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English Language Page Provision of acceptable environment and walking courtyards that are suitable for both children and senior patients is extremely important because the mobility of the majority of patients is limited — they are forbidden to leave the boundaries of the clinic and therefore they have no alternative to the clinical territory. The survey demonstrated that patients of certain institutions are forced to take their walks in unsuitable and uncared-for courtyards that do not meet ecological requirements. The most dispiriting situation with walks was identified at the Rostov-on-Don psychiatric clinic whose territory is neglected and which is located right next to a military base whose weapons and other military equipment constantly produces a lot of noise. The territory of the Dankovskaya psychiatric clinic of the Lipetsk region is totally uncared-for: on the entire territory of the institution there are only three trees and several benches. Walks are an ordeal on the territory of the Altai republican hospital due to a high concentration of dust and permanent clamor. In one of the clinics it is in the walking courtyard for patients institutionalized against their will that there are no trees at all, which is a discrimination against this particular category of patients. Upon the whole clinical territories are well taken care of even though the practice of allocating separate walking courtyards for different categories of patients remains rather pervasive . We are speaking of internal fences or wire gauzes around walking areas. The existence of internal fences is often criticized as a stigmatizing and anti-human isolation measure which may be acceptable only with respect to socially dangerous mental patients undergoing involuntary treatment due to prior delinquent behavior. But the majority of leaders of psychiatric institutions are not prepared to give up the fences and wire gauzes inherited from the Soviet psychiatry considering them to be absolutely necessary for the organization of patients’ walks. Thus, the desire to comply with safety requirements in many cases unnecessarily limits free movement and interaction of patients within the clinic. Practice shows that absence of fences does not result in a significant growth of escapes from institutions but not many can pull up the courage to remove the barrages (there are no internal fences in both Moscow regional psychiatric clinics (Central #1 and #2). Neglect of adjacent territories may result in the fact that walking conditions stop meeting the goals of rehabilitation. For example, patients of the Chita regional psychiatric clinic #2 take their walks on barred balconies. In this case the method of organization of patients’ walks can be viewed as humiliating one’s human dignity. The setup and organization of territories of the rest of the surveyed institutions is mostly primitive. At best — it is walking paths and benches, sports installments and exercise areas, at worst — walking paths and wire gauzes. The setup of territories of some institutions was found to be outdated and requiring refurbishment (e.g., the Novgorod regional psychiatric clinic), others had only a portion of their territory adapted for taking walks (e.g., the Tver regional psychiatric clinic #2 where benches are only available at the building for senior patients). |
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