Information Note on the Court’s case-law No. 103

December 2007

Dybeku v. Albania - 41153/06

Judgment 18.12.2007 [Section IV]

Article 46

General measures

Urgentimprovement of prison conditions: appropriate conditions of detention and adequate medical treatment for prisoners requiring special care on account of their health

Article 3

Degrading treatment

Inhuman treatment

Conditions of detention of a prisoner suffering from mental disorders: violation

Facts : Since 1996 the applicant has been suffering from chronic paranoid schizophrenia. For many years he has received in-patient treatment in various psychiatric hospitals in Albania. In August 2002 criminal proceedings were brought against him and he was eventually arrested and charged with murder and illegal possession of explosives. He was placed in a pre-trial detention facility, where he shared a cell with an unspecified number of prisoners. In May 2003, on the basis of a medical report, which concluded that at the time of the offence the applicant was in remission, the competent court ruled that he was fit to stand trial. The court found him guilty and sentenced him to life imprisonment. The applicant appealed unsuccessfully and his requests for new medical examinations were rejected as unnecessary. Since December 2003 the applicant has been in three different prisons: Tirana Prison no. 302, Tepelene Prison and Peqin Prison, where he has shared cells with inmates who were in good health and has been treated as an ordinary prisoner, despite his state of health. According to the authorities, it was impossible to provide the applicant with the requisite medical treatment and so he was treated with drugs similar to those prescribed by his doctor. He received in-patient treatment in Tirana Prison Hospital only when his health worsened in May/June 2004 and December 2004 and January 2005. The applicant’s father and lawyer lodged several complaints with the competent authorities against the prison hospital administration and the medical unit, alleging that they had been negligent in failing to prescribe adequate medical treatment and that the applicant’s health had deteriorated because of the lack of treatment. Their complaints were dismissed. Given the applicant’s increasingly disturbed state of mind, in January 2005 his lawyer brought proceedings asking for him to be released or transferred to a medical facility on the ground that his detention conditions were inappropriate and put his life at risk. The applicant’s counsel also asked for psychiatric examinations to be undertaken. Those requests were rejected and the applicant’s subsequent appeals were unsuccessful.

Law : Article 3 – The parties agreed that the applicant was suffering from a chronic mental disorder which involved psychotic episodes and feelings of paranoia. His condition had also deteriorated by the time he received in-patient treatment in Tirana Prison Hospital. The Court further noted that all the complaints from the applicant’s father and lawyer had been disregarded and that the last assessment of the applicant’s health dated back to 2002. The applicant’s medical notes showed that he had repeatedly been prescribed the same treatment and that no detailed description of the development of his illness had been given. The feeling of inferiority and powerlessness typical of those suffering from a mental disorder called for increased vigilance in reviewing whether the Convention had been complied with. While it was for the authorities to decide, on the basis of the recognised rules of medical science, on the therapeutic methods to be used to preserve the physical and mental health of patients who were incapable of deciding for themselves, and for whom they were therefore responsible, such patients nevertheless remained under the protection of Article 3. The Court accepted that the very nature of the applicant’s psychological condition made him more vulnerable than the average detainee and that his detention might have exacerbated to a certain extent his feelings of distress, anguish and fear. The fact that the Government admitted that the applicant was treated like the other inmates, notwithstanding his particular state of health, showed a failure to comply with the Council of Europe’s recommendations on dealing with prisoners with mental illnesses. The Government had also failed either to submit detailed information about the material conditions of the applicant’s detention or to show that those conditions were appropriate for a person with his history of mental disorder. Furthermore, the applicant’s regular visits to the prison hospital could not be viewed as a solution since the applicant was serving a sentence of life imprisonment. Many of those shortcomings could have been remedied even in the absence of considerable financial means. In any event, a lack of resources could not in principle justify detention conditions so poor as to reach the threshold of severity for Article 3 to apply. The Court took into account the cumulative effects of the entirely inappropriate conditions of detention to which the applicant was subjected, which clearly had had a detrimental effect on his health and well-being. It also took note of the Council of Europe’s Committee for the Prevention of Torture’s findings in its latest reports concerning the detention conditions in Albanian prisons, particularly with regard to prisoners with mental illnesses. It concluded that the nature, duration and severity of the ill-treatment to which the applicant had been subjected and the cumulative negative effects on his health were therefore sufficient to be qualified as inhuman and degrading.

Conclusion : violation (unanimously).

Article 41 – EUR 5,000 in respect of non-pecuniary damage.

Article 46 – Albania was to take the necessary measures, as a matter of urgency, to secure appropriate conditions of detention, and in particular adequate medical treatment, to prisoners requiring special care on account of their state of health.

© Council of Europe/European Court of Human Rights This summary by the Registry does not bind the Court.

Click here for the Case-Law Information Notes