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The CPT has published the report on its visit to Ukraine, carried out from 26 May to 6 June 2025, together with the response of the Ukrainian authorities.
This was the Committee’s second visit to Ukraine following the outbreak of Russia’s full-scale military invasion in February 2022. The delegation focused on the situation of individuals placed without their consent in psychiatric facilities, as well as persons residing in social care institutions (“internats” and “pensions”) serving people with disabilities and the elderly. The facilities inspected included psychiatric hospitals in Lviv (Kulparkiv), Orlivka (Sarny), and Hlevakha (near Kyiv), along with the Hruskhivskyi internat in Lviv region, a pension for elderly and disabled persons in Vinnytsia, and the Baraboi internat in Odesa region.
Throughout all the establishments visited, the delegation received no reports of physical mistreatment by personnel. The general atmosphere was calm, and interactions between staff and patients or residents appeared constructive and respectful. Incidents of conflict between patients or residents did arise on occasion, but these were relatively minor and staff responded to them in a timely and appropriate manner.
The quality of living conditions differed considerably across and within the establishments. Wards that had undergone renovation offered notably positive conditions, with patients and residents housed in smaller, well-appointed, and individually personalised rooms. Most other wards provided acceptable, if more modest, accommodation. However, unrenovated sections presented markedly inferior conditions, characterised by overcrowded and bare dormitories, inadequate personal storage space, limited privacy, and an absence of any personal touch. Renovation works were underway across all visited institutions with the aim of gradually raising all wards to the standard of the already refurbished ones.
Staffing levels in the psychiatric hospitals were broadly adequate in medical terms, though shortfalls were noted in psychological support and allied therapeutic professions such as occupational therapy, physiotherapy, and social work. The social care homes faced more acute deficiencies, lacking sufficient numbers of doctors, nurses, and care assistants, while the scarcity of therapeutic and rehabilitation professionals was an equally pressing concern.
Treatment across all three psychiatric hospitals relied predominantly on pharmacotherapy, which was broadly appropriate, though prescribing practices at the Orlivka facility occasionally involved unusually high dosages and combinations of medication. Psychosocial and rehabilitative activities were available at Hlevakha and across most wards in Lviv, but remained scarce in Orlivka. The CPT calls on the Ukrainian authorities to redouble efforts to broaden the range of therapeutic approaches and to draw more patients into rehabilitative programmes, which will necessitate hiring additional qualified professionals.
In the social care establishments, pharmaceutical treatment was similarly the dominant mode of care, drawing largely on a narrow selection of older antipsychotic medications. The availability of psychosocial therapies and structured activities was also quite restricted. Concrete steps are needed to expand such provision for residents of these facilities.
None of the psychiatric hospitals visited made use of seclusion. Mechanical restraint was employed only occasionally, as a genuine last resort, and for brief periods only. Ward-level documentation of restraint was satisfactory, but no centralised registers existed. Chemical restraint, although used in practice, was not recorded at all. A significant concern at both Kulparkiv and Orlivka was that patients were sometimes physically restrained in the presence of other patients. At Kulparkiv, the delegation also noted instances where healthcare staff enlisted police officers to assist in restraining patients. These practices must be brought to an end.
The CPT considers that, as a matter of principle, restraint measures have no place in social care settings. Institutions should pursue a policy of progressively eliminating such measures and replacing them with de-escalation approaches, for which staff must receive appropriate training. On those exceptional occasions where a resident remains agitated despite de-escalation efforts, the standard response should be to summon emergency medical services with a view to promptly transferring the individual to a more suitable clinical environment.
With regard to involuntary psychiatric admission and treatment, the applicable legal framework appeared to be properly adhered to in practice in both civil and forensic contexts. Encouragingly, all patients had access to legal representation, generally appointed ex officio, and judicial hearings consistently took place. Nevertheless, the CPT has reservations about whether the consent given by patients on admission could truly be regarded as voluntary and based on adequate information.
In the social care institutions, the legal requirements were broadly observed, including the signing of agreements between residents or their legal guardians and the directors of the facilities, as well as mandatory reviews by medical and medico-social expert commissions. However, residents were not routinely provided with copies of these agreements, and staff rarely made meaningful efforts to explain the documents’ contents or to inform residents of their right to seek discharge. The Ukrainian authorities must address these shortcomings without delay.
The Committee further reiterates its longstanding concern that, in all three social care establishments visited, the role of legal guardian for incapacitated residents is frequently assumed by the facility director — a practice the CPT has repeatedly criticised. The Ukrainian authorities must identify and implement alternative arrangements that provide genuine independence and impartiality in the exercise of guardianship functions.
In their response, the Ukrainian authorities provided information on steps taken and planned in light of the CPT’s recommendations, referring inter alia to ongoing legislative and policy reforms — including deinstitutionalisation initiatives — as well as continued efforts to enhance living conditions, strengthen staffing, and expand access to therapeutic services.
