European Court of Human Rights

 

 

THIRD SECTION

CASE OF A.G. v. RUSSIA

(Application no. 9800/12)

 

 

 

 

JUDGMENT

STRASBOURG

15 June 2021

 

This judgment is final but it may be subject to editorial revision.

In the case of A.G. v. Russia,

The European Court of Human Rights (Third Section), sitting as a Committee composed of:

          Darian Pavli, President,
          Dmitry Dedov,
          Peeter Roosma, judges,
and Olga Chernishova, Deputy Section Registrar,

Having regard to:

the application (no. 9800/12) against the Russian Federation lodged with the Court under Article 34 of the Convention for the Protection of Human Rights and Fundamental Freedoms (“the Convention”) by a Russian national, Ms A.G. (“the applicant”), on 25 January 2012;

the decision to give notice of the application to the Russian Government (“the Government”);

the decision not to disclose the applicant’s identity (Rule 47 § 4 of the Rules of Court);

the parties’ observations;

Having deliberated in private on 25 May 2021,

Delivers the following judgment, which was adopted on that date:

INTRODUCTION

1.  The application concerns the allegedly unlawful continued involuntary treatment in a psychiatric facility (Article 5 § 1 of the Convention), lengthy periods of appeal review of the decisions of the Sovetskiy District Court of Kazan (“District Court”) adopted on 1 June and 18 October 2011 (Article 5 § 4 of the Convention), as well as inadequate conditions of detention in the psychiatric facility and unlawful use of physical restraints (Article 3 of the Convention).

THE FACTS

THE CIRCUMSTANCES OF THE CASE

2.  The applicant, Ms A.G., is a Russian national, who was born in 1981 and lives in Kazan. The applicant was represented by Ms I.V. Khrunova, a lawyer practising in Kazan.

3.  The Government were represented by their Agent, Mr M. Galperin, Representative of the Russian Federation at the European Court of Human Rights.

4.  The facts of the case, as submitted by the parties, may be summarised as follows.

A.    Proceedings for involuntary psychiatric examination

5.  On 28 September 2006 the applicant was convicted of attempted drug trafficking and sentenced to four years imprisonment in the ordinary-regime correctional colony.

6.  On 22 July 2008 she was transferred for a planned voluntary psychiatric examination to the State Psychiatric Hospital of the St Petersburg Federal Penitentiary Service in the Yaroslavl Region (Федеральное Казенное Лечебно-Профилактическое Учреждение «Специализированная психиатрическая больница Управления Федеральной службы исполнения наказаний по Ярославской области») (“the Hospital”).

7.  On 26 March 2009 a panel of psychiatrists issued a report, concluding that the applicant suffered from a chronic paranoid schizophrenia and paranoid hallucinatory syndrome, and that she had not been able to understand or control her actions. The report further stated that she could not continue to serve her sentence and therefore needed compulsory inpatient treatment in a psychiatric facility.

8.  On 28 April 2009 the Rybinsk Town Court of the Yaroslavl Region released the applicant and ordered her to undergo compulsory medical treatment in a psychiatric facility. It relied on the findings and recommendations of the hospital’s report of 26 March 2009 in its reasoning.

9.  Between 3 May 2009 and 19 December 2011 the applicant was hospitalised in the Republican Clinical Psychiatric Hospital of the Republic of Tatarstan (ГАУЗ «Республиканская клиническая психиатрическая больница им. В. М. Бехтерева Министерства Здравоохранения Республики Татарстан») (“the Psychiatric Hospital”).

10.  Between 6 May 2010 and 2 August 2011 the District Court extended on several occasions the applicant’s inpatient involuntary treatment with reference to periodic findings of a panel of psychiatrists, the opinion of attending psychiatrists, as well as conclusions of an independent forensic psychiatric examination carried at the request of the applicant’s representative. The decision to extend her hospitalisation of 1 June 2011 was upheld on appeal by the Supreme Court of Tatarstan on 2 August 2011. The applicant was represented by her guardian appointed by the District Court on 18 October 2010 and her legal counsel.

11.  According to medical reports, the applicant suffered from auditory hallucinations, was not able to maintain daily relationships and answer questions, immersed in her worries and occasionally laughed and cried without any reason. She unconsciously carried out impulsive actions such as taking other patients’ cigarettes or clothes away or grabbing a key from the doctor’s pocket. She calmed down only after intramuscular injections.

12.  On 18 October 2011 the District Court extended the applicant’s treatment in the psychiatric hospital, however on 2 December 2011 the Supreme Court of Tatarstan quashed that decision.

13.  On 19 December 2011 the District Court ordered the applicant’s compulsory treatment to be discontinued and changed it to out-patient surveillance and psychiatric treatment at the place of residence. It relied on the findings of a medical examination of 1 December 2011 according to which the applicant had significant improvement of her mental health.

B.    Conditions of detention in a psychiatric hospital

14.  On 3 May 2009 the applicant was placed in the fifteenth unit of the psychiatric hospital where she remained until 21 December 2011.

15.  There were no toilet and washing facilities in the room and the patients had to use commode chairs (кресла-туалеты), which were separated from the living area by a cloth-screen. They were cleaned only once a day and bad smell persisted in the room. Moreover, until autumn 2011 this unit did not have a recreation yard and patients were therefore confined in their rooms day and night.

16.  In addition, medical staff with the help of male patients of the facility repeatedly used physical restraints on the applicant by attaching her hands and legs to a bed.

17.  On 14 March 2012 the District Court acknowledged a violation of the applicant’s rights due to lack of proper toilet facilities and lack of privacy for toilet, as well as due to the use of physical restraints with the assistance of male patients. The court awarded the applicant 15,000 Russian roubles (RUB) (approximately 400 euros (EUR) at the time) for non‑pecuniary damage. On 10 May 2012 the decision was upheld on appeal by the Supreme Court of Tatarstan.

RELEVANT Domestic law

18.  A summary of relevant domestic law was provided in the case of Zagidulina v. Russia (no. 11737/06, §§ 21-30, 2 May 2013).

THE LAW

I.         ALLEGED VIOLATION OF ARTICLE 3 OF THE CONVENTION

19.  The applicant complained of inadequate conditions of detention in the psychiatric facility. In particular, she alleged that the manner of access to sanitary facilities and the use of physical restraints had amounted to inhuman or degrading treatment contrary to Article 3 of the Convention, which reads as follows:

“No one shall be subjected to torture or to inhuman or degrading treatment or punishment.”

A.    Admissibility

20.  The Government argued that the applicant could no longer claim to be a victim of the violation of her rights under Article 3 of the Convention, as the domestic courts had acknowledged the violation and redressed it by allowing the applicant’s action against the psychiatric hospital and awarding her compensation for non-pecuniary damage (see paragraphs 14-17 above).

21.  The Government further submitted that in any case the applicant had not exhausted the domestic remedies by having failed to lodge a cassation appeal.

22.  The applicant insisted that the conditions in the psychiatric hospital had been inhuman and degrading. She further argued that, despite the fact that the domestic courts had acknowledged the violation of her rights, she had not lost her “victim” status, as the compensation of RUB 15,000 could not be considered as an adequate redress for two and a half year of hospitalisation in appalling conditions.

23.  The Court first observes that the Government objected that the applicant had failed to bring two cassation appeals in the civil proceedings for compensation. However, according to the Court’s practice, a decision taken by a second-instance court at regional level under the former cassation procedure in Russia was a final national decision for the purposes of Article 35 of the Convention. The rule to exhaust two-level cassation in civil proceedings under the new cassation procedure has been applied since 4 June 2015 (see Abramyan and Others v. Russia (dec.), nos. 38951/13 and 59611/13, §§ 69-73, 12 May 2015). The Court observes that the applicant lodged the application on 25 January 2012 when the new cassation procedure did not exist. Accordingly, the Court dismisses the Government’s objection.

24.  The Court further notes that the Government raised the objection that the applicant had lost the victim status. This issue is closely linked to the merits of the applicant’s complaint and the Court finds it necessary to join the examination of the Government’s objection to the merits of the applicant’s complaint under Article 3 of the Convention.

B.    Merits

25.  It is a common ground between the parties that the conditions of the applicant’s hospitalisation and the treatment to which she had been subjected in the psychiatric hospital had been in breach of Article 3 of the Convention.

26.  The Court notes that the national courts in compensation proceedings (see paragraph 17 above) had effectively acknowledged a violation of the applicant’s rights under Article 3 of the Convention by the conditions of her hospitalisation and the use of the physical restraints. The Court notes with attention the national courts’ findings and does not discern any grounds to rule otherwise.

27.  Turning to the compensation awarded to the applicant in connection with the above violation, it must be observed that RUB 15,000 (EUR 400) is considerably lower than the amounts awarded in comparable cases by the Court (see, for example, Yefimenko v. Russia, no. 152/04, § 171, 12 February 2013, Butrin v. Russia, no. 16179/14, § 74, 22 March 2016, Kolesnikovich v. Russia, no. 44694/13, § 88, 22 March 2016). Therefore, the Court concludes that the redress provided to the applicant on the national level was not sufficient to deprive the applicant of her victim status.

28.  Accordingly, the Court dismisses the Government’s objection and concludes that there had been a violation of Article 3 of the Convention.

II.      ALLEGED VIOLATION OF ARTICLE 5 § 1 OF THE CONVENTION

29.  The applicant complained that her continued involuntary treatment in a psychiatric facility had been unlawful due to the failure of the national authorities to meet the substantive requirements for the exception under sub‑paragraph (e) of Article 5 § 1 of the Convention. The Article reads as follows in its relevant part:

“1.  Everyone has the right to liberty and security of person. No one shall be deprived of his liberty save in the following cases and in accordance with a procedure prescribed by law:

...

(e)  the lawful detention ... of persons of unsound mind ...”

30.  The Government contested that argument.

31.  The Court must first examine whether this complaint complies with the requirements of Article 35 of the Convention.

32.  The applicant argued that her continued involuntary treatment had not been justified and the courts should have relied on the evidence beyond medical opinions. She also alleged that the medical examinations had not been carried out by independent specialists.

33.  The Government in their submissions disagreed with the applicant’s allegations and maintained that the national authorities, including medical professionals and judges, had given careful consideration to the applicant’s health conditions and provided good reasons for their decisions.

34.  The applicable general principles have been established by the Court in the case of Winterwerp v. the Netherlands (24 October 1979, §§ 37-52, Series A no. 33) and recently confirmed in the case of Ilnseher v. Germany ([GC], nos. 10211/12 and 27505/14, §§ 126-141, 4 December 2018). In particular, an individual cannot be deprived of his liberty as being of “unsound mind” unless the following three minimum conditions are satisfied: firstly, he must reliably be shown to be of unsound mind, that is, a true mental disorder must be established before a competent authority on the basis of objective medical expertise; secondly, the mental disorder must be of a kind or degree warranting compulsory confinement; thirdly, the validity of continued confinement depends upon the persistence of such a disorder (ibid.).

35.  Turning to the present case, the Court observes that the parties did not dispute that the applicant had a mental disorder and her involuntary placement in a psychiatric facility had entailed a deprivation of liberty. The parties further agreed that the applicant’s admission to hospital had complied with the formal procedural requirements of the domestic law. However, the applicant disagreed that the extension of a such measure was lawful within the meaning of Article 5 § 1 (e) of the Convention.

36.  The Court further notes that the decision placing the applicant in a psychiatric facility for treatment, as well as the subsequence extensions of that decision were issued by the domestic courts in line with periodically conducted medical recommendations and took into account her contemporaneous mental state (see paragraphs 7, 10-11 above). Lastly, the applicant was released once an improvement of her mental state has been established (see paragraph 13 above).

37.  Moreover, the Court is satisfied that the applicant was represented by her guardian and her legal counsel, who were able to present their arguments in the proceedings. The Court notes in particular that the domestic courts granted the requests to adjourn hearings and order an independent psychiatric examination (see paragraph 10). Despite the applicant’s allegations to the contrary, her relatives’ statements were duly assessed by the domestic courts in the extension proceedings.

38.  In view of the above, the Court is satisfied that the authorities reliably established that the applicant had a true mental disorder, that this disorder was of a kind or degree warranting compulsory confinement and that the validity of the continued confinement depended upon the persistence of that disorder (see Winterwerp, cited above, § 39). Accordingly, the applicant’s complaint under Article 5 § 1 of the Convention is manifestly ill-founded and must be rejected under Article 35 §§ 3 and 4 of the Convention.

III.   ALLEGED VIOLATION OF ARTICLE 5 § 4 OF THE CONVENTION

39.  The applicant further complained that the domestic courts had not decided speedily on her appeals against judicial decisions of 1 June and 18 October 2011 authorising extension of her continued hospitalisation. Article 5 § 4 reads as follows:

“4.  Everyone who is deprived of his liberty by arrest or detention shall be entitled to take proceedings by which the lawfulness of his detention shall be decided speedily by a court and his release ordered if the detention is not lawful.”

A.    Admissibility

40.  The Court notes that these complaints are not manifestly ill-founded within the meaning of Article 35 § 3 of the Convention. It further notes that they are not inadmissible on any other grounds. They must therefore be declared admissible.

B.    Merits

41.  The applicant argued that she promptly lodged the appeals and the delays of over forty days were incompatible with the requirement of speediness under Article 5 § 4 of the Convention.

42.  The Government stated that the Supreme Court of Tatarstan had reviewed the applicant’s appeals within a reasonable time.

43.  The applicable general principles have been summarised by the Court in the case of Ilnseher, cited above, §§ 251-56.

44.  The Court observes that the first round of appeal proceedings lasted between 3 June 2011 and 2 August 2011 and the second round between 26 October 2011 and 2 December 2011, i.e. sixty-two and forty-six days respectively.

45.  Nothing in the available materials or in the parties’ submissions indicates that the above delays could be attributable to the applicant or could be justified by any objective obstacles. Accordingly, the Court considers that the above periods of sixty-two and forty-six days cannot be considered compatible with the “speediness” requirement of Article 5 § 4. There has therefore been a violation of that provision.

IV.   APPLICATION OF ARTICLE 41 OF THE CONVENTION

46.  Article 41 of the Convention provides:

“If the Court finds that there has been a violation of the Convention or the Protocols thereto, and if the internal law of the High Contracting Party concerned allows only partial reparation to be made, the Court shall, if necessary, afford just satisfaction to the injured party.”

A.    Damage

47.  The applicant claimed just satisfaction in respect of non-pecuniary damage in the amount to be determined by the Court.

48.  The Government objected to that claim.

49.  The Court, having regard to the violations found and the domestic award, awards the applicant 25,600 euros (EUR) in non-pecuniary damage.

50.  The Court considers it appropriate that the default interest rate should be based on the marginal lending rate of the European Central Bank, to which should be added three percentage points.

B.    Costs and expenses

51.  The applicant also claimed EUR 2,430 for the costs and expenses.

52.  The Government objected to that claim.

53.  Regard being had to the documents in its possession and to its case law on the matter, the Court considers it reasonable to award this claim in full to cover costs and expenses under all heads.

FOR THESE REASONS, THE COURT, UNANIMOUSLY,

1.      Declares the complaints under Articles 3 and 5 § 4 admissible and the complaint under Article 5 § 1 inadmissible;

2.      Holds that there has been a violation of Article 3 of the Convention on account of conditions of the applicant’s hospitalisation in a psychiatric facility and the use of physical restraints;

3.      Holds that there has been a violation of Article 5 § 4 of the Convention on account of the length of appeal review proceedings concerning extensions of her hospitalisation;

4.      Holds

(a)  that the respondent State is to pay the applicant, within three months, the following amounts, to be converted into the currency of the respondent State at the rate applicable at the date of settlement:

(i) EUR 25,600 (twenty-five thousand six hundred euros), plus any tax that may be chargeable, in respect of non-pecuniary damage;

(ii) EUR 2,430 (two thousand four hundred and thirty euros) plus any tax that may be chargeable to the applicant, in respect of costs and expenses;

(b)  that, from the expiry of the above-mentioned three months until settlement, simple interest shall be payable on the above amounts at a rate equal to the marginal lending rate of the European Central Bank during the default period plus three percentage points.

Done in English, and notified in writing on 15 June 2021, pursuant to Rule 77 §§ 2 and 3 of the Rules of Court.

{signature_p_1}                                                                    {signature_p_2}

Olga Chernishova                                                                    Darian Pavli
Deputy Registrar                                                                       President