclude an inmate from association, the

inmate will, as a minimum, be informed that the prison intends to make such decision on

exclusion, and he or she will be allowed to express an opinion. When the decision has been

made, he or she will be informed of the statutory provisions under which the decision has been

made.

The Department of Prisons and Probation believes that the placement criteria and the legal

reasons for placement have already been described and defined, and that the transparency

relating to the use of Copenhagen Police Headquarters Prison is therefore satisfactory.

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Paragraph 38 in CPT’s report

CPT’s

recommendation concerning paragraph 38:

the CPT recommends that the Danish authorities take the necessary measures to ensure

that:



any prisoner subject to prolonged solitary confinement:

has the right of appeal to an independent authority;

has a plan drawn up to address the reasons for the issues which require

the prisoner to be kept in solitary confinement;

has a multi-disciplinary team to review the plan initially after one month

and thereafter every three months, with the right to appeal any decision

to prolong the solitary confinement;

the longer the situation of solitary confinement continues, the more thorough

the review should be and the more resources made available to attempt to

(re)integrate the prisoner into the main prison community;

the above-mentioned prisoner is provided with psychological and, if necessary,

psychiatric counselling to assist him to associate with other prisoners and more

importantly prepare him for reintegration into society;



The rules on administrative exclusion of inmates from association with other inmates are set

out in the Sentence Enforcement Act and the Executive Order on Exclusion of Inmates from

Association (Executive Order No. 283 of 26 March 2012 on Exclusion of Inmates from

Association, including Placement in Observation Cells, etc. in State and Local Prisons).

It should be noted that a working group has looked at ways to reduce the use of exclusion

from association with other inmates. In 2010, the working group made a number of proposals

to revise the rules on exclusion from association, partly to reduce the number of exclusions

from association and partly to reduce the length of such exclusions. As a result, new rules on

the exclusion from association with other inmates were introduced on 1 April 2012.

Section 63(1)-(3) of the Sentence Enforcement Act reads as follows:

‘63.

(1) The director of the institution or the person so authorised may exclude an

inmate from association with other inmates if necessary

–

(i) to prevent escape, criminal activities or violent behaviour;

(ii) to carry out measures necessary for reasons of security or required to prevent

any danger of infection; or

(iii) because the inmate exhibits gross or frequently repeated impermissible

behaviour obviously incompatible with continued association with other inmates.

(2) The director of the institution or the person so authorised may exceptionally

exclude an inmate from association with other inmates for up to five days if

necessary to protect the inmate against assaults.

(3) If there is reason to assume that the conditions of subsection (1) hereof for

exclusion from association are present, the institution may temporarily exclude

the inmate from association with other inmates while the question of exclusion is

being considered. If there is reason to assume that the conditions of section 25 of

this Act for transfer to a closed prison or of section 26 of this Act for transfer

between uniform closed enforcement institutions or of section 28 of this Act for

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transfer to a local prison are present, the institution may also temporarily exclude

the inmate from association with other inmates while the question of transfer is

being considered.’

Section 63(6)-(9) of the Sentence Enforcement Act contains rules on proportionality,

considerateness and period of exclusion from association with other inmates, etc.:

‘(6)

An inmate may not be excluded from association if the exclusion would be

disproportionate in view of the purpose of the measure and the indignity and the

discomfort presumably caused by the measure.

(7) Exclusion from association must be accomplished as considerately as

circumstances permit.

(8) Exclusion from association must be discontinued promptly when the conditions

for such exclusion are no longer present. The institution shall consider the

question of complete or partial discontinuation of the exclusion from association

at least once a week.

(9) The period of exclusion from association may not exceed three months. The

Department of Prisons and Probation may make a decision on exclusion from

association for more than three months in the event of highly exceptional

circumstances. In such case, subsection (8), second sentence, hereof applies

correspondingly.’

The above rules apply to the enforcement of prison sentences and safe custody, see section 1

of the Sentence Enforcement Act. The rules apply correspondingly to the use of administrative

exclusion of remand prisoners from association, see section 1(1), second sentence, of the

Executive Order on Exclusion of Inmates from Association, cf. section 776, first sentence, of

the Administration of Justice Act.

The Executive Order on Exclusion of Inmates from Association contains detailed rules on the

consideration of cases concerning the exclusion of inmates from association.

Special rights and offers to inmates excluded for more than 14 days

Inmates who have been excluded from association for more than 14 days must receive

guidance on the special rights and offers for which they are eligible under section 6 of the

Executive Order on Exclusion of Inmates from Association. Therefore, the staff must at all

times be particularly aware of whether such inmates need increased staff contact, medical or

psychiatric assistance, etc. The staff must be aware that such needs increase with the length

of the exclusion from association, see section 6(1) of the Executive Order.

The staff must also be particularly aware of whether the exclusion from association can be

relaxed through association with one or more inmates in the cell or during exercise in the

courtyard, work in association with other inmates or leisure time activities with other inmates

or the staff, etc., see section 6(2) of the Executive Order.

An inmate who has been excluded from association for more than 14 days must also be offered

regular and long consultations with a psychologist, a doctor, a minister of religion or a similar

person, have a television set made available free of charge, and be offered special access to

individual tuition and work, including any other approved activity which may help reduce the

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particular stress and risk of impairment of the mental health connected with exclusion from

association, see section 6(3) of the Executive Order.

Inmates who have been excluded from association for more than three or six months,

respectively, and inmates under the age of 18 who have been excluded from association for

more than four weeks have additional rights to increased contact with others, see sections 7

and 8 of the Executive Order.

Considerations of whether to discontinue exclusion from association and plan for reintegrating

the inmate into the prison community

Under section 9 of the Executive Order on Exclusion of Inmates from Association, the

authorities are subject to a special duty to make records of the continuous considerations of

whether to discontinue the exclusion from association:

‘9.

(1) When exclusion from association is discontinued, see section 63(8), first

sentence, of the Sentence Enforcement Act, a record must be made of the date

and time of the discontinuation of the exclusion.

(2) In addition, a record must be made of the considerations of the institution

under section 63(8), second sentence, of the Sentence Enforcement Act on

complete or partial discontinuation of the exclusion, including the date and time of

such considerations. The record must also include a plan for returning the inmate

to association, including a plan for relaxing the measure of exclusion from

association, see section 6(2) of this Order.

(3) The record referred to in subsection (2) hereof is subject to the approval of

the director of the institution or the person so authorised. The director of the

institution cannot delegate such authority to any person other than the deputy

state or local prison director or finance director.’

Section 9 of the Guidance Notes on Exclusion of Inmates from Association, including Placement

in Observation Cells, etc., in State and Local Prisons (Guidance Notes on Exclusion of Inmates

from Association) contains the following plan for reintegrating inmates into the prison

community:

‘When an inmate is excluded from association with

other inmates, a plan must be made

on how to reintegrate the inmate into the prison community, including how to relax the

measure of exclusion from association, see section 9(2) of the Executive Order. Such plan

must be made the first time the institution considers the issue of whether to discontinue

the exclusion from association, whether in full or in part, and, just like the weekly

records, it is subject to approval by the director of the institution or the person so

authorised. However, the director of the institution cannot delegate such authority to any

person other than the deputy prison director/finance director/deputy prison governor.

If the exclusion from association is continued, the plan for reintegration must be adjusted

and updated on a continuous basis, and the plan for reintegration must be included in the

subsequent weekly records.’

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Special procedural requirements relating to exclusion from association for more than 14 days

or three months, respectively

Under sections 10 and 11 of the Executive Order, special procedural requirements apply when

an inmate has been excluded from association for more than 14 days or three months,

respectively:

‘10.

When an inmate has been excluded from association for fourteen days, the

exclusion must be reported to the Department of Prisons and Probation under the

Ministry of Justice. The same applies at the end of each subsequent fourteen-day

period. The report must be accompanied by copies of the records referred to in

sections 5(4) and (5) and 9(2) of this Order.

11.

(1) Where the institution finds it necessary, very exceptionally, to exclude an

inmate from association for a period exceeding three months, the institution shall

send a recommendation to that effect to the Department of Prisons and Probation

under the Ministry of Justice. The institution shall send the recommendation to

the Department in time for it to be received two weeks before the exclusion has

lasted for three months to allow the Department to make a decision before the

period of exclusion exceeds three months.

(2) Before the Department of Prisons and Probation under the Ministry of Justice

makes its decision, the relevant inmate is entitled to an interview with a

representative of the Department. In its recommendation, the institution shall

state that the inmate has been informed of such right and indicate whether the

inmate wants to make use of it.

(3) If the Department of Prisons and Probation under the Ministry of Justice has

decided on exclusion from association for more than three months, the institution

shall submit the records prepared pursuant to section 9(2) of this Order to the

Department at least once a week for use by the Department in its considerations

on whether to discontinue the exclusion from association in full or in part.’

The purpose of revising the rules on exclusion from association was to reduce the number of

exclusions from association, to reduce the periods of exclusion and to increase focus on

allowing excluded inmates to associate with other inmates during part of the exclusion period,

in order to alleviate the negative effects of solitary confinement.

The revision to the rules has had a positive effect on the number of exclusions from

association. Accordingly, the number of discontinued exclusions was 741 in the institutions of

the Danish Prison and Probation Service in 2011, while the number was 543 in 2013,

corresponding to a decline of 27 per cent.

Although fewer inmates have been excluded from association, and it must be assumed that

this measure is only used in particularly serious situations, the proportion of exclusions under

which inmates have been allowed to associate with other inmates has remained stable: 248

out of 741 exclusions in 2011 (33 per cent) and 181 out of 543 exclusions in 2013 (33 per

cent).

As regards the periods of exclusion from association, the revision to the rules has also had a

positive effect. In fact, there were fewer exclusions from association in the categories of 0-3

days, 4-7 days, 8-14 days and 15-28 days in 2013 compared with 2011. Only the number of

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exclusions exceeding 28 days has remained unchanged. It should be noted that, due to the

reporting duty, the individual cases concerning exclusion from association for more than 14

days are monitored on a continuous basis by the Department of Prisons and Probation.

Right to appeal the decision to an independent authority

As regards the right to appeal a decision to an independent authority, it should be noted that

inmates are entitled to bring decisions on exclusion from association before the Parliamentary

Ombudsman. The Parliamentary Ombudsman cannot change a decision, but he may request

the Department of Prisons and Probation to reconsider the case. In practice, requests made by

the Parliamentary Ombudsman are always complied with. Furthermore, administrative

decisions may be brought before the courts under section 63 of the Danish Constitution. Court

proceedings will not stay the execution of a decision to exclude.

Against that background, the Department of Prisons and Probation finds that the existing rules

on exclusion of inmates from association reflect the due process protection pointed out by the

CPT.

A specific case from Vridsløselille State Prison

As regards the specific case to which the CPT refers in paragraph 38, Vridsløselille State Prison

has informed the Department of Prisons and Probation that the inmate concerned has

gradually been reintegrated into the prison community in the following manner:



From 5 March 2014, he was allowed association in a cell with a fellow inmate

From 20 March 2014, he was allowed to attend the weekly church services with the

other inmates

From 31 March 2014, he was allowed to exercise every day in the courtyard together

with other inmates

On 1 July 2014, he was transferred to a normal prison unit, and he was allowed to sing

in the prison’s choir.

From 10 July 2014, he was allowed to work at the prison’s textile workshop.

As regards psychological/psychiatric assistance, the prison states that the inmate has had nine

consultations with the prison’s

psychologist in the period from 5 March 2014 to 24 September

2014.

The Department of Prisons and Probation refers to the above response from the prison.

Paragraph 39

in CPT’s report

CPT’s

recommendation concerning paragraph 39:

The CPT recommends that the Danish authorities carry out a full review of the police

investigation into this case of alleged ill-treatment by prison officers at East Jutland Prison

in 2009, and inform the Committee of the outcome accordingly.

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The case mentioned by the CPT concerns a prisoner of the State Prison of East Jutland, who

through his defence attorney claimed to have been ill-treated by prison officers in connection

with a disciplinary interrogation in January 2009.

The Director of Public Prosecutors has informed that the prison officers in question were

charged and questioned, and that the case was investigated.

On 27 January 2010, the local Prosecution Service of South Eastern Jutland decided not to

prosecute the allegations against the prison officers.

The decision was taken in accordance with section 721, paragraph 1(2), of the Administration

of Justice Act. According to this provision, charges can be dropped when further pursuance of

the case is not likely to result in the person being found guilty.

The Prosecution Service referred in their reasoning to the following:

The prison staff had claimed to be not-guilty of the alleged assault; there were no witnesses to

the alleged assault; the nurse who removed a gold chain from the prisoner’s neck, stated that

the prisoner had no injuries to the back of his head; persons present in the fixation room have

stated that the prison officer accused by the prisoner of i.a. hitting and kicking the prisoner

was not positioned by the prisoner’s head; the prison staff has stated that

the prison officer in

question was not in the fixation room when oxygen was requested; the doctor who examined

the prisoner noticed marks on the prisoner’s neck and extravasations of blood behind both

ears. The doctor stated that the marks may very well be caused by the heavy gold chain

carried by the prisoner during the incident. Based on this, the Prosecution Service found that it

would not be possible to lift the burden of proof in the case.

The prisoner was informed of the decision in writing on 27 January 2010. The letter contained

information on how to file a complaint against the decision to the higher level of the

Prosecution Service.

According to section 724, paragraph 1, of the Administration of Justice Act, a decision not to

prosecute can be appealed to the superior level of the prosecuting authority, in this case the

State Prosecutor. According to the case file, the prisoner has not filed a complaint against the

decision of the South East Jutland Prosecution District.

It is noted that the abovementioned incident also was reported to the police with charges of

assault committed by the prisoner against three of the prison officers involved, and that these

charges on the other hand resulted in an indictment.

In August 2010, the Court in Horsens sentenced the prisoner in question to ten months of

imprisonment. Besides the account of assault, the case also involved one account of attempted

escape and one account of illegal possession of a mobile phone with the view of escaping. The

sentencing was reasoned by the fact that the prisoner was found guilty of violence against

three prison officers committed in the facility where he served a sentence. The Court also took

into consideration that the prisoner was previously convicted of escaping from prison and of

assault.

According to section 901 of the Administration of Justice Act, the decision of the court could be

appealed to the High Court. However, according to the case file, the prisoner has not appealed

the decision of the Court of Horsens.

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In the light of the review of the case, the Director of Public Prosecutors has not found reason

for further remarks.

The Department of Prisons and Probation has also consulted the South-East Jutland Police on

the incident. The South-East Jutland Police has provided additional information regarding the

incident that led to the prisoner being charged for assaulting three prison officers.

On 20 August 2010, the prisoner was convicted by the District Court of Horsens for violation of

section 119(1) of the Danish Criminal Code because he had punched one of the prison officers

present three times in the face, bit another prison officer below the right breast and slapped

the officer’s face several times and punched a third prison officer twice in the face during the

interrogation. In that connection, the court took into account that the inmate had punched one

of the prison officers in the face without any provocation on the part of the prison officer,

except that as interrogator he had confronted the inmate with the case being the subject-

matter of the interrogation. Furthermore, the court found it substantiated that the other prison

officers had then attempted to pacify the inmate who was hitting in all directions, and in that

connection he had slapped the face of one of the prison officers several times and bit the

officer’s chest, and he had also punched another prison officer twice in the face. Finally the

court found that there was no reason for assuming that any of the victims had provoked the

inmate’s use of violence.

The Department of Prisons and Probation adds that the case has not given rise to any

disciplinary reactions against the prison officers involved since the Department has found that,

due to the very special nature of the case and the particular circumstances, the acts were

lawful self-defence.

Paragraph 40

in CPT’s report

CPT’s

recommendation concerning paragraph 40:

The CPT recommends that steps be taken to ensure that prisoners in all remand

establishments, notably Western Prison and Police Headquarters Prison in Copenhagen

have ready access to a proper toilet facility at any time of the day or night. It would be

far preferable to install in-cell toilets in all prison establishments.

Both the Western Prison and Copenhagen Police Headquarters Prison are institutions located in

very old buildings, and therefore they do not fully meet the requirements for modern prison

facilities. There are no in-cell toilets, and therefore these institutions must be staffed to ensure

that all inmates can access a toilet at any time of the day or night.

Seen in the light of the recommendations of the CPT, the Department of Prisons and Probation

has pointed out to the remand institutions visited that inmates must have access to a toilet at

any time, also at night.

It should be added that, when constructing new prison facilities, the Danish Prison and

Probation Service only establishes residential units with a toilet attached to each cell.

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Paragraph 43

in CPT’s report

CPT’s

recommendation concerning paragraph 43:

The CPT recommends that every effort be made to avoid accommodating two prisoners in

cells designed for single occupancy at Western Prison. Efforts should also be made to

replace damaged furniture and missing curtains.

Copenhagen Prisons have taken note of the recommendation.

The Department of Prisons and Probation refers to the above response from the prison.

CPT’s

recommendation concerning paragraph 43:

Further, the CPT encourages the management of Western Prison to pursue their efforts to

offer all prisoners access to purposeful activities during their time at the establishment.

The Western Prison has informed the Department of Prisons and Probation that the

occupational activities offered by the prison are adjusted on a continuous basis to offer

meaningful activities to all inmates, including to foreign national inmates. The prison admits

that sometimes it has been difficult to provide information about the activity offers to all

inmates because of the language barriers experienced in the communication with the inmates,

who speak many different foreign languages.

In the light of these difficulties, the Western Prison has launched a communication project

called ‘Information On Admission’ (IVI) which aims at providing better information on the stay

in the prison in general and guidance on the activities offered in the prison. The project aims at

overcoming the challenges and frustrations that may be caused by language barriers. It will

therefore benefit foreign national inmates in particular. Since some of the inmates of the target

group are unable to read, the project information is communicated by means of symbols and

images, which replace the traditional written information. The preliminary project results are

positive, and the prison expects that the project will be able to alleviate communication

problems in future.

Moreover, it should be noted that the prison offers English classes especially for foreign

national inmates.

It should also be mentioned that the Western Prison is currently investigating the possibility of

offering hygiene courses tailored specifically to foreign national inmates and that, in relation to

cell work where inmates work on the prison’s own product line ‘Made By Prisoners’, the prison

has a special focus on ensuring that this offer must also be relevant to foreign national

inmates.

The Department of Prisons and Probation refers to the information provided by the prison.

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Paragraph 45

in CPT’s report

CPT’s

recommendation concerning paragraph 45:

The CPT recommends that the Danish authorities review the policy of placing juveniles

remanded in custody pending trial in a prison establishment rather than a secure

institution for juveniles. Further, all juveniles held in remand custody must be provided

with a full programme of vocational, education, sports and recreational activities.

The Administration of Justice Act’s chapter on remand in custody also applies to minors

(children under the age of 18).

Accordingly, the Administration of Justice Act section 765 stipulates that when the

prerequisites for remand in custody are fulfilled and the purpose of remand in custody can be

attained by less invasive measures the court can decide that the minor shall be placed in a

secure institution instead, if the minor consents.

The Director of Public Prosecutors has issued instruction No. 4/2007 on treatment of cases

regarding juvenile offenders, which establishes guidelines as to how the Prosecution Service

shall handle cases where remand in custody of a minor is considered. The guidelines stipulate

that it should always be attempted to place the minor in a surrogate to remand in custody

unless specific reasons deem remand in custody necessary e.g. if the crime committed is of a

very serious or dangerous nature.

As such it is not the Danish authorities’ policy

to place minors remanded in custody in a prison

establishment rather than a secure institution. It should be noted that if a minor is placed in

remand in custody the Administration of Justice Act section 768 a(2) contains strict time limits

as to the duration hereof.

Most of the relatively few juveniles who are remanded in custody in the institutions of the

Danish Prison and Probation Service are held for quite short periods of time. Against that

background and considering the special rules for juveniles of the Danish Prison and Probation

Service which aim at protecting juveniles from older inmates, the Danish Prison and Probation

Service has decided to give the following areas a high priority: education guidance,

screening/testing of the linguistic skills of the juveniles, primary and lower secondary school

education and improvement of basic reading, arithmetic and writing skills.

It should be noted that, in recent years, the Danish Prison and Probation Service has

intensified its educational efforts towards all inmates, especially juveniles and continues to

implement relevant initiatives and develop the area. The CPT’s recommendations will be

included in its work.

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Paragraph 46

in CPT’s report

CPT’s

request for comments and information concerning paragraph 46:

If it is considered necessary to have a separate unit for sentenced juveniles, consideration

might be given to locating that unit on the grounds of an open prison which was

accommodating sentenced juveniles. In this way, a specialised centre focused around the

needs of juveniles could be put in place which would also provide increased options for

managing juveniles in the closed and open sections, including joint activities. The CPT

would appreciate the observations of the Danish authorities on this matter.

Further, given that many of the juveniles/young adults had already spent time in several

institutions before prison, a major challenge lies in assisting them make the transition

from prison (with its support and structure) to life in the community. The Committee

would like to be informed of the measures being taken to facilitate this process.

The Danish Prison and Probation Service is working on a continuous basis to develop the form

and contents of its prison units. As a main rule, sentenced juveniles (i.e. persons of 15-17

years of age) are placed in institutions outside the prison system.

The Minister for Justice has initiated a survey on juveniles in prison in order to gain knowledge

and determine possible future measures. The CPT’s considerations

will be taken into account if

possible in that connection.

As regards the CPT’s comments on assistance to sentenced juveniles to make the transition

from prison to life in the community, it should be noted that juveniles serving a prison

sentence in an institution of the Danish Prison and Probation Service already receive education

guidance, assistance from social workers, etc.

An action plan is prepared for the individual juvenile, and his or her home municipality is

contacted, e.g. for the purpose of coordinating action plans.

Moreover, on release on parole, the individual juvenile will be subjected to supervision, and in

that connection he or she will also receive guidance and assistance. Finally, the supervisory

authority charged with the supervision of the juvenile released on parole must consider

whether the juvenile should have a mentor if he or she has not already been given a mentor

during the stay at the institution.

Paragraph 47

in CPT’s report

CPT’s

recommendation concerning paragraph 47:

The CPT recommends that regular psychiatric input for Odense Remand Prison be

sourced. Further, doctors’ on-call

should be reminded of their duty to attend the prison

when circumstances so require.

As regards regular psychiatric assistance at Odense Local Prison, the prison governor has

informed the Department of Prisons and Probation that the prison employs a psychiatric

consultant 2-4 hours per week. The psychiatrist is also employed in the forensic psychiatric

sector. As a result, the psychiatrist is able to attend to/see two or three inmates per week. In

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periods when the need for attending to inmates is lower, the psychiatrist also performs

supervision of the prison’s nurses.

The Department of Prisons and Probation refers to this information.

As for the (somatic)

doctor’s duty to attend when needed, the prison governor has informed

the Department of Prisons and Probation that, according to the prison’s general experience,

the doctor usually attends when needed, including to inmates with mental problems. The

specific case at Odense Local Prison referred to by the CPT is therefore not characteristic of the

usual medical attendance at the prison.

The Department of Prisons and Probation agrees that a doctor on-call during working hours

must meet his obligation to attend the prison when warranted by circumstances.

It should be noted that, outside normal working hours, the inmates of the local prison only

have access to the normal public medical emergency service, like all other citizens in Denmark.

In Denmark, the medical emergency service is operated by the regional authorities.

Paragraph 51

in CPT’s report

CPT’s

recommendation concerning paragraph 51:

The CPT recommends that the Danish authorities take steps to ensure that every newly-

arrived prisoner be properly interviewed and physically examined by a medical doctor, or

a fully qualified nurse reporting to a doctor, during the initial screening. Such screening

should always take place within 24 hours of a person’s admission to prison, and

preferably on the day of arrival at the establishment. Further, each prison health-care

service should have in place a screening tool to enable them to properly assess the

health-care needs of each newly-admitted prisoner.

When the CPT visited Denmark in 2002 and 2008, the CPT also pointed out that the Danish

Prison and Probation Service should take steps to ensure that inmates are always screened by

a medical doctor or a qualified nurse as soon as possible and no later than 24 hours after

admission to the institution.

In connection with the visit in 2002, the Department of Prisons and Probation informed the CPT

that it considered the Danish practice, according to which inmates are informed of the health

care services available at the institution when admitted and are offered an appointment with

the doctor or nurse of the institution, to be in accordance with the European Prison Rules

according to which a doctor or nurse reporting to the doctor must attend to all inmates as soon

as possible after their admission and examine them, unless it is obvious that such examination

is unnecessary.

On the basis of the recommendation maintained by the CPT in connection with its visit in 2008,

the Department of Prisons and Probation decided to launch a screening project with systematic

screening of all inmates in selected institutions for somatic diseases. The project has not yet

been completed, and therefore it is not possible to draw any final conclusions at this stage.

The Department of Prisons and Probation expects the results to be ready in early 2015. A

detailed assessment will then be made to determine whether the screening should be

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continued and offered to inmates of all institutions of the Danish Prison and Probation Service

and which model should be applied.

Furthermore, the Danish Prison and Probation Service completed a screening project

concerning mental illnesses among remand prisoners at Western Prison from 2009 to 2012.

The results were published in December 2013. The purpose of the project was to examine

whether it would be possible to develop a screening tool for the nurses of the Danish Prison

and Probation Service which would enable them, on a systematic basis, to identify early signs

of mental illness and the need for psychiatric monitoring of remand prisoners. On the basis of

the screening project results, it was concluded that the screening tool did not enable prison

nurses to make a qualified identification of all remand prisoners with mental illnesses. The

report therefore recommends that alternative methods be found to identify mental illness, such

as the institution of special reception units and closer cooperation with the psychiatric sector

outside the prisons. As from 1 January 2015, reception units will be established in all prisons

to make it easier to identify inmates with mental illnesses. The Department of Prisons and

Probation

is currently examining the CPT’s other recommendations.

Paragraph 52

in CPT’s report

CPT’s

recommendation concerning paragraph 52:

The CPT recommends that the necessary instructions be issued to ensure that any

relevant statements by newly-arrived prisoners or an inmate involved in a violent incident

in prison are recorded by the health-care

service, together with the doctor’s observations.

The existing procedures should be reviewed in order to ensure that whenever injuries are

recorded by a doctor which are consistent with allegations of ill-treatment made by a

prisoner (or which, even in the absence of allegations, are indicative of ill-treatment), the

record is immediately and systematically brought to the attention of the supervisory

authority, regardless of the wishes of the person concerned.

Inter-prisoner violence must be registered in the electronic Client System of the Danish Prison

and Probation Service. The registration must be

made in the victim’s case file and regardless

of whether the victim wishes to report the matter to the police. The registration must be made

when it has been established, in connection with an interrogation, that violence has occurred,

regardless of whether the interrogation leads to a sanction. Reference is made to the response

to paragraph 32 above.

According to the Danish practice, inmates are not forced to receive medical assistance.

However, inmates are guided by staff on the right to medical attendance and to report a

violent incident to the police, if relevant. If an inmate has been subjected to violence, he or

she will be examined by a doctor upon request. The doctor will record the incident in the

inmate’s medical records.

If the health care staff suspects that the staff has used violence against an inmate, such

suspicion will in practice be reported to the management of the institution. Violence used by

staff against inmates is not tolerated, and the management will therefore report any such

violence

to the police immediately regardless of the inmate’s wish. Depending on the outcome

of any criminal proceedings, the employee involved can be dismissed.

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In case of suspicion that violence has been used against an inmate before admission, this will

be reported to the police depending on the circumstances. In practice, an inmate bearing signs

of violence/ill-treatment or stating that he or she has been subjected to violence/ill-treatment

will be examined by a doctor or nurse who will enter a report of the incident in the medical

records.

Paragraph 53

in CPT’s report

CPT’s

recommendations concerning paragraph 53:

The CPT recommends that steps be taken to ensure that medical consultations at Western

Prison take place in a location which guarantees medical confidentiality (i.e. that the

medical examination is conducted out of the hearing and

–

unless the doctor concerned

expressly requests otherwise in a given case

–

out of the sight of non-medical staff).

Further, the system of making an application to see a member of the health-care staff

should be reviewed to ensure that it guarantees medical confidentiality. In particular,

prisoners should not be obliged to openly state the reason why they wish to see a

member of the health-care staff; they should be informed about the possibility to make

an application using a sealed envelope. Further, medication should only be distributed by

health-care staff.

Copenhagen Prisons have provided the Department of Prisons and Probation with the following

information:

‘As regards

medical confidentiality in relation to appointments with a doctor for consultations

and medical examinations, such consultations and examinations most often take place in the

inmate’s cell with the door left ajar. A prison officer will be stationed outside

the door only in

case of a particular security risk.

Consultation rooms have been established, and they can be used if considered necessary by

the doctor. If an inmate is to be examined in the consultation room, it will still be necessary to

leave the door ajar in case of a particular security risk, and in that case two prison officers will

always be stationed quite near for security reasons.

As regards confidentiality concerning the reason why the inmate wishes to see a doctor, it

appears from the prison house rules that the inmate may opt to place a request in a sealed

envelope.

Moreover, the prison also informs newly-arrived inmates of this option as part of the screening

procedure.

As regards the administration of medications, the prison follows the rules laid down by the

Department of Prisons and Probation.

Newly-appointed officers receive instructions from the head nurse on how to handle the

administration of medications when they take up their positions.’

The Department of Prisons and Probation refers to the information provided by Copenhagen

Prisons, but adds the following:

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The Circular on the Dispensing of Medicines, etc. to Inmates of State and Local Prisons reads

as follows:

‘2.

The administration of any type of medicines is subject to prescription by the doctor

responsible for the area, but see section 2(5) and section 9 on non-prescription drugs.

(2) Medicines must be administered by the doctor or the person so authorised by the doctor,

see subsection (3).

(3) In addition to nurses, the doctor may use other staff without nurse training who have

received instructions in the dispensing of medicines (e.g. prison officers) as assistants.

(4) Such powers may be delegated to staff without nurse training only if they have been

informed of the instructions on the dispensing of medicines in the relevant area, see section 5.

(5)

(…)

3. (1)

The doctor is responsible for prescribing all medicines to be administered, including

the medicines dispensed by nurses and staff without nurse training.

(2) Nurses and staff with no nurse training shall comply with the treatment prescribed or

ordered by the doctor.

4. (1)

The doctor shall instruct the staff without nurse training in the administration of

medicines and also provide guidance on the dosage and dispensing of medicines and any need

for observation of actions and adverse reactions. The doctor shall supervise the administration

of medicines by this group of staff.

(2)

(…)

5. (1)

When staff without nurse training assist in the administration of medicines, written

instructions must be available at the institution concerning the dosage and dispensing of

medicines.

(2) (...)

-(1) The doctor shall keep medical records for each patient and enter prescription

information, etc. in those records.

-(1) The doctor/nurse/staff

without nurse training shall also note down all the doctor’s

prescriptions and orders for dispensing of medicines on a suitable drug chart (e.g. Form DFK

172). The persons dosing and/or dispensing the medicines must also separately and

independently record both the dosage and dispending in the drug chart.

(2) (...)’

The task of dispensing medication is handled by doctors, nurses and other staff without nurse

training. The Department of Prisons and Probation finds that it is safe to let staff without nurse

training handle the dispensing of medication, as they have received special instructions and

training. However, the Department of Prisons and Probation is fully aware of the problem and

is therefore currently running a large number of medication administration courses for staff

without nurse training at all local prisons. It is not possible to let the task be handled by

doctors and nurses alone within the framework of the existing health-care staffing levels.

The Department of Prisons and Probation is also aware of the importance of registering the

dispensing of medication to the inmates, including by entering the relevant information in the

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inmates’ medical records. Pursuant to the Circular on the Dispensing of Medicines, etc.,

information must be recorded on a special drug chart. The Department of Prisons and

Probation believes that the rules of the Circular are complied with.

Finally, it should be mentioned that the Department of Prisons and Probation is currently

exploring whether it is possible to connect to the reporting system of the National Agency for

Patients’ Rights and Complaints (Patientombuddet) for ‘adverse reactions’ and not least the

establishment of national electronic medical records. These systems would make it possible to

report and record errors, etc. to the benefit of other parts of the Danish Prison and Probation

Service.

Paragraph 54

in CPT’s report

CPT’s

recommendation concerning paragraph 54:

The CPT recommends that initial assessments of substance misuse should include a

physical examination and that all prisoners prescribed detoxification treatment should be

seen by a doctor and have a care plan drawn up. The CPT also recommends that more

effective steps be taken to implement a three-pronged strategy in all prisons: to put an

end to the supply of drugs, to reduce as far as possible the demand for drugs and to

provide appropriate assistance to prisoners with drug-related problems.

It is difficult to keep prisons free of illegal substances, but in recent years the Danish Prison

and Probation Service has further increased its efforts to prevent controlled substances from

entering the institutions. During the past few years, more sniffer dogs have been used, and

more searches have been carried out in the institutions than previously. At the same time, a

wide range of drug abuse treatments are offered in all state and local prisons. In the local

prisons, the nature of the treatment is primarily motivating, whereas the treatments offered in

the state prisons target a large number of different types of abuse, and the intensity of the

treatments varies according to need.

In 2013, more than 4,000 inmates were offered treatment, and more than three out of four

treatment courses were successfully completed.

Social drug abuse treatment is handled by external treatment centres in close cooperation with

the employees of the Danish Prison and Probation Service, whereas medical treatment is

handled by the health-care staff of the Danish Prison and Probation Service.

The Danish Prison and Probation Service has no common standard for the treatment of

substance abusers. However, it is expected that focus on this problem will be intensified in the

coming years as and when the Danish Prison and Probation Service examines the possibility of

establishing electronic medical records. At the same time, the Danish Prison and Probation

Service will consider the introduction of uniform application of medicinal products in all

institutions. However, the individual doctor is entitled to prescribe medication, and it is

therefore impossible to order doctors to prescribe specific medicinal products, but the Danish

Prison and Probation Service may appeal to doctors to follow the directions on the application

of medicinal products that the Danish Prison and Probation Service is expected to give.

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Today, all newly-arrived inmates having an active substance abuse problem or receiving

substitution treatment are offered prescribed detoxification with substitution products or

prescribed continuation of the existing substitution treatment. A doctor will always be involved

in the treatment at the institution of the Danish Prison and Probation Service since only

doctors may prescribe medication. Before an ongoing treatment is continued, relevant

information will be obtained from the doctor of the treatment centre to which the inmate has

been attached.

An actual physical examination of the inmate is carried out if needed. Then a plan will be made

for the continued treatment plan. However, the plan, including the clinical follow-up, will

depend on the doctor/nurses of the institution since, as stated above, no fixed standard

applies to the choice of medicinal products and the duration of treatments.

Due to the limited size of certain local prisons, remand prisoners cannot participate in

motivation groups and special educational therapy. However, if the remand prisoner receives

an unconditional prison sentence this will subsequently be taken into account when the

enforcement institution is chosen.

As regards the entering of information into medical records and medicinal charts, reference is

made to the response to paragraph 53.

Paragraph 57

in CPT’s report

CPT’s

recommendation concerning paragraph 57:

The CPT recommends that the Danish authorities put in place a more comprehensive

reception and induction process in all remand prisons which should include the provision

of information in a language that the prisoner understands.

The Danish Prison and Probation Service has an information folder entitled ‘Information about

arrest

and remand custody’ which the staff must hand out to all new inmates on arrival. The

folder describes the most important rules applicable to arrested persons and remand prisoners.

According to the folder, inmates are entitled to see the rules of the Danish Prison and

Probation Service, the European Prison Rules and any special rules of the local prison (e.g. the

local prison’s house rules in which also practical issues, such as the possibility of buying

necessities, visiting hours, etc. are described). If an inmate wishes to receive further

information, he or she is always welcome to borrow the rules and regulations from the staff,

and, in case of any doubt, the inmate can always ask the staff for clarification.

The information folder covers a large number of issues, such as special dietary needs, options

available in connection with visits, letter writing, leaves, work, education and training,

treatment and leisure time. The possibilities of community service and home detention with

electronic tagging are also briefly described. The folder also describes issues such as illness,

dental treatment, complaints, appeals, transfer to a state prison, practical assistance from

social workers and the staff’s duty of confidentiality.

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The folder is available in the following languages: Arabic, Danish, Dari, English, Estonian, Farsi,

Finnish, French, Greenlandic, Latvian, Lithuanian, Mandarin, Pashto, Polish, Russian, Serbo-

Croatian, Somali, Spanish, Czech, Turkish, German and Urdu. The relevance of adding new

languages is considered on a continuous basis.

A similar information folder is available to persons serving a prison sentence. It is entitled

‘Information on serving a prison sentence’. Also this folder has been translated into a number

of languages.

Both information folders are currently being revised. Once the revision has been completed,

the Department of Prisons and Probation will ensure that the new updated folders will be

distributed to all state and local prisons (and made available at the website of the Danish

Prison and Probation Service). In that connection, the Department of Prisons and Probation will

impress on the institutions that they must adapt their reception procedures to ensure that the

folders are handed out to all new inmates on arrival. Just like the old version of the folders, the

new version will be translated into a large number of foreign languages.

The information folders are able to cover a vast need for information on basic issues and

routines, but obviously they are unable to cover all needs in all situations imaginable.

The individual institution must ensure at all times that all inmates, not least foreign national

inmates, understand what is going on in the institution. Consequently, in each particular

situation the institutions of the Danish Prison and Probation Service must decide on the

language of the daily communication with a foreign national inmate about practical issues and

issues governed by law. Inmates are not entitled to communication in their native languages

or the language preferred by the individual inmate. However, communication must always take

place in a language that the inmate reasonably understands. If communication is to take place

in another language than Danish, the communication must in general be performed by a

member of staff who speaks the language chosen. Alternatively, a fellow inmate may assist as

an interpreter if the inmate agrees. If no member of staff or no fellow inmate speaks the

language in which communication is to take place, an interpreter from the list kept by the

Danish National Police must be summoned.

It may be necessary to use an interpreter on admission and in a number of other situations,

e.g. in connection with measures of force or in connection with medical attendance and

treatment. However, interpreting is only one way to solve communication and information

problems in connection with reception and admission to a local prison.

As mentioned in the response to paragraph 43, the Western Prison is working on a

communication project which will be to the benefit of foreign national inmates in particular.

The project is called ‘Information On Admission’ (IVI). The project aims at meeting the

challenges and frustrations that may be caused by language barriers. One of the ambitions of

the project is to develop a concept which can also be used by other institutions facing the

same challenges.

In the light of the CPT’s comments, the Danish Prison and Probation Service will consider

whether it will be possible to improve the reception and admission procedures for remand

prisoners in local prisons and local prison units. The experience from the above-mentioned

communication project at the Western Prison will be taken into account.

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Paragraph 59

in CPT’s report

CPT’s request for information concerning

paragraph 59:

However, with the increasing number of foreign national prisoners and Danish prisoners

from ethnic minorities entering the prison system, there is a greater need to recruit staff

from diverse backgrounds, preferably with a knowledge of foreign languages, to reflect

better the prison population. The CPT would appreciate the observations of the Danish

authorities on this matter.

About 10 per cent of the newly-appointed prison officers have an ethnic background other than

Danish. This information is based on an assessment since the ethnic background of employees

is not registered.

At present, prison officers are required to have knowledge of English (Level C - lowest upper

secondary school level), but they are not required to have knowledge of other foreign

languages.

For a number of years, the Danish Prison and Probation Service has focused and continues to

focus on employing prison officers with ethnic backgrounds other than Danish, provided always

that the candidates meet the formal requirements of the employment, including adequate

educational skills and compliance with the guidelines of the Danish Prison and Probation

Service for employment of persons with a criminal record.

Paragraph 60

in CPT’s report

CPT’s

recommendation concerning paragraph 60:

The CPT recommends that the Danish authorities take the necessary steps to enhance the

ongoing training for prison officers, particularly as concerns inter-personal communication

skills. Further, consideration should be given to providing the necessary support to foreign

national prisoners in all establishments and the appointment of a dedicated foreign

national prison officer at Western Prison, in the light of the above remarks.

In 2014, an extensive further training programme was introduced for all experienced prison

officers, defined as officers who completed their training as prison officers more than five years

ago. The further training programme will run until 2016 and covers three subjects for prison

officers:



Understanding of role (in relation to inmates and colleagues)

Relational work (in relation to inmates)

Reflection (of own practices)

As a result, the training programme covers the recommended area of ‘inter-personal

communication skills’.

The basic training programme for prison officers was revised in 2010 to the effect that prison

officers who have been trained after 2010 have received more thorough training in relational

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work and communication skills compared with officers trained under the previous basic training

programme.

In addition to the two folders mentioned in the response to paragraph 57, which apply to all

inmates, a special information folder is available to inmates having been sentenced to

expulsion. The folder is under revision. It contains information about various different issues,

such as the rules on release from prison, the possibilities of serving a sentence in the country

of origin and practical information concerning the return journey. The folder also contains a

brief description of the asylum seeking procedure.

In its current form, the information folder for inmates having been sentenced to expulsion is

available in the following languages: Arabic, Danish, English, Farsi, Serbo-Croatian, Somali and

Turkish. In its revised form, it will also be made available in other languages.

At present, the Danish Prison and Probation Service is not planning to appoint dedicated

foreign national prison officers in the local prisons. As described in the response to paragraph

57, the individual institution must ensure that the individual foreign national inmates

understand what is going on at the institution. This can be communicated by staff, fellow

inmates or an interpreter. Moreover, as described in the response to paragraph 57, the

Western Prison is currently working on a communication project where information on central

routines and procedures at the institution is communicated by means of symbols and images.

Paragraph 61

in CPT’s report

CPT’s

comments and recommendation concerning paragraph 61:

In the Committee’s view, a continuous

period of up to 28 days of solitary confinement as

a punishment is excessive. The Committee considers that the maximum period of solitary

confinement as a punishment should be no more than 14 days for a given offence, and

preferably lower. Further, there should be a prohibition on sequential disciplinary

sentences resulting in an uninterrupted period of solitary confinement in excess of that

maximum period. Any offences committed by a prisoner which might call for more severe

sanctions should be dealt with through the criminal justice system.

As regards minors, the CPT has very strong reservations as concerns any form of solitary

confinement of juveniles as this can compromise their physical and/or mental integrity. To

this end, it considers that a juvenile should not be placed in solitary confinement for

disciplinary purposes for more than three days.

The CPT recommends that the Law on the Enforcement of Sentences and other relevant

regulations in relation to disciplinary matters be revised accordingly, taking into account

the above remarks.

The Danish Prison and Probation Service is fully aware of the risk of negative effects of solitary

confinement, inter alia, in connection with the placement in a disciplinary cell. In that

connection, see also the response to paragraph 38 concerning the exclusion of inmates from

association with other inmates.

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Because of the focus of the Danish Prison and Probation Service on this area, a working group

was set up in 2012 for the purpose of reducing the use of disciplinary cells. However, due to

other extensive projects relating to a major reorganisation of the Danish Prison and Probation

Service, the work of the group has not yet been completed. In early November 2014, the

working group submitted its preliminary recommendations to the Department of Prisons and

Probation. Based on these recommendations, the Department has decided to suspend the work

of this group and to continue the work on the tasks originally assigned to the working group

and preliminary recommendations on the basis of a partnership model. Representatives of the

new regional areas of the Danish Prison and Probation Service (established on 1 October 2014)

and the Department of Prisons and Probation will participate in this work.

The CPT’s recommendations

to reduce the maximum period of placement in a disciplinary cell

from the existing four weeks, see section 70(1) of the Sentence Enforcement Act, will be

considered in connection with the further work under the new partnership strategy for the

purpose of reducing the use of disciplinary cells.

In that connection, it should be noted that disciplinary punishment in the form of placement in

a disciplinary cell for more than 14 days is used by the Danish Prison and Probation Service

only in exceptional cases. Only five out of 2,959 placements in disciplinary cell in 2013 in the

institutions of the Danish Prison and Probation Service lasted for more than 14 days (and the

longest placement in that year lasted for 21 days). From 2004 to 2013, the average annual

number of placements in disciplinary cells lasting for more than 14 days was 4.4 placements.

Under section 775 of the Administration of Justice Act, remand prisoners may be placed in a

disciplinary cell for disciplinary purposes for up to two weeks, or their wages may be seized.

Consequently, a maximum period already applies to the placement of remand prisoners in

disciplinary cells as suggested by the CPT in general.

Moreover, inmates serving a prison sentence under section 112(1)(iii) of the Sentence

Enforcement Act may appeal a decision on disciplinary punishment in the form of placement in

a disciplinary cell for more than seven days to the courts. Only few decisions on placement in

disciplinary cells for more than seven days are appealed. From 2010 to 2013, a maximum of

three decisions of this kind were heard by the courts every year.

As regards juveniles between 15 and 17 years who are serving a sentence in a state or local

prison, it should be noted that, according to the rules, it is possible to punish these juveniles in

the same manner as the other inmates by placing them in a disciplinary cell. In practice, the

institution will pay great attention to the juvenile’s age, and if it is considered necessary the

institution will attempt to alleviate any negative effects of solitary confinement, e.g. by offering

the juvenile association with another juvenile inmate in the cell or participation in activities

with the staff.

On the basis of an open letter dated 6 October 2014 from the Danish Institute for Human

Rights (Institut for Menneskerettigheder) and the National Council for Children (Børnerådet) to

the Minister for Justice concerning solitary confinement of juveniles, the Minister has requested

the Danish Prison and Probation Service to examine whether the use of solitary confinement of

juvenile inmates between 15 and 17 years may be reduced even more.

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On 8 October 2014, the Department of Prisons and Probation therefore at first instructed the

state and local prisons to make special efforts to reduce the placement of juveniles under the

age of 18 in disciplinary cells.

On 20 November 2014, the Minister for Justice consulted the Parliamentary Legal Affairs

Committee (Folketingets Retsudvalg) on the placement of juveniles in solitary confinement,

and in that connection she stated that she had requested the Department of Prisons and

Probation to closely monitor the development in the use of placement of juveniles in

disciplinary cells over the next three months. In practise, all cases will be reported to the

Department of Prisons and Probation to ensure that all institutions comply with the instructions

to reduce the use of disciplinary cells as much as possible.

If the number of situations in which juveniles are placed in disciplinary cells is not reduced

significantly over the next three months, the Minister will request the Department of Prisons

and Probation to take further initiatives in this field.

Paragraph 63

in CPT’s report

CPT’s

recommendation concerning paragraph 63:

The CPT recommends that the Danish authorities review the use of pepper spray in the light

of the above remarks.

Most recently, on 1 February 2013, the Department of Prisons and Probation evaluated the use

of pepper spray.

The Danish Institute for Human Rights is currently working

on a report on ‘The use of pepper

spray in Danish state and local prisons’. It will therefore be obvious to await the conclusions of

this report before evaluating and possibly adjusting the use of pepper spray in the institutions

of the Danish Prison and Probation Service.

The CPT has referred to a case at Copenhagen Police Headquarters Prison in which the staff

applied pepper spray through the hatch of an observation cell door to pacify a foreign national

inmate who was threatening to harm himself.

The Department of Prisons and Probation has pointed out to Copenhagen Prisons that the

application of pepper spray through the hatch of a cell door and into a cell in which an inmate

had been placed is contrary to the rules governing the use of pepper spray.

The

Department of Prisons and Probation will take the CPT’s comments on the use of pepper

spray in Danish prisons, including in particular the comment that pepper spray should not be

used in closed rooms, into consideration in its coming evaluation of the use of pepper spray

when the above-mentioned report from the Danish Institute for Human Rights has been

published.

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Paragraph 64

in CPT’s report

CPT’s

recommendation concerning paragraph 64:

The CPT recommends that the Danish authorities take the necessary steps to clarify the

legal regulations concerning the placement of prisoners in observation and security cells.

With reference to the rules described below, the Department of Prisons and Probation finds no

need to specify the rules for placement in observation cells. As regards the rules for placement

in security cells, reference is made to the response to paragraph 71 below.

Paragraph 65

in CPT’s report

CPT’s

request for information concerning paragraph 65:

In this respect, the Committee would like to be informed of the safeguards surrounding

placement in such a cell when it exceed days, and lasts for weeks and months on end.

The rules on placement of inmates in observation cells have been laid down under section

64(2) of the Sentence Enforcement Act. The rules have been detailed in Executive Order No.

283 of 26 March 2012 on Exclusion of Inmates from Association, including Placement in

Observation Cells, etc., in State and Local Prisons (the Executive Order on Exclusion of

Inmates from Association).

According to section 16 of the Executive Order, inmates may only be placed in observation

cells:



if it is necessary to prevent vandalism,

if it is required for vital reasons of order and security at the institution, or

if special observation is required.

Principle of considerateness and discontinuation

According to section 16(2) of the Executive Order, inmates may not be placed in observation

cells if the placement would be disproportionate in view of the purpose of the measure and the

indignity and the unpleasantness presumably caused by the measure.

According to section 18 of the Executive Order, placement in observation cells must be carried

out as considerately as circumstances permit, and the placement must be discontinued

promptly when the conditions for such placement are no longer present.

Reporting

Under section 19(2) of the Executive Order, the institution must promptly prepare a report on

the matter. The report must include a record of the decision and the reason for it, information

on the date and hour when the inmate was notified of the decision and information on the

considerations of the institution under section 20. As a result, the exact reason for the

placement, including whether special observation is required, will always appear from the

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report. In that way, it is clearly considered whether the purpose of the placement is to prevent

suicide or other self-harm.

Medical attendance

According to section 20(1) of the Executive Order on Exclusion of Inmates from Association, a

doctor must be called if it is suspected that an inmate placed in the observation cell has fallen

ill, including been injured, or if the inmate him or herself requests medical assistance.

As regards examination and any change of the inmate’s clothes, reference is made to the

responses to paragraph 66 below.

Special procedural rules applicable to measures for the prevention of suicide or self-harm

As regards inmates placed in an observation cell to prevent suicide or self-harm

(‘special

observation is required’), it should be noted

in particular that detailed rules on the

consideration of cases concerning the death, suicide, attempted suicide or other suicidal or

self-harming behaviour of inmates have been laid down (Circular No. 84 of 23 November 2012

on the Institutions’ Consideration

and Reporting of Incidents related to Death, Suicide,

Attempted Suicide and other Suicidal or Self-harming Behaviour among Inmates in the Care of

the Danish Prison and Probation Service).

If an inmate is considered suicidal, the rules set out in part 5 of the above Circular provide that

the director of the institution must assess whether, in addition to the measures already taken

by staff (such as placement in an observation cell), it must be assumed that further measures

are required to prevent suicide, etc., and whether an interview with the inmate is required to

identify his or her motive and state of mind, preferably conducted by the doctor or psychiatric

consultant of the institution.

The director of the institution must also ensure that a case is created in the suicide module of

the Client System and that, if the suicide threat was presented verbally, the incident has been

entered in the security list. The considerations of the prison director concerning the need for

further measures must be entered in the suicide module.

Supervision and duty to make records

While placed in an observation cell, inmates must be attended to regularly by staff, see section

21(1) of the Executive Order. Any person attending to an inmate must make a record thereof

an observation form regardless of whether there are any changes in the inmate’s situation.

The record must include information on the date and hour of the attendance and information

on the inmate’s condition as well as comments on the need to continue the

placement. The

frequency of attendance depends on a specific assessment.

Appeal guidelines

Furthermore, it must be recorded when the inmate has been informed of his or her right to

appeal to the Minister for Justice and of the time-limit for appeal, see section 111(2) of the

Sentence Enforcement Act.

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Reporting in case of placement for more than three days and nights

If it is decided to continue the placement in the observation cell for more than three days and

nights, the institution must promptly submit a report on such decision to the Department of

Prisons and Probation under the Ministry of Justice, see section 21(2) of the Executive Order

on Exclusion of Inmates from Association. The report must include a detailed explanation of

why the conditions for continued placement in an observation cell are considered met, and a

copy of the report prepared under section 19(2) as well as the observation form filled in under

section 19(1) must be appended. The provision underlines that inmates may be placed in an

observation cell for more than three days and nights only in exceptional situations.

CPT’s request for information concerning paragraph 65:

Further, it would like to receive information on the reasons why the three persons

referred to above were placed in an observation cell for such prolonged periods, and what

their daily regime was during this period.

Copenhagen Prisons have stated that the three specific cases referred to by the CPT have all

been registered incorrectly in the Client System of the Danish Prison and Probation Service,

and that it had therefore not entered in the Client System when the placements in observation

cells were discontinued.

The following comments are made in respect of the specific cases:

Case on 16 May 2013: The inmate had set fire to his cell. He was evacuated and taken to an

observation cell. Shortly after, he was admitted to hospital for observation for asphyxiation

and treatment of a burn injury. According to the duty officer’s report, the fire alarm went off at

2.25 pm, and the ambulance left the prison at 2.55 pm. Consequently, the inmate spent less

than 30 minutes in the observation cell.

Case on 21 June 2013: According to the information entered in the observation cell module of

the Client System, the inmate was placed in an observation cell on 20/21 June 2013 at around

midnight. The first information was recorded at 0.09 am on 21 June 2013. The inmate was

taken out the same day at 12.43 pm and therefore spent less than 13 hours in the cell.

Case on 29 September 2013: The inmate was placed in an observation cell at 11.20 pm and

was taken out on 30 September 2013 at 8.43 am, which means that the inmate spent 9 hours

and 23 minutes in the cell.

The Department of Prisons and Probation refers to the above response from Copenhagen

Prisons.

CPT’s recommendation

concerning paragraph 65:

At the very least, the CPT recommends that all persons held in an observation cell longer

than 24 hours are offered one hour of outdoor exercise.

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According to section 43(3) of the Sentence Enforcement Act, inmates are entitled to spend at

least one hour every day in the open air unless this is incompatible with the handling of

security by the institution, or the relevant inmate was placed in a security cell under section 66

of the Act.

The general rule is therefore that also inmates who are excluded from association with other

inmates, including inmates placed in observation cells, are entitled to spend at least one hour

every day in the open air (courtyard exercise). If an inmate is placed in an observation cell for

24 hours or longer, he or she will be entitled to exercise in the courtyard/to spend time in the

open air during placement in the cell, unless impossible for security reasons.

Paragraph 66

in CPT’s report

CPT’s

recommendation concerning paragraph 66:

The CPT recommends that the Danish authorities review the use of observation cells both

as regards prisoners at risk of suicide or self-harm and for prisoners who are disruptive or

violent. Further, in those cases where the risk of self-injury warrants the removal of

clothes, prisoners should be provided with rip-proof clothing and footwear.

As regards the issue of whether there is a need for reviewing the use of observation cells,

reference is made to the response to paragraph 64 above.

According to section 20(2) of the Executive Order on Exclusion of Inmates from Association, a

search of an inmate’s person will be made in connection with the placement in an observation

cell in accordance with the rules in section 60 of the Sentence Enforcement Act, unless the

institution considers it unnecessary.

Section 20(2) of the Executive Order also provides that an inmate’s clothes may also be

changed if necessary in the specific case. If so, the inmate must be requested to change his

clothes himself or herself.

If, in a specific case, it is considered necessary to change the clothes of an inmate placed in an

observation cell, he or she must receive at least underpants or a blanket. The inmate must

also be offered a vest.

If the changing of an inmate’s

clothes may in itself escalate the situation, the institution may

decide not to change the clothes.

The Department of Prisons and Probation considers it unnecessary to buy rip-proof clothes

since an inmate placed in an observation cell is attended to regularly, and therefore the risk

that the inmate will rip his or her underwear (and blanket) without being detected is limited.

As mentioned in the response to paragraph 64, the Department of Prisons and Probation has

found no reason to revise the rules on the use of observation cells. The Department also finds

that the rules on and the possibilities of calling a doctor are proportionate to the form of

placement since a doctor must be called in case of suspicion of illness or injury or if the inmate

makes a request for medical assistance.

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Paragraph 67

in CPT’s report

CPT’s

observation concerning paragraph 67:

In the CPT’s view, the doctor should always visit a fixated prisoner.

As a consequence of the CPT’s recommendation, the

Department of Prisons and Probation has

examined for a certain period of time how many cases inmates placed in a security cell were

attended to by a doctor.

According to the information available, almost all inmates were attended to immediately after

being placed in a security cell with fixation. A very limited number of inmates were attended to

by a nurse who then contacted the doctor by telephone. On the basis of the nurse’s

information about the inmate’s physical and mental condition, the doctor assessed whether

medical assistance is required. Finally, in very rare cases, inmates had not been attended to

due to the very short duration of the fixation as there had not been enough time to call a

doctor.

It should be noted that neither the Department of Prisons and Probation nor the prison director

has any power to give directions to doctors. The decision of whether medical assistance is

required is always based on the doctor’s professional assessment, see section 66(5) of the

Sentence Enforcement Act. However, such assessment or complaint may subsequently be

appealed to the

National Agency for Patients’ Rights and Complaints.

In that connection, it should be added that, when the Committee of Ministers of the Council of

Europe adopted the European Prison Rules in 2006, Denmark reserved the right to observe or

not to observe rule 43.2 since the Danish Government found that the requirement that medical

professionals must visit inmates in solitary confinement every day gives rise to serious ethical

considerations concerning the possible role of such staff in that they have expressly stated an

opinion of whether a particular inmate is fit for continued imprisonment in solitary

confinement.

With reference to the above, the Department of Prisons and Probation finds that it is not

necessary to revise the rules, as they work as intended.

Moreover, the Department of Prisons and Probation is not aware of any cases of inmates

placed in a security cell with fixation who have complained of not being attended to by a

doctor.

Reference is made to the response to paragraph 71 below where the rules on placement in

security cells are described in further detail.

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Paragraph 68

in CPT’s report

The CPT has not requested that this paragraph be commented on separately, but apparently

the CPT has several serious concerns relating to the use of fixation in the prisons on the basis

of its examination of a number of cases concerning the fixation of inmates placed in a security

cell in Western Prison. In that connection, the CPT mentioned two specific cases.

The first case concerned a Syrian inmate who was transferred to the Western Prison from the

Ellebæk Institution for Detained Asylum-Seekers,

and who became agitated in the prison’s

reception area when he was told to undress for a strip search. The inmate started to shout and

attempted to hit a prison officer. Consequently, he was escorted naked apart from a pair of

underpants through the ground floor of the southern wing and across a courtyard to a security

cell in which he was fixated for two hours and 45 minutes. During the transfer, the inmate did

nothing and said nothing.

In the other case, an inmate, who had harmed himself, was being transferred to an

observation cell without the use of handcuffs. Suddenly, the inmate began hitting in the air

and speaking in Arabic. Three prison officers decided to restrain the inmate, who resisted while

being held down on the bed, and he was subsequently carried by four prison officers to the

security cell in which he was stripped of his clothes and fixated for 2 hours and 36 minutes.

Copenhagen Prisons have informed the Department of Prisons and Probation that unfortunately

it has only been possible to identify the last case referred to.

According to the observation cell report, the inmate was involved in a fight in the courtyard

area on 4 February 2014, and he had not obeyed staff orders to leave the courtyard area

together with the courtyard staff. When the staff used force to remove him from the courtyard

area, he suddenly started to resist and struggle to get loose. He was therefore taken to the

observation cell and remained there for around five hours.

It also appears from the security cell report that, on the next day, the inmate pounded on the

door because he had cut himself. He said something in an incomprehensible language and

moved his hand across his neck in a cutting movement, which was interpreted to mean further

self-harm. It was therefore decided to place him in an observation cell. On the way to the

observation cell

–

he was following voluntarily

–

he suddenly began punching the air and

saying something incomprehensible. To avoid further escalation of the situation, he was

escorted to the cell by force (hand grips). In that connection, his head was held down as he

started to spit.

In the observation cell, he was placed on the bed on his stomach and held down, and he then

started to resist violently. His arm was bleeding very much, and the nurse arrived and applied

an emergency dressing. He was still resisting and was therefore carried to the security cell

where he was fixated.

After 40 minutes’ fixation, the staff talked to him and informed him that if he remained calm,

the fixation would be removed quicker to which he nodded. Subsequently, his wound was sewn

by a doctor, and since he remained calm, his other arm was loosened after another one and a

half hours. The fixation was removed altogether after a further 45 minutes.

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In respect of this case, Copenhagen Prisons refers to the report according to which the inmate

had previously been compulsorily admitted to hospital

(‘code red’), in December 2013 he had

attempted to hit a prison officer, and the day before he was placed in the security cell he had

been placed in an observation cell after a fight in the courtyard, on which occasion

–

after he

had apparently calmed down

–

he had attempted several times to struggle to get loose from

the prison officers escorting him from the courtyard. Against that background, Copenhagen

Prison finds no basis for criticising the extent of the fixation used.

According to the security cell report, the situation escalated when the staff decided to use

force. In that connection, Copenhagen Prisons have also stated that the inmate punched the

air in the direction of the staff, and that his behaviour was loud and threatening and his tone of

voice aggressive.

It has further been stated that, in general, inmates who are restrained and who resist, are

placed on the stomach which is the most expedient for both the inmate and the staff when the

hand grips are loosened. It should also be mentioned that, at this point, the inmate was still

attempting to spit at the staff.

The Department of Prisons and Probation finds that the grounds for placing him in a security

cell, including the fixation, were adequate. It has been taken into account that the inmate had

cut himself and that he resisted in a violent manner. Furthermore, with reference to the above,

the Department finds no basis for criticising the extent of the fixation.

Paragraph 71

in CPT’s report

CPT’s

observations and recommendations concerning paragraph 71:

the findings of the 2014 visit demonstrate that there is a need to review the current

approach towards the resort to fixation in prison and put in place far stricter rules

governing its application. In particular, the following issues should be reviewed:



Regarding its appropriate use, fixation should only be used as a last resort to prevent

the risk of harm to the individual or others and only when all other reasonable

options would fail to satisfactorily contain those risks; it should never be used as a

punishment or to compensate for a shortage of trained staff.

Any resort to fixation should always be either expressly ordered by a doctor or

immediately brought to the attention of a doctor, and the doctor should in all cases

visit the fixated prisoner.

The duration of fixation should be for the shortest possible time (usually minutes

rather than hours). The exceptional prolongation of restraint should warrant a further

review by a doctor. Restraint for periods of days at a time cannot have any

justification and would amount to ill-treatment.

Persons subject to fixation should receive full information on the reasons for the

intervention.

The management of any establishment which might use fixation should issue formal

written guidelines, taking account of the above criteria, to all staff who may be

involved.



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Further, the person concerned should be given the opportunity to discuss his/her

experience, during and, in any event, as soon as possible after the end of a period of

restraint.

The Committee recommends that the Danish authorities take the necessary steps to

ensure that all the principles and minimum safeguards set out above are applied

rigorously in all prison establishments resorting to the measure of fixation and, if

necessary, amend the law accordingly.

According to section 66 of the Sentence Enforcement Act, an inmate may be placed in a

security cell if necessary to avert imminent violence or overcome violent resistance, or to

prevent suicide or other self-harm. During his or her placement in a security cell, the inmate

may be fixated by force by the application of a body belt, wrist and ankle straps and mittens.

Under subsection (4), a fixated inmate must have a constant guard.

Fixation in a security cell may not be used as a punishment in any circumstances, and, as

described above, it may only be used as a preventive measure if necessary to avert imminent

violence or overcome violent resistance or to prevent suicide or other self-harm.

It further follows from section 66(5) of the Act that, in case of fixation of an inmate, the

institution must promptly request a doctor to attend to the inmate. The doctor must attend to

the inmate, unless the doctor considers such attendance unnecessary for obvious reasons.

According to section 5 of the Guidance Notes on Use of Means of Restraint in State and Local

Prisons, the staff must provide the doctor with the actual information about the inmate’s

condition, and the assessment of any signs of illness should then be left to the doctor. When a

doctor is called, the staff will not normally be responsible for assessing whether the inmate is

ill or injured. In that connection, it should be noted that the doctor is responsible only for

assessing the inmate’s health condition.

Reference is also made to the response to the recommendation in paragraph 67.

As regards placement in security cells and fixation, it also follows from section 66(2) and (3) of

the Sentence Enforcement Act that the measures must not be disproportionate and that the

measures must be taken as considerately as circumstances permit.

The constant guard must be an experienced permanent staff member who has not been

involved in the fixation. Furthermore, it must be assessed whether it will be advisable if the

guard is familiar with the fixated inmate. The guard must not attend to other tasks apart from

attending to the fixated inmate.

Finally, the guard must record information on the supervision of the inmate every 15 minutes

as long as the inmate is fixated in the security cell.

An inmate may be fixated for more than 24 hours only in exceptional cases. Regardless of

whether the inmate is fixated or not, the guard must ensure that a doctor is called again if the

inmate shows any signs of illness.

Under the Executive Order on Use of Means of Restraint in State and Local Prisons, the

institution must prepare a report on the use of security cells, including fixation, and other

means of restraint as soon as possible. The report must state the reason for such use, the date

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and hour when the use of the means of restraint was discontinued and whether the inmate has

been informed of his or her right to appeal to the Minister for Justice and when the time-limit

for appeal expires, see section 111(2) of the Sentence Enforcement Act. The report must also

contain information on the considerations of the institution concerning medical attendance and

reporting under the Executive Order. The inmate is entitled to receive a copy of the report

upon request.

The Department of Prisons and Probation finds that the rules governing medical attendance in

situations in which inmates are fixated for a long period of time are satisfactory. Because of

the rules on supervision by a guard, it is possible to call a doctor quickly and efficiently if the

inmate shows any signs of illness, etc. Moreover, the Department of Prisons and Probation has

not identified any cases in which the inmate has been harmed because of lack of medical

attendance.

As regards debriefing after fixation in security cell, the CPT stated after the visit in 2008 that it

found that inmates should be offered an interview after having been fixated in a security cell.

Against that background, the Department of Prisons and Probation stated in its letter of 13

August 2010 that the institutions must ensure that, after fixation in a security cell, the inmate

is offered to talk about the measure with a senior member of staff.

Paragraph 72

in CPT’s report

CPT’s request for

comments concerning paragraph 72:

the delegation met a number of prisoners at Western Prison who had relatives within the

prison but who were not permitted to have contact with them due to the “B & B” regime

being applied to them. Such a restriction would appear excessive, especially when they

had no other close relatives in the country. The CPT would appreciate the observations of

the Danish authorities on these matters.

Usually interpreters will be present when remand prisoners have legal counsel or are being

questioned by the police. However, the purpose of “B&B” judicial restrictions is to

prevent the

remand prisoner from obstructing the course of the proceedings, in particular by removing

traces or warn or influence others. During most visits from friends or family, the police will

therefore require that the conversation is held in Danish or English, as the delay caused by

interpretation would otherwise make it impossible for the police to prevent the remand

prisoner from warning or influencing the visitors.

The rules governing a remand prisoner’s right to telephone conversation are based

on the

same safeguarding principles as the rules governing a remand prisoner’s right to visits and to

send and receive letters and other restrictions in a remanded prisoner’s rights.

The Remand Custody Order contains specific regulation concerning telephone conversation.

Pursuant to Section 72 of the Remand Custody Order, a remand prisoner can be allowed to

have telephone conversations if correspondence by letter cannot be awaited without

substantial nuisance, and to the extent that it is possible in practice. Section 72 also stipulates

that the police may oppose telephone conversations by a remand prisoner in view of the

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purpose of the custody. A remand prisoner’s requests to have telephone conversation with his

attorney are generally granted.

Similarly

to the rules safeguarding a remand prisoner’s right to visits and to send and receive

letters, the police may however only deny telephone conversations if such a restriction is

deemed necessary in accordance with Section 770 of the Administration of Justice Act.

A remand prisoner can demand that the decision to restrict his/her right to telephone

conversation is submitted to the court for decision, cf. Section 773 of the Administration of

Justice Act.

As regards remand prisoners, who have little contact with the outside world, the prison is

obliged to help to increase their contact with the outside world as far as possible and to the

extent that it is safe and sound, cf. Section 56 of the Remand Custody Order.

As regards the prisoners at Western Prison referred to by the CPT who had relatives within the

prison, but who were not permitted to have contact with them due to the “B&B” judicial

restrictions, the Danish authorities has no knowledge of any specific cases. However, in

general the “B&B” judicial restrictions do not impose restrictions on the remand prisoners’ right

to social intercourse with other inmates, but in specific cases the “B&B” judicial restrictions

may also apply with regard to visits from other prisoners who are placed e.g. in other units of

the prison.

Pursuant to Section 23 of the Remand Custody Order a remand prisoner, who is not in solitary

confinement by decision of the court, shall, whenever possible, be given access to social

intercourse with other inmates in accordance with the Community Order.

The Enforcement of Penalties Act number 435 of 15 May 2012 and the Community Order

number 36 of 7 January 2014 provide regulation on remand prisoners’ access to social

intercourse with other inmates.

Pursuant to Section 33 of the Enforcement of Penalties Act an inmate must as far as possible

have access to social intercourse with other inmates. Section 16 of the Community Order

states that the prison staff assesses whether it is considered to be safe to give an inmate

access to social intercourse with other inmates.

Paragraph 73

in CPT’s report

CPT’s recommendation

concerning paragraph 73:

The CPT recommends that the Danish authorities review the prisoner complaints system

in the light of the above remarks.

As regards the inmates’ right to

make written complaints, the Department of Prisons and

Probation would like to inform the CPT that at the large institutions the inmates must in

practice fill in and hand over a request form to the staff if they wish to talk to specific

members of staff, such as the nurse or the head of the prison unit. A request may be handed

over in a sealed envelope. Request forms are available to the inmates of the unit/cell.

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Likewise, the inmates may hand over a complaint of matters relating to the institution in a

sealed envelope.

The rules for the submission of requests described by Copenhagen Prisons in connection with

the response to paragraph 53 above therefore reflect the rules of the Danish Prison and

Probation Service as a whole, both in relation to request forms and other written

communications, including complaints.

Inmates are entitled to unmonitored communication with public authorities, including to submit

complaints to the management of the state or local prison. As a result, it is not permitted to

open, read or withhold sealed letters addressed to public authorities. Likewise, inmates are

entitled to unmonitored correspondence with the minister of religion attached to the

institution.

As regards assistance to help inmates word complaints, there are no general rules. Oral

complaints must be recorded by the staff, see section 13 of the Danish Access to Public

Administration Files Act. Such a record may form the basis of a complaints procedure.

Inmates may also request the staff, e.g. his or her contact person or a social worker attached

to the institution, to assist in writing a complaint.

As regards decisions which may be appealed to the courts, it follows from section 1(1) of the

Executive Order on Requests for Appeal of Certain Final Administrative Decisions on Sentence

Enforcement, etc. that, if an inmate submits a request for appeal, information on the request

and the time of its submission must be recorded. A request for a judicial review submitted to

one of the institutions or units of the Danish Prison and Probation Service must be sent to the

Department of Prisons and Probation under the Ministry of Justice as soon as possible, see

section 2 of the Executive Order.

Information on the right to file a complaint is provided in the two folders ‘Information

on arrest

and remand custody’ and ‘Information on serving a prison sentence’, which are handed out by

the institutions on admission (see more information about the folders under the response to

paragraph 57).

It should also be noted that, under Danish public administration law, communications from

inmates must be put on record. This also applies to complaints, etc., from the inmates, which

will be registered in the Client System.

No time-limits

apply to the institutions’ processing of communications from

the inmates, but

public authorities must reply to communications from citizens within a reasonable time. The

Department of Prisons and Probation finds that, in general, communications from the inmates

are processed at the pace required by the individual communication and that it is not

necessary to lay down further rules in this respect.

Consequently, the Department of Prisons and Probation finds that the existing system does not

restrict the inmates’ right to file complaints and have complaints processed

during their

imprisonment.

The Department of Prisons and Probation would also inform the CPT that, for the purpose of

communicating with inmates concerning the conditions at the institution, rules on a spokesman

scheme are set out in section 34 of the Sentence Enforcement Act.

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The management of the institution must hold regular meetings with the spokesman or group of

spokesmen. At such meetings, general complaints from the inmates about the conditions at

the institution may be discussed. In that way, the institution is able to acquaint itself with the

inmates’ general wishes and complaints.

II.C. Foreign nationals held under aliens legislation

Paragraph 77

in CPT’s report

CPT’s recommendations

concerning paragraph 77:

every effort should be made to avoid resorting to the deprivation of liberty of an irregular

migrant who is a minor.

The CPT recommends that the Danish authorities put an end to the detention of children

at Ellebæk, in the light of the above remarks.

Please be informed that unaccompanied children between the age of 15 and 18 years only

under exceptional circumstances are detained and only when the purpose of detention cannot

be attained by less interfering measures.

It is strived that the period of detention is as short as possible, and furthermore the Ellebæk

Institution has implemented specific guidelines regarding detention of unaccompanied children

between the age of 15 and 18 years in order to show consideration for their special needs.

When an unaccompanied child between the age of 15 and 18 years is detained in the Ellebæk

Institution the personnel will inform the Danish Red Cross organization who will assign a

personal representative for the child. During the detention the child will be offered expanded

options regarding participation in recreational activities and classes etc.

Paragraph 78

in CPT’s report

CPT’s recommendation

concerning paragraph 78:

The CPT recommends that efforts be made to maintain the establishment in a decent

state of repair and to limit the carceral environment to a minimum.

The Department of Prisons and Probation would like to inform the CPT that the Ellebæk

Institution finds that the facilities available to the clients are being seriously worn down, and

the conditions and quality of the buildings generally require a substantial and continuous work

to maintain them in acceptable condition. The residential buildings, in particular, appear to be

worn down some places, but maintenance work and projects are performed on a continuous

basis to improve conditions.

As regards

the attempt to reduce the institution’s prison appearance, it should be noted that,

for security reasons, the Department of Prisons and Probation finds that it is not possible to

make adjustments without increasing the risk of escapes.

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CPT’s recommendation

concerning paragraph 78:

Further, arrangements should be made to ensure that regular activities are not cancelled

due to lack of staff. Consideration should also be given to extending the possibilities for

detained persons to cook their own food.

The Ellebæk Institution has provided the Department of Prisons and Probation with the

following information:

‘The Institution has noted that the CPT has taken notice of the number and scope of leisure

time activities, work, education and training, etc., offered to inmates. However, the CPT also

states that the regime of the institution has not changed since 2008, which the institution

cannot recognise. In fact, a large number of initiatives have been taken concerning the

approach to tasks, the everyday life of the inmates and the general physical conditions, etc.

To fill the various positions and use human resources in the most effective manner, the

institution has an employee with a flexible job content on duty every day to handle special

tasks in the morning until noon and tasks relating to activities in the afternoon. The person in

this flexible position is also used to cover for employees who are absent due to illness to

minimise the need to call in staff and work overtime. It is therefore correct that sometimes the

activities planned to be undertaken by the person in this flexible position are cancelled, without

any replacement activities being offered instead on that particular day.

The institution believes that its organisation of work schedules, education and training and

leisure time activities, etc., is satisfactory

–

partly to alleviate any harmful effects of the

imprisonment, but also in relation to the staff’s working environment and the relationship

between inmates and staff. Fundamentally, the institution believes that as many activities as

possible should be offered. However, the amount of leisure time activities, etc., sometimes has

to be limited for operational and financial reasons. Within the existing framework, it is very

difficult to find ways of offering additional activities or avoid cancelling activities.

However, the institution recognises that the inmates sometimes become frustrated when

activities are cancelled. In the opinion of the institution, such frustration must be handled as

part of the daily relationship between inmates and staff, for which reason the competencies of

the staff must be improved as much as possible. In that connection, the institution refers to

the fact that a competency development plan has been prepared for the staff of the institution,

focusing on increased knowledge of the inmates’ circumstances and mental reaction

patterns/mental backgrounds.’

As regards the inmates’ possibility of cooking their own food, the institution has stated the

following:

‘The CPT recommends

that the institution considers the possibility of extending the existing

arrangement under which food is cooked at the institution twice a week. This is confirmed by

the feedback from the meetings with ‘spokespersons’ at which the inmates often express

wishes for adjustment of the meals served at the institution. This means that the institution is

aware of the inmates’ wishes and satisfaction with the possibility of cooking their own food.

Against that background, the institution will consider whether it will be possible to extend the

arrangement within the existing framework.’

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The Department of Prisons and Probation refers to the above statement made by the

institution.

Paragraph 79

in CPT’s report

CPT’s recommendations

concerning paragraph 79:

The CPT recommends that the Danish authorities ensure that every newly-arrived

detainee is clinically assessed by a medical doctor or by a fully qualified nurse reporting to

a doctor, as soon as possible after his/her admission to Ellebæk. Such health-care

screening should be conducted in an appropriate and confidential setting.

Further, the CPT recommends that specific screening be put in place aimed at identifying

victims of torture, with clear rules on the procedures to be undertaken whenever a

medical practitioner reports on any detained person who may have been the victim of

torture.

On the basis of the CPT’s recommendation, the Department of Prisons and Probation has

requested a statement from the Ellebæk Institution. On 8 October 2014, the institution made

the following statement:

‘The nurses of the institution are present on weekdays from 8.00 am to 5.00 pm. During that

time, health screenings are carried out on admission, the nurses being present in the reception

area to handle the task directly. Following

a specific assessment or at the inmate’s request, the

screening may be continued in the consultation room of the institution.

Inmates who arrive outside these hours will be contacted by a nurse on the following day, or in

case of arrival during the weekend, on the following Monday. In that situation, the staff

receiving new inmates may contact a nurse by telephone, and it is also possible to contact the

ordinary health service for advice. The institution finds that the response time for health

screenings is satisfactory, and there have been no episodes giving rise to health-care

concerns.

Consequently, initial health screenings are carried out in the reception area or in the inmate’s

living room. In the first situation, the initial screening is carried out with the assistance of the

accompanying interpreter and in the presence of the prison officers on duty and the escorting

police officers. In the last situation, the screening is carried out without the presence of other

persons than the inmate, unless he or she wishes that a fellow inmate should be present or if

the presence of others is necessary for security reasons. In both situations, a follow-up

screening is carried out in the consultation room with the assistance of an interpreter if it is

deemed necessary or if so requested by the inmate.

During the initial health screening, the inmate receives information about the institution’s

health-care services, and the inmate is asked about current and previous health problems and

any medication taken. The inmate in question is informed that a follow-up screening may be

carried out in the consultation room in a more confidential setting. After admission, the inmate

may also submit a discrete request to that effect in a sealed envelope.

As regards screenings to identify victims of torture, the institution has stated the following:

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‘The institution performs no independent investigation on whether inmates have been

subjected to torture or war crimes. Any such information will be included in the assessment of

any necessary health-related requirements caused by the imprisonment and the placement in

the institution. If it is established that an inmate is a victim of torture, this will have no formal

significance in relation to the handling of the task of the institution, but it may affect the

consideration of the inmate’s case by other authorities, such as

the Danish Immigration

Service and the police. Against that background, the institution finds that this issue is primarily

relevant for the police to ensure that the necessary basis for the court order is obtained prior

to imprisonment and in connection with the extensions of custody.’

The Department of Prisons and Probation refers to the statement made by the Ellebæk

Institution in its entirety.

Paragraph 80 in CPT’s

report

CPT’s observation concerning

paragraph 80:

As regards medical confidentiality issues during consultations and the delivery of

medication, the same observations made in relation to Western Prison apply to Ellebæk

and should be addressed accordingly (see paragraph 53 for the relevant

recommendation).

The Ellebæk Institution has provided the following information:

‘The institution finds that the necessary considerations are shown to ensure discretion in

connection with the guidance provided by the health-care staff at the first meeting with the

inmate. On the basis of the CPT’s recommendation, the institution will, however, take steps to

increase focus on the guidance to inmates provided by the health-care staff and the

considerations shown to ensure discretion. However, it should be mentioned that these

matters are already taken into account in the ordinary health-care services offered, and it

should also be noted that information about the health-care services, including the possibility

to write directly

to the nurses, is described in the institution’s information folder, which has

been translated into the most relevant languages and is available to all inmates.’

The Department of Prisons and Probation has no further comments.

Paragraph 81

in CPT’s

report

CPT’s recommendation

concerning paragraph 81:

The CPT recommends that the Danish authorities make the necessary arrangements for

interpretation services to be provided when required, taking into account the above

remarks.

The Ellebæk Institution has provided the following information about interpreting assistance:

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‘As regards the use of interpreters, the health-care

staff use interpreters if requested by the

inmate and if considered necessary. However, the staff is not unwilling to accept the assistance

of a fellow inmate for interpreting if that is also the inmate’s wish, and consent has therefore

been given.’

The Department of Prisons and Probation confirms that this is in compliance with the rules for

interpreting assistance in the institutions of the Danish Prison and Probation Service, and the

Department therefore refers to the institution’s response.

Paragraph 82

in CPT’s report

CPT’s recommendation

concerning paragraph 82:

The CPT recommends that the Danish authorities takes steps to improve the provision of

information to irregular migrants from the outset of their detention and that they improve

the possibilities for contact with the outside world such as permitting persons detained at

Ellebæk to possess mobile phones, in the light of the above remarks

The Ellebæk Institution has made the following comments to the CPT’s recommendation:

‘The CPT recommends that the inmates of the institution are permitted to possess mobile

phones with a view to enhancing communication with their families and others outside the

institution. In that connection, it should be noted that, within the existing framework, inmates

are permitted to receive visitors at the institution, and they also have unlimited access to the

telephones at the residential units.

However, the possession of mobile phones is not permitted in the institution, and, under

section 2 of the Executive Order on Inmates’ Personal Property, such possession cannot be

permitted despite the CPT’s recommendation. The institution believes that the possession

mobile phones will in itself improve the inmates’ contact with the outside world, and it may

also contribute to increasing the individual inmate’s safety. However, the institution also

believes that the possibility to communicate with inmates in the other residential units, to

communicate with the outside world, to take photos with the mobile phone camera, etc., may

constitute a security risk in relation to escapes, etc.’

The Department of Prisons and Probation refers to the statement made by the Ellebæk

Institution in its entirety.

II.D. Secure institutions for juveniles

Paragraph 83

in CPT’s report

CPT’s recommendation

concerning paragraph 83:

The CPT considers that a secure institution for juveniles is not an appropriate place to

accommodate foreign minors under the age of 15 for the sole reason of not having a

resident’s permit.

The Committee recommends that the law be changed accordingly.

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The Ministry of Justice observes that according to the section 36 of the Danish Aliens Act an

asylum seeker can be deprived of liberty to ensure enforcement of a refusal of entry,

expulsion, transfer or in circumstances where the asylum seeker refuses to co-operate in the

administrative procedures of the Danish Immigration Service. An asylum seeker can only be

held under detention when the less interfering measures mentioned in section 34 of the Danish

Aliens Act are insufficient in order to ensure the presence of the asylum seeker for the purpose

of expulsion.

As deprivation of liberty is a very intrusive measure the Danish National Police has

implemented a strategy concerning the use of detention in relation to the Danish Aliens Act. It

is therefore a leading principle of this strategy that all use of detention requires careful

consideration and that detention can only be upheld as long as it is necessary and

proportional.

The use of detention must be in accordance with national law and Danish international

obligations and with special consideration for vulnerable asylum seekers such as minor asylum

seekers.

In line with this it follows from section 35 of Executive Order No. 419 of 29 April 2014 (on the

use of force against children and juveniles under care) that an asylum seeker can only be held

under detention when less interfering measures are insufficient in order to ensure the presence

of the asylum seeker for the purpose of expulsion.

Accordingly foreign minors under the age of 15 are not accommodated in a secure institution

for the sole reason of not having a resident permit in Denmark.

The placement of a minor asylum seeker under the age of 15 in a secured institution will

always be for as short a period of time as possible.

Paragraph 85

in CPT’s report

CPT’s request for information concerning paragraph

85:

The CPT would like to be informed about the outcome of the work of the Committee.

The Ministry of Children, Equality, Integration and Social Affairs expects the report from the

Ministerial Committee mandated to scrutinize the current legislation concerning the application

of forceful measures on juveniles, to be completed in March 2015 whereupon the Ministry will

forward the report to the Committee.

Paragraph 86

in CPT’s report

CPT’s request for information concerning paragraph

86:

The CPT would appreciate the comments of the Danish authorities on the application of

the use of force at the Secure Institution for Juveniles Grenen.

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The Ministry of Children, Equality, Integration and Social Affairs has requested comments from

Danish Regions about the conditions at The Secure Institution for Juveniles Grenen. Danish

Regions reports that Region Midtjylland, where the secure institution Grenen is located,

informs that employees at Grenen are trained to handle various situations that may have the

potential to develop into a dangerous situation for the employees or the juveniles. Therefore,

according to the safety policy at Grenen, the individual employee continually assesses the

needs for calling for backup from colleagues in those cases in which the employee feels

insecure.

An assessment made by the employee to call for backup may in some cases be perceived by

the juvenile as being too quick and an escalation of the conflict. However, at Grenen it is a

substantial consideration, that in cases in which an employee feels insecure and thus as a

preventive measure calls colleagues through a personal protection equipment (alarm system)

it is based on a professional assessment of the situation, which also works preventively and

reassuringly.

It may be noted that the alarm has only been used once in the period from the 29th of July

2014 to the 7th of October 2014. There are no logs available for a longer period.

As for the overall precepts for the use of force in secure institutions The Ministry of Children,

Equality, Integration and Social Affairs observes that the Committee has been extensively

informed on the matter in connection with the Committee’s visit on 4 to 13 of February 2014.

However, the Ministry observes that the purpose of the existing rules on forcible measures is

to protect all children and young people placed in care, including juvenile offenders. The rules

of the use of forcible measures in exceptional situations are laid down in the Order on forcible

measures. Hence, section 1 of the Order on forcible measures prescribes that the use of

forcible measures against children and young people pursuant to the Order shall be used only

if it is authorized by the Act on Social Services. The use of forcible measures must never

replace the care and socio-educational assistance and should be used in accordance with the

children’s and young people’s integrity and self-determination.

The use of forcible measures

must be limited to what is strictly necessary and must be proportionate to the purpose.

Physical punishment is not allowed, nor is fixation. Fixation is defined as the use of mechanical

means of restraint such as belts, straps for hands and feet and other mechanical fastening.

Humiliating, taunting or other degrading treatment is prohibited.

All episodes involving use of forcible measures are to be reported

to the youth’s residential

municipality and to the relevant social supervisory authority.

Paragraph 88

in CPT’s report

CPT’s recommendation

concerning paragraph 88:

Some of the young persons interviewed did not know whether they were allowed to ask

for access to the toilet at night or whether they had to use the flask. In the CPT’s view, all

juveniles should be provided with ready access to toilet facilities without undue delay,

including at night, and should be informed about this right. The CPT recommends that

such an approach be rigorously applied.

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The Ministry of Children, Equality, Integration and Social Affairs has requested comments on

this from Danish Regions. Region Midtjylland informs that the juveniles have and should have

access to use a toilet at night as well as the young individual has the right to choose if he/she

wants to use a urine flask. As a result of the findings of the CPT this option is now integrated

as part of the written information handed out to all the juveniles on their first day at the

Secure Institution for Juveniles Grenen.

Paragraph 89

in CPT’s report

CPT’s recommendation

concerning paragraph 89:

The CPT recommends that the Danish authorities review the application of this restrictive

measure at the Secure Institution for Juveniles Grenen.

With regard to the rules for social contact at the secure institutions for juveniles, especially at

the Secure Institution Grenen, Region Midtjylland informs that it may be noted that the rooms

of the young people are locked at 11.30 pm on Saturdays and at 10.30 pm on the remaining

days of the week.

The task of a secure residential institution is among other to ensure that the young people who

are subject to visit- and letter scrutiny, cf. The Danish Administration of Justice Act, do not

communicate directly or indirectly with the outside world

–

unless they have explicit

permission from the police to do so. A part of this task is to ensure that a juvenile is not able

to affect other juveniles to influence witnesses and other people who may have an influence on

the investigation of the police. In some situations, thus, there may be instances in which the

young people are not allowed to spend time alone with other young people.

Furthermore, the environment at a secure institution is

characterized by a massive educational

presence. This provides an institutional environment where young people rarely are alone

together.

Region Nordjylland informs that restrictions about social interaction among the juveniles

should be considered as protection of the most vulnerable of the juveniles.

It is the opinion of the Ministry of Children, Equality, Integration and Social Affairs that the

rules should not be too restrictive, but that situations may occur that would justify a restriction

of social contact on the grounds of issues of order and security.

Paragraph 90

in CPT’s report

CPT’s recommendation

concerning paragraph 90:

The CPT recommends that efforts be made by the Danish authorities to take the

necessary steps to ensure that at least one teacher is qualified to teach juveniles with

learning disabilities.

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The Ministry of Children, Equality, Integration and Social Affairs has requested the Ministry of

Education to evaluate the recommendation of the CPT. The Ministry of Education is responsible

for the education at secure institutions. According to the Ministry of Education it follows from

the rules for special education at institutions for placement that special educational support

shall be provided by personnel with the appropriate educational and professional qualifications

for the task.

The local council in the municipality, where the secure institution is located, is responsible for

teaching at the regional secure institution.

Special education in secure institutions requires the conclusion of an agreement between the

institution and the municipality where it is located. The agreement must include provisions for

the personnel. It must be clear what qualifications the staff has to handle the special needs

assistance.

As for the specific circumstances at the secure institutions for juveniles, Danish Regions

observes the following: “The

teachers at Grenen are all educated at a teachers training college

and their skills are maintained through follow-up education and participation in conferences

regarding

special education to update and qualify the teachers’ skills also in regard to juveniles

with learning difficulties

Through supervision conducted by external psychologists the teachers acquire knowledge

about how the teaching with regard to the individual student can and must be carried out in a

teaching- and learning situation.

Region Hovedstaden finds that the teachers at Sølager are all qualified even though they are

not specialised in teaching juveniles with learning disabilities.

Region Nordjylland informs that it could be difficult for some of the secure institutions, to make

sure that at least one teacher is specialised in teaching juveniles with learning disabilities, if it

means they need a secondary education.”

Paragraph 92

in CPT’s report

CPT’s recommendation

and request for information concerning paragraph 92:

The CPT recommends that juveniles held at the Secure Institutions for Juveniles Sølager

and Grenen be guaranteed prompt access to a doctor at any time. Further, the CPT would

like to be informed whether there is always someone competent to provide first aid

present at the establishments, including at night.

The Ministry of Children, Equality, Integration and Social Affairs informs that access to

healthcare overall falls under the authority of the Ministry of Health, while Danish Regions is

responsible for the secure institutions. On the Ministry’s request for comments to the CPT’s

recommendation Danish Regions reports that Region Nordjylland agrees with the

recommendation in the matter of access to a doctor. Grenen informs that they offer the

juveniles fast access to a doctor. And finally Danish Regions report, that all regions remark

that members of the staff are able to provide first aid.

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Paragraph 93

in CPT’s report

CPT’s recommendation

concerning paragraph 93:

The CPT recommends that foreign nationals held in Secure Institutions for Juveniles are

provided with free health care and medication similar to that enjoyed by Danish juveniles.

The matter of foreign nationals falls under the authority of The Ministry of Justice. The

Ministry of Justice observes that there is made no distinction between minor asylum seekers

and other children residing in Denmark regarding the right to health care treatment, whereas

adult asylum seekers are entitled to free health care treatment if the treatment is necessary,

urgent or alleviating.

Paragraph 94

in CPT’s report

CPT’s

observation concerning paragraph 94:

The CPT trusts that only staff who have been appropriately trained are tasked with the

distribution of medicine.

On this matter Danish Regions report that in all the regions staff who handles medicine are

educated in handling medicine.

Paragraph 95

in CPT’s report

CPT’s recommendation

concerning paragraph 95:

The Committee reiterates its recommendation that steps be taken to ensure that every

newly-admitted juvenile be physically examined by a health-care professional within 24

hours of his or her admission.

On the matter of the practice of physical examination upon admission Danish Regions observe

that Region Midtjylland remarks that in case a member of staff finds that a juvenile needs

medical attention, a doctor will be contacted without any hesitation. Region Nordjylland

remarks that it should be an individual assessment in every case.

Finally, it is noted that juveniles at secured units have equivalent access to healthcare as any

other citizens in the Danish community.

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Paragraph 97

in CPT’s report

CPT’s observation concerning

paragraph 97:

At Grenen, the delegation was informed that difficult behaviour in a juvenile was generally

dealt with by behavioural approaches, rather than by medication. […]

Such an approach

represents an example of good practice from which prison establishments might be able

to learn.

In connection with the establishment of special units for juveniles, the Danish Prison and

Probation Service has obtained inspiration from the secure social institutions.

It should also be noted that the units for juveniles and the juvenile section at Copenhagen

Prisons employ social educators and use special educational approaches. Consequently,

behavioural problems are not solved by means of medication. If an external doctor has

prescribed medication for a juvenile who is placed in one of the institutions of the Danish

Prison and Probation Service, he or she may continue to take such medication. However, this

decision will always be based on a specific assessment.

Paragraph 98

in CPT’s report

CPT’s

recommendation concerning paragraph 98:

The CPT recommends that - if needed at all - the period of confinement of a juvenile in

his/her room upon admission should be based on individual assessment and reduced to

the absolute minimum necessary. Furthermore, all young persons should be offered at

least one hour of outdoor exercise every day and human contact and other activities

during the application of the admission measure. The first days of a juvenile’s placement

should be used by staff to engage with the young person so as to assess his/her specific

needs and establish a trusting relationship. Further, the confinement of juveniles to their

rooms should be properly recorded.

The Ministry of Children, Equality, Integration and Social Affairs has asked Danish Regions for

comments regarding the CPT’s recommendation and comments. Danish

Regions Region

Midtjylland informs that it must be emphasized that during the individual introduction the

juvenile is fully or partly participating in the social community with the other juveniles and

activities. Furthermore the juvenile is introduced to the school and the workshops at Grenen.

Moreover, it must be emphasized that during the introduction course the juvenile is offered at

least 1 hour of outdoor activities every day. During the individual introduction, the newly

placed juvenile is in contact with the pedagogical staff and the other juveniles in a context and

pace, which is assessed to be sound and caring to the newly placed juvenile, the other

juveniles, integrity, need and group dynamic.

The individual introduction is a pedagogical initiative which is carried out in a period of 5 days

on average. The purpose is to build an environment as safe as possible for the newly placed

juvenile, the other juveniles and the pedagogical staff. When a juvenile is placed in a secured

residential institution, the juvenile is often characterized by chaos. This considerable and

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intrusive measure, which a placement in a secured department is, is a stressful factor for the

juvenile. Thus it often makes the juvenile react inappropriately due to thoughts and emotions

characterized by fear, anxiety, anger, stress, sadness etc. At the time of the placement at the

secured department, the juvenile is often characterized by problems relating to abuse. There is

a special focus on that the newly placed juvenile feels safe around the pedagogical staff, the

other juveniles, the activities, teaching, structure and rules of the institution.

The individual introduction is planned in accordance with a standardized activity plan, which is

continuously evaluated and adjusted accordingly. Furthermore all individual courses are

evaluated by the management when the introduction is completed. The activity plan and the

evaluation is documented and recorded electronically.

Paragraph 99

in CPT’s report

CPT’s request for information concerning

paragraph 99:

The CPT would like to be informed of the various language versions currently available.

The Ministry of Children, Equality, Integration and Social Affairs has forwarded the request to

Danish Regions, who reports that at Grenen, the activity plans and procedures are in Danish.

For the foreign juveniles the staff translates the necessary information via Google Translate,

use an internal interpreter and in more rare cases end external interpreter, if it is found

necessary. At Sølager they expect to have information materials in Arabic, Turkish and English

by 2015.

Paragraph 100

in CPT’s report

CPT’s

recommendation concerning paragraph 100:

The CPT recommends that the presence of at least one female staff member should be

guaranteed at the Secure Institution for Juveniles Grenen whenever female juveniles are

being accommodated.

On the matter of the presence of female staff whenever female juveniles are being

accommodated Danish Regions reports that Region Nordjylland seeks the presence of female

staff at any time. However it cannot always be guaranteed in an acute institution, that there

will be a female staff available when a female juvenile arrives. Region Midtjylland furthermore

informs that it would be expedient always to have a female member of staff present when a

juvenile girl arrives at the institution. However, there are relatively few girls placed at the

secured units and few women apply for a job at Grenen. Grenen continuously tries to attract

female applicants who can work with the juveniles on the secured units.

The Ministry of Children, Equality, Integration and Social Affairs has taken note thereof.

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Paragraph 102

in CPT’s report

CPT’s request for information concerning paragraph

102:

The CPT would like to receive confirmation that all means of manual physical restraint

applied to juveniles are safe and induce as little pain as possible.

To this, Danish Regions observes that a distinct effort is made to ensure that any use of force

at Grenen is carried out as short and gently as possible with great attention to the adolescent.

The staff is continuously educated in the “Order of use of force towards children and

adolescents placed outside the home” and in gentle use of force. The education is continuously

refined. Any use of force is analysed with the purpose of creating learning, preventing use of

force and making sure that physical force is only used when absolutely necessary and carried

out in a proportional and least intrusive manner.

Paragraph 103

in CPT’s report

CPT’s

recommendations concerning paragraph 103:

The CPT recommends that the Danish authorities ensure that resort to strip searches is

based on an individual risk assessment and subject to rigorous criteria and supervision.

Further, they should review the way in which juveniles are searched upon admission to

the Secure Institution for Juveniles Grenen, in the light of the above remarks.

The Ministry of Justice informs that it follows from Section 792 e of the Administration of

Justice Act that the search

of a suspect’s body must be of a proportional and careful manner. If

a strip search is deemed necessary, the search must if possible be conducted by a person of

the same sex or by health care personnel.

According to the Police Act decisions by the police to conduct strip searches must be based on

an individual assessment and are subject to rigorous standards and supervision.

The Ministry of Children, Equality, Integration and Social Affairs informs that it follows from

Section 123a of the Consolidation Act of Social Services that the principal of the institution or

his/her authorised deputy may decide to inspect the child’s or young person’s body on

suspicion that the child or young person holds effects the possession of which constitutes a

violation of regulations and the non-observance of security precautions. An inspection of the

effects kept by a child or young person on his/her body shall not be conducted if, given the

purpose of the restrictive measure and the anticipated ensuing humiliation and discomfort, the

measure is considered disproportionate. Any inspection shall be conducted as gently as the

circumstances allow. Furthermore an inspection of this kind shall only in exceptional

circumstances be conducted and supervised by a person of a different gender than the young

person.

Furthermore it follows from Section 24 of the order of use of force against children and

adolescents placed outside the home that body searches shall only be conducted by patting the

juvenile outside the clothes and by searching pockets and shoes. The staff can demand that

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the juvenile remove outdoor clothes, cap and shoes. A body search must be proportional,

gentle and preceded by other more lenient measures.

Danish Regions observe that the Police carry out body searches. The staff at Grenen, as well as

in other secure institutions, never attends any body searches carried out by the police.

Paragraph 104

in CPT’s report

CPT’s request for information concerning paragraph

104:

The CPT would like to receive the breakdown of the figures of isolation (number of cases,

length) for each of the three units of Grenen for the first half of 2014.

The Ministry of Children, Equality, Integration and Social Affairs has forwarded the request for

information to Danish Regions who report that Grenen informs that during the first 6 months

of 2014 there has been one placement in isolation. It took place in the special secured unit,

department SOUTH. The placement in isolation lasted 7 minutes.

Paragraph 105

in CPT’s report

CPT’s requests

for information concerning paragraph 105:

The Committee would like to be informed about the frequency and length of “shielding” at

the Secure Institution for Juveniles Sølager for the period June 2012 to June 2014.

Further, it wishes to be informed of the procedures and safeguards surrounding this

measure.

Danish Regions observe that at Sølager the concept “shielding” is used, when a unit is

separated into two groups. The juveniles are informed of the reasons for separating the unit

and of the following plan for the separation. A group can consist of one or two juveniles.

A unit is separated when juveniles have difficulties with social relations and behaviour against

other juveniles.

When the unit is separated into two groups, a plan is made with the juvenile(s) in the smaller

shielded group with regard to the intended objective for the shielding and for activities

required to achieve the intended objective. Part of the plan could be that staff and juvenile

consider how similar conflicts can be avoided, when the shielding will end and/or make an

agreement of conflict resolution among the implicated parties. There is always staff with the

smaller shielded group.

The length of “shieldings” ranges from a few hours to 2-3

days. A plan is always made with the

shielded group to take part in meals and/or activities with the rest of the juveniles during the

shielding. Some juveniles voluntarily request to be shielded from the rest of the group with the

purpose of calming their own sense of chaos. The length of this kind of shielding has been up

to 2-3 days. Also with this type of shielding a plan will be made with the shielded juvenile to

take part in meals and/or activities with the rest of the juveniles.

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The total

number of “shieldings” is 10 in the period June 2012 to

June 2014.

Paragraph 106

in CPT’s report

CPT’s request for

comments concerning paragraph 106:

The CPT would like to receive the Danish authorities’ comments on the approach

employed by staff at Grenen juvenile secure institution with regard to confinement to a

room.

The request for comments has been forwarded to Danish Regions who report that the

situations described in the report cannot be recognized as being the practice at Grenen. Nor

are the situations described compatible with the pedagogical approach of Grenen or the ethical

framework to intervene with a "time-out" at a room. The approach of using time-out has and

must have care and security as its main purpose, and it must be used in accordance with the

principles of proportionality and minimizing interference.

A time-out

is in most cases carried out at the juvenile’s unlocked room and in a time frame not

exceeding 3 hours. Time-out is a method that in time, location and activity is matched to the

individual and current need for treatment as well as an ongoing evaluation. Thus, the time-out

process is professional didactic motivated and substantial efforts are made to make the

juveniles understand the background and purpose of the process.

The Ministry of Children, Equality, Integration and Social Affairs takes note thereof.

Paragraph 107

in CPT’s report

CPT’s request for

comments concerning paragraph 107:

The CPT has doubts over the practice of calling police officers into juvenile institutions to

manage violent situations. The institutions’ staff

is in charge of maintaining order within

the institution and should be able to control a violent outburst by one or more juveniles.

Indeed, it appeared that staff at both institutions were in fact trained accordingly and did

use force when necessary to prevent violent incidents. The CPT would like to receive the

Danish authorities’ comments on this matter.

The request for comments on the matter has been presented to Danish Regions. Danish

Regions observes that in the report this matter is justified by the relationship between the

juveniles and the staff. Furthermore Danish Regions report that Sølager informs that the

practice of calling the police is justified by the fact that the police are under different

regulations in relation to the use of force. The institution (Sølager) is regulated pursuant to the

“Order of use of force towards children and adolescents placed outside the home”.

The Ministry of Children, Equality, Integration and Social Affairs take note thereof.

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Paragraph 108

in CPT’s report

CPT’s recommendation concerning paragraph 108:

The Committee recommends that handcuffs be only applied on individual grounds, based

on the principle of proportionality and never on a routine basis.

Reference is made to the Ministry of Justice’s response to paragraph 9 of the CPT’s report

above.

The Ministry of Children, Equality, Integration and Social Affairs take note thereof.

Paragraph 111

in CPT’s report

CPT’s

recommendation concerning paragraph 111:

The CPT reiterates its recommendation that the application of limitations on detained

juveniles’ contact with the outside world be reviewed. The imposition of such limitations

should be the exception, not the rule.

The Ministry of Justice observes that for minors remanded in custody or in a secure institution

the rules in the Administration of Justice Act section 770-773 regarding restrictions on remand

prisoners’ right to contact with the outside world apply.

Reference is made to the response to paragraph 33 and 35.

With regards to minors placed in a secure institution they have an extended right to

correspondence pursuant to order No. 419/2014 on the use of force against children and youth

placed outside the home, section 29. Accordingly, a minor remanded in a secure institution is

entitled to receive unsupervised visits from the social supervision, that supervises the

operation of the institution and to unmonitored correspondence with the social supervision, the

Appeals Permission Board, the Prosecution Service, the Police, the European Court of Human

Rights, the European Committee for the Prevention of Torture, the United Nations Committee

Against Torture, the United Nations Human Rights Committee, members of the Danish

Parliament and other public institutions.

The institution can according to order No. 419/2014 on the use of force against children and

youth placed outside the home,

section 28, where it is necessary in regards to the minor’s

health and development and upon a decision from the Children and Youth Committee monitor

letters, telephone calls or other communication between the juvenile and certain people

outside the institution.

Decisions to monitor the minor’s contact with specified persons for a limited period of time are

only made in exceptional cases and when required because of the child’s

or young person’s

health and development, and are thus not the rule.

Decisions made by the Children and Youth Committee can be appealed to the National Social

Appeals Board pursuant to order No. 419/2014 on the use of force against children and youth

placed outside the home, section 49.

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Danish Regions and the institutions reiterate, that issues concerning visit- and letter scrutiny

are regulated by the police and the court, not by the secure institutions.

Paragraph 112

in CPT’s report

CPT’s request for

comments concerning paragraph 112:

In the CPT’s view, staff should foster the young persons’ confidence in the effectiveness of

the complaints system. The Committee would like to receive the Danish authorities’

comments on this matter.

The CPT’s request

for comments on the matter has been presented to Danish Regions who

observe that one of the tasks at Grenen is to help the young people be more aware of the

procedures for filing complaints as well as improving their confidence that complaints are dealt

with properly. With a systematic and documented approach Grenen is much concerned with

how to inform and guide the juveniles on their rights to file a complaint. Grenen will, if

necessary, help the juvenile to formulate a complaint.

The Ministry of Children, Equality, Integration and Social Affairs also finds that it is important

that young persons placed outside their home know and trust the complaints procedures as

well as their right to file complaints.

II.E. Psychiatric institutions

Paragraph 115 in CPT’s

report

CPT’s observation concerning paragraph 115:

In welcoming these proposals as a clear step in the right direction, the CPT trusts that the

Danish authorities will invest the necessary resources in psychiatry to implement the

plans to reduce the use of coercion.

The Government has declared it a goal to improve conditions for people with mental illness,

including a reduction in the use of coercion. Just on 15 May 2014 the Government presented a

comprehensive long-term action plan for the future development and expansion of the services

to people with mental illness. This plan includes e.g. targets for reducing coercion in

psychiatry, including mechanical restraint, and will support the new framework and direction

for psychiatry that has been recommended by the Commission. The keyword for the plan is

equal effort. Psychiatric patients must receive the same effort, have the same rights and get

the same high quality in treatment and rehabilitation as patients with physical illness. 2.2

billion Danish kroner has been reserved for an increase of capacity in psychiatry, e.g. in

outpatient psychiatry and closed wards.

Link to the action plan (in Danish):

http://www.sum.dk/Aktuelt/Nyheder/Psykiatri/2014/Maj/~/media/Filer%20-

%20Publikationer_i_pdf/2014/Ligevaerd-psykiatriplan-maj-2014/Psykiatri_handlingsplan-netudgave.ashx

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One of the most important objectives for the Government is to reduce coercive measures with

50 % in 2020.

Currently, the Government enters into partnerships with the regions responsible for

progression on the reduction of coercion in psychiatry. With the Financial Act for 2014 the

Government has permanently allocated 50 million Danish Kroner per year to these

partnerships as well as 100 million Danish Kroner in 2014 to create a better physical

environment at hospitals to support a reduction of coercion. There has furthermore been

allocated 74 million Danish kroner over four years (2014-2017) to experiment with force-free

units in the psychiatry and.

Inspired by what is being done on cancer and heart disease, the Government formed a Task

Force for psychiatry. The Task Force will be following the development of the area in general,

including monitoring the goal regarding the 50 % reduction of coercive measures.

To achieve the objectives in the action plan, the Danish Government and the other ”satspulje”

parties agreed on a significant investment in psychiatry. The result is the 2.2 billion Danish kr.

mentioned above primarily to reduce waiting lists and create the necessary environments for a

reduction in the use of

coercive measures.

More specifically the agreement

(”satspulje”) has the following focus areas:



More capacities of high quality

More and better skills in psychiatry

A modern psychiatry with focus on physical facilities and environment

Cross-disciplinary efforts in child and adolescent psychiatry

A better physical environment and more appropriate facilities are important in order to achieve

proper treatment, to secure the safety of patients as well as of staff, and to reduce the use of

coercion. Therefore it must be seen as part of an expansion of the treatment capacity in

psychiatry.

With the agreement it will be possible to increase capacity and modernise the regional

psychiatry, which leads to a more equal treatment of psychiatric patients and increased quality

in treatment.

The regions will as part of the agreement have the possibility to hire up to 500 more people in

psychiatry. This will lead to faster diagnosis and treatment, and thus shorter waiting lists.

The outcome of the agreement will be monitored annually e.g. how the regions fulfil their

goals.

Paragraph 121 in CPT’s report

CPT’s observation concerning paragraph 121:

the Committee considers that applying instruments of physical restraint to psychiatric

patients for days on end cannot have any medical justification and amounts to ill-

treatment.

Reference is made to the Ministry of Health’s response to paragraph 125 in CPT’s report below.

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Paragraph 122 in CPT’s report

CPT’s comment concerning paragraph 122:

Documentation examined by the delegation showed that in the case of a patient who had

been continually immobilised for a period of 34 days at Amager, authorisation in writing

by a second doctor had only been provided twice during the whole period. Staff were of

the opinion that only one such authorisation was required, even if the patient was

restrained for more than a month.

CPT’s recommendation concerning paragraph 122:

Existing legal safeguards must be rigorously enforced.

Psykiatrisk Center Amager has informed the Ministry of Health that the staff at the intensive

wards have great knowledge of the psychiatry law, including the rules of second opinion after

the 48 hours belt fixation, and hereafter the weekly inspection of fixations that last more than

a week.

The staff is aware that in accordance with the law they must make sure, that the inspection

and interviews are being carried out. The doctor does the evaluation. Fixations that last more

than 48 hours very rarely occur.

Paragraph 125 in CPT’s report

CPT’s recommendation concerning paragraph 125:

The CPT again calls upon the Danish authorities to review the legislation and practice of

immobilising psychiatric patients and in particular to ensure that immobilisation with a

belt:

is only used as a last resort to prevent risk of harm to the patient or to others;

is applied for the shortest possible time (usually minutes rather than hours) and is

always terminated as soon as the danger of harm has passed; the maximum

duration should ordinarily not exceed six and under no circumstances exceed 24

hours;

is never applied or its application prolonged due to a shortage of staff;

is subject to regular review by a second doctor in case of an exceptional

prolongation of immobilisation beyond the six hours limit, and thereafter at

reasonably frequent intervals; and that in cases of disagreement between the

treating and the second doctor about the prolongation of immobilisation, the

matter be automatically referred to an independent third authority for decision.

The same procedure should apply if the use of mechanical restraint is repeated

within 24 hours following the termination of a previous measure of restraint.

The Psychiatric Act lays down the conditions for using coercive measures. When these

conditions no longer exist the coercive measure must be discontinued. As regards to long-term

immobilisation, it is the aim of the Ministry of Health that the use of this should be reduced.

However, the Ministry of Health has not found basis for establishing an absolute legal limit to

the duration of immobilisation in connection with the upcoming amendment of the Psychiatric

Act in 2015 as this might deprive psychiatric departments and staff of the means to undertake

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necessary measures for the protection of the patient concerned and other patients, should the

patient’s condition be unaltered at the expiry

of the time limit.

In order to ensure high quality in the use of coercive measures and limit the duration of the

immobilisations, the Ministry of Health has instead proposed that clear and uniform rules be

laid down stipulating a minimum frequency of medical supervision and simultaneous

assessment of whether the immobilisation should cease or continue.

According to the forthcoming bill, medical assessment of the immobilisation must take place at

least three times a day at evenly spaced intervals. This means that the medical assessment of

immobilisation will be reduced from four to three times a day. On the other hand, according to

the upcoming amendment of the Psychiatric Act, the decision to maintain immobilisation,

which is currently subject to a special review (second opinion) if it is extended beyond 48

hours, will be changed from 48 to 24 hours. The review is to be undertaken by a doctor who is

not employed in the psychiatric department in which the measure is being enforced, is not

responsible for treating the patient, and is not a subordinate of the doctor treating the patient.

This measure will ensure impartiality in relation to the evaluation of the need to continue the

immobilisation. The doctor undertaking the external review must be a trained medical

specialist in either psychiatry or child or adolescent psychiatry.

It is the opinion of the Ministry of Health that, in addition to enhancing the level of

professionalism in relation to the application of long-term immobilisation, the above mentioned

measures improve the legal protection of patients’ rights.

If there is a divergence of opinion between the assessments of the two doctors concerning the

need to continue the immobilisation, the decision of the doctor treating the patient will be

decisive, as this doctor will have a more in-depth

familiarity with the patient’s health situation

than the external doctor, and is responsible for the continuing treatment of the patient. The

discrepancy between the two doctors’ assessments of the situation

must, however, be

communicated to the patient both verbally and in writing, as the patient must be fully informed

in case of wishing to lodge a complaint to the Psychiatric Patients’ Complaints Board.

Moreover, the nursing staff can at any time discontinue a physical immobilisation without prior

assessments of a doctor when restraint is no longer deemed necessary.

The Ministry of Health is of the opinion that the above mentioned rules and the surveillance by

the public health medical officers will diminish the risk of abuse and give the patients the

necessary safeguards.

Since the visit of CPT in 2008, different initiatives have been taken in order to reduce the use

of mechanical restraint

–

both nationwide and on a regional basis.

The Psychiatric Act has been amended by the Danish Parliament in 2010. The purpose of the

amendment was among other things to reduce the use of coercion in psychiatry with more

stringent requirements for the use of mechanical restraint, including a minimum frequency of

medical supervision and simultaneous assessment of whether restraint should cease or

continue.

Furthermore, in 2015 the Government will introduce a bill to change the Psychiatric Act in

order to ensure better rights for psychiatric patients, who are subject to detention or coercion.

The proposal will e.g. include measures with the aim to:

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Clarify the legal status of minors in psychiatric care

Ensure a stronger emphasis on the need to seek advance indications from the

patient regarding treatment during the admission interview

Tighten the criteria for and supervision of the use of medical restraint.

Moreover the Government has declared it a goal to improve conditions for people with mental

disorders, including a reduction in the use of coercion.

Paragraph 126

in CPT’s report

CPT’s observation concerning paragraph 126:

The CPT trusts that the Danish authorities will ensure that immobilisation does not take

place in view of other patients.

CPT’s request for information concerning paragraph 126:

Patients at

Sct. Hans

and

Sikringen

were regularly offered a debriefing after having been

subjected to immobilisation. At

Amager,

this was still not systematically the case, but the

delegation was assured that a regular debriefing would be introduced in the near future.

The CPT would like to receive confirmation that this is the case now.

Psykiatrisk Center Sct. Hans has informed the Ministry of Health, that all units at Sct. Hans

have a room dedicated to handling restraining of patients in cases where all other measures

prove inadequate. Staff does its utmost in these situations to show respect for the patient’s

dignity and to make sure that other patients do not witness the situation. Depending on how

and where in the ward a situation takes place, it is not always possible to avoid other patients

witnessing the incident while staff gets the situation under control and escort a patient to the

patient’s room or the dedicated room.

Psykiatrisk Center Amager has informed the Ministry of Health that, as a general rule, other

patients do not witness restraint on fellow patients, as they are being guarded by the staff or

the restraint takes place at the patient´s room.

In special occasions with acute unpredictable and violent behavior from the patient, it can be

necessary to interfere before taking care of the fellow patients at the ward.

Furthermore, if the situation starts a conflict between patients, there will be patients that may

see interference from the staff.

After the Committee’s visit, PC Amager has issued an action plan to ensure that all patients are

being offered an interview/conversation with respect to each and every restraint precaution. It

is a continuous point of focus of the LEAN boards.

It is strived to carry out the interview at the first round, and in the presence of contact person,

doctor and patient.

It is the contact person’s responsibility to make sure that the interview is

carried out.

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Paragraph 127 in CPT’s report

CPT’s observation concerning paragraph 127:

in the CPT’s view, hospital staff should

be sufficient in number and appropriately trained

to handle violent situations without recourse to the police.

Psykiatrisk Center Sct. Hans has informed the Ministry of Health that staff is continuously

screening the patients and the ward environment to anticipate and prevent violent situations.

Sometimes that includes calling staff from other wards to make sure that a situation does not

escalate or

–

if unavoidable

–

to handle a violent situation as considerately as possible for

patient and staff.

The number and training of staff in general enable them to handle these situations.

In very few and special situations the patient behaviour is so violent that regardless of the

number of staff it is considered most safe for patient and staff to ask the police to handle the

situation. The cooperation with the police about this is in general good, and the police are very

respectful in their approach to the patients.

Psykiatrisk Center Amager agrees that it must strive towards being sufficiently and

appropriately staffed to handle the intense situations. It is correct that police are being called,

when it is estimated that the situation cannot be handled without risking security for both

patients and staff. In these situations police can be part of the solution.

As mentioned under paragraph 115

the Danish Government and the other ”satspulje” parties

have agreed on a significant investment of 2.2 billion Danish kr. in psychiatry. The

regions will

as part of the agreement (”satspulje”) have the possibility to hire

up to 500 more people in

psychiatry. This will lead to faster diagnosis and treatment, and thus shorter waiting lists.

Paragraph 128 in CPT’s report

CPT’s recommendation concerning paragraph 128:

The CPT recommends that the Danish authorities take the necessary action to ensure that

pepper spray is only ever authorised inside a hospital when there is a real risk of threat to

life.

The use of pepper spray by the police is governed by the general rules on the use of force by

the police in the Police Act.

The Police Act stipulates that the police may only use force if it is necessary and sensible, and

only by means and to an extent that are reasonable relative to the interest which the police

seek to protect. Force must be used as considerately as possible under the circumstances and

in such a manner that potential bodily harm is minimized. Furthermore, any risk of harm to

bystanders must be taken into consideration.

Specific rules on pepper spray are contained in Executive Order no. 978 of 21 September 2004

(as amended). It follows from this Executive Order that the police is only authorized to

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disperse pepper spray under certain circumstances and that the use of pepper spray always

must be based on an individual assessment with proper consideration taken to the present

circumstances, including the location on which the spray is to be dispersed.

The Ministry of Justice considers the current rules governing the use of pepper spray by the

police to be appropriate and sufficiently strict.

Paragraph 132 in CPT’s

report

CPT’s recommendation concerning paragraph 132:

The CPT calls upon the Danish authorities to reinforce staffing levels in the psychiatric

establishments visited, and notably the number of nurses. Further steps should be taken

to fill the vacant

psychiatrists’ posts at all three establishments as a matter of urgency.

The responsibility for the service provided in the health care lies with the regions. Therefore

the regions are obliged to ensure the appropriate staffing level in the psychiatric wards.

As mentioned in paragraph 115

the Danish Government and the other ”satspulje” parties have

agreed on a significant investment of 2.2 billion Danish kr. in psychiatry. This means e.g. that

as part of

the agreement it will be possible to increase capacity and modernise the regional

psychiatry, which leads to a more equal treatment of psychiatric patients and increased quality

in treatment.

Region Hovedstaden has made the below listed general remark concerning the fact that the

European Committee for the Prevention of Torture and Inhuman or Degrading Treatment or

Punishment (CPT) in its report of September 17, 2014 has commented the staff levels at PC

Amager and PC Sct. Hans, which is found too low. CPT compares The Mental Health Services of

the Capital Region of Denmark (Region Hovedstaden) with i.a. the UK.

The Mental Health Services of the Capital Region of Denmark (Region Hovedstaden) will first

point out the difficulties in relation to comparing staffing of wards at a cross-country level, as

there are significant differences in the proportion of how many psychiatric patients get

hospitalized from country to country. Take for instance the UK, that has far fewer psychiatric

beds per. 1,000 inhabitants, which makes the pressure on each ward higher.

The Capital Region of Denmark´s (Region Hovedstaden) strategy in relation to the psychiatric

beds includes fewer but better staffed psychiatric beds. This approach is commenced but it

must be emphasized that the number of FTEs (fulltime employed) per. 1,000 [patient] bed

days has increased from 4.3 in 2009 to 5.4 in 2013. The Capital Region of Denmark (Region

Hovedstaden) has in recent years

–

in particular in the context of the budget for 2015 -

devoted resources to increase staffing in a number of wards. At the same time as funds have

been allocated to hire about 15 employees, activity offers in the afternoon and evening hours

have increased. In addition, the Ministry of Health has earmarked funds for two projects to

reduce the use of belt restraints by hiring more personnel. Finally, the coming years will see a

significant education effort to increase employee skills in terms of raising the activity in the

wards.

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It may be noted, with respect to the construction project at the New Psychiatric Centre Sct.

Hans, that the Ministry of Health had some requirements associated to new hospital

construction projects to achieve economies of scale in terms of human resources. This is made

possible by placing the ward sections close to each other.

Psykiatrisk Center Sct. Hans has informed the Ministry of Health that Sct. Hans is focusing

both on covering the patients’ needs as nuanced as possible and at achieving the highest

quality level as possible with the resources at hand. That includes careful planning,

recruitment, training and patient involvement. An increase of staff will make it possible to take

those efforts to a higher level. The buildings, though, put a limit to how far it is possible to get.

That situation will change dramatically when the patients move into the new building in a few

years’ time. The new building will offer a wide range of possibilities for the patients, where

insufficient number of staff can become a hindrance to exploit those possibilities.

Regarding vacant psychiatrists’ post the department is

trying in every possible way to recruit

the necessary numbers of psychiatrists including from other countries.

Psykiatrisk Center Amager agrees that there must be sufficient staffing with relevant education

on the intensive wards. Mental Health Services Capital Region of Denmark, will start an

analysis of the 24 hours treatment in primo 2015

–

hereby looking into staffing at the intensive

wards.

It is the assessment of PC Amager that there should be an extra staff in each shift full day. The

first step to accommodate that is that PC Amager in 2015 will receive extra resources equaling

one extra full time staff at each of the two intensive wards. This should contribute to

increasing the activity possibilities for the patients and thereby contribute to reducing the use

of restraint.

Paragraph 133 in CPT’s report

CPT’s request for information concerning paragraph 133:

Sikringen continued to employ 18 security guards from a private security firm, at least

partly because of its long-standing difficulties in recruiting male health-care

staff. […]

The

CPT would like to know if the employment of security staff from a private company is

further envisaged for the new Secure Department at Slagelse and, if so, to be informed

about any safeguards or guidelines in place regulating such employment.

The Psychiatry in Region Zealand has regarding Sikringen informed the Ministry of Health that

the security guards from the private security firm G4S (Group 4 Security) are employed under

a three-year contract concluded between G4S and the Department of Forensic Psychiatry. The

current contract expires in 2016.

The Department does not envisage any changes to the tasks performed by the security guards

or to matters concerning the contract in general, as the Department is satisfied with the work

performed by the security guards.

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If, after relocating to the new psychiatric hospital in Slagelse (in 2015), it turns out to be

possible to recruit a sufficient number of male health-care staff, this could prompt a

reassessment of the need for a future contract.

Paragraph 135 in CPT’s report

CPT’s recommendation concerning paragraph 135:

In the meantime, efforts should be made to equip the outdoor exercise yards at Sct. Hans

with a shelter from inclement weather pending the opening of the new forensic facility.

Psykiatrisk Center Sct. Hans has informed the Ministry of Health that all wards offer patients

sheltered outdoor facilities for relaxation/smoking. The department is positive about the idea

to establish sheltered areas in the outdoor exercise yards.

Paragraph 138 in CPT’s report

CPT’s recommendation concerning paragraph 138:

The CPT recommends that the Danish authorities take the necessary steps to provide all

patients with a wide range of rehabilitative and recreational activities as part of their

treatment plan.

The department at Sct. Hans agrees with the CPT on this recommendation.

Psykiatrisk Center Sct. Hans is continuously trying to increase the type and the number of

activities to be offered to the patients. This includes the possibilities associated with the fact,

that the centre is placed in a large park that needs maintenance. The department is increasing

the numbers of occupational therapists and expects all units to have at least one occupational

therapist at the end of 2015. At the moment several units already have two occupational

therapists. All units already have a staff member dedicated and trained to offer patients

different activities.

The department also offers patients free access to the use of mobile phones, TV and the

internet recognising that this also gives the patients different and individual opportunities of

entertainment and relaxation.

Psykiatrisk Center Amager strives, depending on the patients’ condition, to offer activities for

all on a daily basis, and to include them as a part of the treatment plan for each patient.

PC Amager is in the process of establishing “sense rooms” at both intensive wards, and there

is a gym at the center.

There is an occupational therapist (OT) associated that does groups based and individual

activities with the patients, and in 2015 the OT staffing will be expanded with one extra full

time staff member at each intensive ward. This is to widen the possibilities for goal-oriented

activities with the patients.

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The Psychiatry in Region Zealand has regarding Sikringen informed the Ministry of Health that

all patients

– except for those who for short periods of time are confined to the “0 room” (zero

stimulus room)

–

can access the yard alone or with other patients for at least thirty minutes

twice a day and they also have the possibility of taking part in sports, exercise, classes,

occupational therapy, cooking classes and music therapy.

In the lounge, the occasionally locked-up and not locked-up patients have the opportunity to

meet one another and the staff, and play computer games and other games, watch television,

listen to the radio and generally spend time with others as part of milieu therapy activities. By

and large, patients are allowed to go outdoors every day accompanied by staff (two

employees) on the hospital grounds, nearby areas, or the town and environs, depending on

the patient’s condition, status, etc.

Besides helping and activating the patients, the activities are used by staff to observe the

patients’ condition

and to supplement the observations made while accompanying patients to

bathing and toilet facilities.

The following employees are responsible for handling patients’ activities: 2 physical education

teachers, 1�½ occupational therapists, 6 activity assistants and �½ musical therapist. Adult

special-needs classes are also conducted by external instructors as required and/or requested.

There is no workshop or possibility of actually working.

After relocating to the new psychiatric hospital in Slagelse, it is expected that the staff will

have more time for additional activities with patients, partly because the new premises will be

more expediently designed and furnished.

Paragraph 139 in CPT’s report

CPT’s comment concerning paragraph 139

Access to outdoor exercise was also limited in all three establishments, mainly due to the

lack of staff. For example, at Amager, the delegation met two patients who alleged that

they had not been offered access to the outdoor exercise yard since their admission 13

and 7 days earlier respectively.

CPT’s recommendation concerning paragraph 139:

The CPT recommends that the Danish authorities take the necessary steps to ensure that

all patients are offered at least one hour of outdoor exercise every day.

Psykiatrisk Center Sct. Hans has informed the Ministry of Health, that several outdoor areas

have got a new fence that reduces the risk of absconding and thereby increases the

possibilities for the patients to use the outdoor facilities. The fences were finished after the

visit of the CPT. Otherwise, the CPT report is accurate, and it will be difficult to make major

changes under the current legislation, the current physical standard of the buildings and the

current level of staff.

Psykiatrisk Center Amager has informed the Ministry of Health that the patients at the center

have the option of going outside to the courtyard with the staff.

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Furthermore PC Amager has a football field that can be used in company with the staff. The

patients can, all depending on their condition, daily go outside either by themselves or

accompanied by the staff.

The Psychiatry in Region Zealand has regarding Sikringen informed the Ministry of Health that

after relocating to the new psychiatric hospital in Slagelse, it will be possible to significantly

increase the time spent by patients outdoors.

The new Secure Department has been set up so that three patients can each have direct

access to a private yard. A yard will also be associated with the protected unit (comprising

three or four bed wards, including

the “0 room”) in each of the three new wards, and each of

the three sections will also have a courtyard openly connected to the dining room and an

activity yard. Finally, the new Secure Department will have a common sports field.

As a rule, at present, locked-up patients in the Secure Department at Nykøbing Sjælland have

thirty minutes of access to the yard twice a day.

The “0 room” is a zero stimulus room, which is why patients confined to this room are not

allowed to access the yard. Also, the duration

of confinement to the “0 room” is short (from a

few hours to a few days).

Paragraph 141 in CPT’s report

CPT’s request for comments concerning paragraph 141:

The CPT would like to receive the Danish authorities’ comments regarding the frequent

application of involuntary ECT.

The Government would like to inform CPT that the latest statistics from 2012 show that the

number of voluntary ECT amounted to 17,814 treatments whereas the number of involuntary

ECT amounted to 312 treatments. This is equivalent to

1.7% of all ECT’s in Denmark in 2012.

This is in the Ministry of Health’s opinion not to be characterized as frequent application of

involuntary ECT.

Paragraph 144 in CPT’s report

CPT’s comment concerning paragraph 144

The delegation gained the overall impression that the three-year experiment of using

walking belts had been handled well, with appropriate supervision and outside monitoring

and as much respect for patients’ dignity as possible. Nevertheless

the utmost care should

be taken to ensure that

“walking-restraint” is exclusively applied to patients whose

condition requires restraint and the measure should be ended as soon as it is no longer

necessary. As with any other form of restraint, it should never be applied to compensate

for shortages of trained

staff. Moreover, in the CPT’s view, “walking-restraint”

should not

be a substitution for more modern, professional and less restrictive methods to control

violent behaviour.

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CPT’s recommendation concerning paragraph 144:

The CPT recommends that the Danish authorities take into consideration the above

remarks with a view to reducing resort to mechanical restraint; such a reduction should

not be achieved through an increased recourse to isolation measures.

The Psychiatry in Region Zealand has regarding Sikringen informed the Ministry of Health that

as regards the information about the access of patients with walking restraints to the

surroundings outside the Secure Department, it should be noted that permission to go outside

the department and the terms of this are notified by the Ministry of Justice. The Danish Health

and Medicines Authority is also notified of the special terms of restraint which apply to the

patient concerned.

Paragraph 146 in CPT’s report

CPT’s comment concerning paragraph 146

The measure of locking a patient in his or her room is decided by a doctor. However the

laws does not provide for a regular review of that measure. The CPT’s delegation was

told by the management of

Sikringen

that every patient’s condition and treatment,

including the need for continued locking-up, was discussed every six weeks during the

ward staff meeting.

CPT’s recommendation concerning paragraph 146:

The CPT recommends that the Danish authorities make every effort to radically reduce

the resort to locking patients in their rooms for extensive periods of the day at the Secure

Department of Nykøbing Sjælland Psychiatric Hospital. It should be applied to the

absolute minimum necessary and always on an individual basis, and accompanied by

appropriate safeguards, in particular through provision for a regular formal review.

Locking of patients should never be resorted to due to lack of staff. The alternative to

locking-up is clearly not an increased use of physical immobilisation.

The Psychiatry in Region Zealand has regarding Sikringen informed the Ministry of Health that

the

use of locked confinement for some of the Secure Department’s patients is based on a

specific, individual assessment and is done for either therapeutic or security reasons. This also

means that the use of locked confinement ceases as soon as this is deemed possible.

The use of locked confinement to treat a patient does not mean that the patient is completely

isolated. The employees of the Secure Department observe the requirements for up to ten

minutes of supervision an hour, but they also respect the patients’ individual requests for

contact, including a wish to be alone.

Some of the locked-up patients are only locked up for certain periods every day. Several

locked-up patients are also allowed to go outside, have limited periods of time in the yard or

lounge with other patients, receive occupational therapy, music therapy and take part in

sports.

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Finally it should be noted that before 1987, all patients in the Secure Department were locked

up 24 hours a day, apart from the time spent in workshop activities and in the yard.

The Department expects that after relocating to the new psychiatric hospital in Slagelse

–

with

its better physical framework and possibilities for other environmental-therapy activities with

the patients

–

the need to lock up patients will be reduced.

Paragraph 149 in CPT’s report

CPT’s comment concerning paragraph 149

A patient’s request for discharge has to be responded to by the head doctor only “as soon

as possible and

at least within 24 hours”. In the CPT’s view, the rule should be that a

voluntarily admitted patient is either able to leave the hospital immediately upon his/her

request or, if the conditions for involuntary retention are met, the procedure for

involuntary hospitalisation is initiated.

CPT’s recommendations concerning paragraph 149:

The CPT recommends that legislation and practice are brought in line with this approach.

The Committee further reiterates its recommendation that the retention of a voluntarily

admitted patient requires an opinion from a second doctor who is independent of the

department accommodating the patient.

In order to use detention or compulsory treatment the patient must be insane or in a condition

similar to insanity. The following two conditions must be met prior to any compulsory

admission of a patient to a psychiatric ward:

1. The patient must be insane (mentally ill) or in a similar condition and

2. It must be deemed unjustifiable not to admit the patient for treatment.

This is the case:

When the prospect of recovery or a significant and decisive improvement of the

patient’s condition would otherwise be seriously reduced, or

When the patient exposes him or herself or others to significant harm.

The conditions for detaining an admitted patient are the same conditions that apply to

compulsory admission. If these conditions are not met patients, who wish so, must be

discharged.

If a patient in a psychiatric ward wants to be discharged, the consultant doctor must decide

within 24 hours whether the patient may be discharged or is to be detained. If the patient has

been involuntarily admitted and requests to be discharged within the first 24 hours following

admission, the consultant doctor must inform the patient no longer than 48 hours after

admission whether he or she may be discharged.

The time limit of 24 and 48 hours is stipulated so that the head doctor will obtain adequate

time to establish whether the patient meets the conditions of being detained or discharged as

mentioned above.

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The Ministry of Health has no immediate plans to alter this arrangement.

However the Ministry of Health would like to point out, that whenever a patient is exposed to

coercive measures it must be noted in a special protocol at the psychiatric ward, and this

information is also reported to the local authorities as well as the central Governmental

institutions.

In the Regional State Administrations a local Patient Board of Complaints is set up. Complaints

about the board’s decisions concerning the deprivation

of liberty (involuntary placement and

forcible detention), restraint, involuntary treatment in out-patient care, protective restraint,

and locking of doors in the ward, can be lodged to the regular court system. The Court

appoints a lawyer for the patient, and the costs are paid by the State.

Furthermore, the patient must be offered a patient advisor to safeguard these rights.

Paragraph 150 in CPT’s report

CPT’s comment concerning paragraph 150

If the application of restraint to a voluntary patient is deemed necessary, the legal status

of the patient as “voluntary” should be reviewed. This would secure the patient’s

safeguards under Danish law.

CPT’s recommendation concerning paragraph 150:

The CPT recommends that whenever restraint is applied to a voluntary patient, the legal

status of that patient should be reviewed.

In Denmark no admission, examination, treatment or care may be initiated or continued

without informed consent of the patient unless otherwise provided for by statute or statutory

provisions. Every time a person is subjected to coercive measures a separate protocol has to

be filled out as required by the Danish Psychiatric Act. Besides, this information is also

reported to the National Board of Health. The Danish data for the use of coercion are of high

quality, publicly available and highly validated.

Other safeguards in connection with coercive measures are the assignment of a patient

advisor. The advisor must be assigned as soon as the decision has been taken and has to visit

the patient within 24 hours of being assigned. Whenever coercive measures are used, the

patient must be advised on complaints procedures.

Furthermore, patients have the right to be informed why coercion is required and what effect

treatment may be expected to have on their health condition, including what the outcome may

be if the treatment is not undertaken.

As mentioned above the patient also has the right to appeal the decision and in some cases

access to legal representation.

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Paragraph 151 in CPT’s report

CPT’s comment concerning paragraph 151:

The examination of annual reports from the Patient Complaint Board of Sjælland Region

showed a number of hospital decisions on involuntary hospitalisations, forced medication

and the use of restraint had been overruled by the Board. However it is unclear whether

the overruled decisions have a wider impact on the way in which the hospitals concerned

practice the application of coercion.

CPT’s request for information concerning paragraph 151:

The CPT would like to be informed whether there are any wider policy implications

emerging from the individual Board decisions.

The Region Hovedstadens Psykiatri has informed the Ministry of Health that in Denmark there

are no wider policy implications emerging from the individual Board decisions.

The responsibility for the professional treatment of patients and the quality development of

patient treatment lie with the local management of each section of the psychiatric centres of

the Capital Region (Region Hovedstaden), and with the Head of Clinic of each centre. The

decisions made by the Patient Complaints Board serve as an important source of learning.

In connection with the upcoming revision of the hospitals internal guideline to handling

complaints on involuntary hospitalizations, forced medication and the use of restraint the

Mental Health Services of the Region Hovedstaden will develop guidelines to ensure a more

systematic use of the decisions of the Board in quality development.

The Psychiatric Patient Complaint Board has informed the Ministry of Health that the Board has

no authority to take any political initiative in this respect.

However, the Psychiatric Patient Complaint Board attempts to provide an overview for the

political decision-makers by drawing up an annual report on its activities. For the very first

time the Psychiatric Patient Complaint Board has drawn up an annual report covering the

entire country with its report for 2013.

The Psychiatric Patient Complaint Board presents its annual report to the Ministry of Health, to

the Parliament and to the Danish Health and Medicines Authority.

The Psychiatric Patient Complaint Board is willing to discuss its practice with the hospitals and

patient advisors when participating in local meetings around Denmark.

The intent of having an appeals board is to impact the practice of the Patient Complaints Board

and also to impact the hospital decisions on - in most cases - forced medication. There can be

various reasons for the appeals board to overrule a decision from the Psychiatric Patients

Complaints Board. However, the appeals board has noticed that a main reason for overruling

decisions regarding forced medication has been lack of or insufficient motivation of the patient

for voluntary medication. This may also be due to lack of documentation of the motivation. The

appeals board does not have any information as to whether the individual regions have

adapted their policies accordingly, but it is our impression that several departments are

beginning to systematize their motivation of the patients further, for instance by using

separate sheets in the medical records listing what the specific patient needs to be informed of

§71, Alm.del - 2014-15 (1. samling) - Bilag 47: Orientering om Danmarks samlede besvarelse på Torturkomitens rapport, fra ministeren for sundhed og forebyggelse

and motivated for daily, including when the patient in fact has been informed and motivated

for the treatment.

Paragraph 152 in CPT’s report

CPT’s recommendation concerning paragraph 152:

The CPT reiterates its recommendation to ensure that all forensic patients and patients

subject to physical immobilisation benefit from the appointment of a representative with

the necessary skills and duties to support him/her effectively in the exercise of his/her

patient’s rights in accordance with Danish law.

It follows from Section 71 of the Danish Criminal Code that where there is a possibility that the

court may order an accused to be placed in an institution or in safe custody, the court may

appoint for him a guardian representative (“bistandsværge”), who together with the assigned

lawyer is to assist the accused/defendant in the proceedings. According to this provision, the

guardian representative should preferably be a member of the immediate family of the

accused/defendant.

The legislator has thus found that where a guardian representative is to be appointed in a case

that may result in a judgment ordering a defendant to be placed in an institution or in safe

custody, the guardian representative shall preferably be a person whom the

accused/defendant knows and trusts. In such a situation, the defendant will also have a

defence lawyer to safeguard his rights.

In pursuance of Section 71(2) of the Danish Criminal Code, the court shall appoint a guardian

representative (“bistandsværge”) where it is ordered that the defendant must be placed in an

institution or in safe custody, or where the decision gives rise to this possibility. According to

this provision, the guardian representative shall stay apprised of the condition of the convicted

person, and see to it that the stay and other measures last no longer than necessary.

According to section 3(3) of Statutory Order No. 947 of 24 September 2009, concerning

guardian representatives issued by the Ministry of Justice, the guardian representative should

preferably be a member of the immediate family of the accused/defendant.

The police are required to initially ask if there is a specific person the person in question would

like to have appointed as a guardian. If the person in question does not have a specific

request, does not have near relatives, or neither of the persons are willing or

suitable/qualified, the police shall appoint a representative from the official list of Guardians

issued by the Danish authorities [statsforvaltningen] cf. Section 5(2) of Statutory Order No.

947 of 24 September 2009.

It should be noted, that if a guardian representative who is also a member of the immediate

family of the accused/defendant grossly neglects the duties following from the appointment, or

otherwise appears to be unsuited for the task, the court can decide that the person in question

be disqualified from performing the task as guardian representative, cf. Section 17(5), cf.

Section 17(2) of Statutory Order No. 947 of 24 September 2009.