Prohibition of Torture, Inhuman or Degrading Treatment

II. Rights of Persons in Closed Type Institutions and Deinstitutionalization

Residential Care Homes for Infants and Children

 The UN Convention on the Rights of the Child establishes that children that are temporarily or permanently deprived of their family environment, or when remaining in said environment is against their interests, have a right to state protection and support.[1] When planning and providing services to families, the state must ensure the child's right to, above all, be raised in his own family, and should only take the child away if all measures to help the family have been exhausted and the efforts of social workers had failed.[2] Should it be impossible for the child to be raised by his biological family, the state must ensure his right to be raised in another family, with institutional care being the option of last resort in extreme cases; in fact, the institutionalization of children under three years of age is a violation of their rights in and of itself.[3]

  There are 106 residential care institutions for children operating in Lithuania: 5 care homes for infants with development disorders; 8 state-managed children's care homes; 4 residential care homes for children with disabilities; 55 municipal children's care homes; 13 municipal care groups; 21 children's care homes that are not managed by the state.

 All infants' homes in Lithuania are called "care homes for infants with development disorders", even though these institutions admit not only children with special needs or severely disabled children, but healthy children as well. 3-6 months spent in the institution is sufficient to impair the development of healthy children.

The Vilnius Care Home for Infants with Development Disorders, Alfa.lt photo

 Even though officially Lithuania has been in the throes of child care reform since 2007, children deprived of a family environment are still not being offered enough alternatives to be cared in a family or a community, with institutionalization in reality being the go-to measure instead of the measure of last resort. The state's priorities in the child care system are reflected in the level of support that the state lavishes on institutional care; to compare, the support given to foster families is several times smaller, while adoptive families receive no support whatsoever.[4] 

 Following the launch of the reform of the child care system back in 2007, the development of the infrastructure of care institutions received the most funds and attention, i.e. in 2013-2014, a total of 51,8 million LTL (around 15 million EUR) were allocated and used in the development of the infrastructure of residential child care institutions (insulation, construction of new institutions, etc.) under EU and multilateral EEA grants. The fact that priority in funding was given to investing in the infrastructure instead of in establishing community based services for families and children left without parental care demonstrates that the authorities responsible for the reform of child care and monitoring the quality of investment hold dismissive attitudes towards the reform and do not understand it correctly.

 The problem of the selection of the type of care for the child (in a family, in a communal home or in an institution) remained acute in the 2013-2014 period – that is, in choosing the type of care, preference was given to institutionalization instead of its alternatives. The fact that institutional care is often the go-to measure is also reflected in statistical data: out of 2112 children that were left without parental care in Lithuania in 2013, a whopping 1234 were institutionalized (some children were institutionalized more than once: 1272 cases of institutionalization were recorded in total); more than a third of cases of institutionalization annually involve children under 3 years of age. Data from 31 December 2013 shows there were 10 146 children under state care at the time: 3821 were in institutions, 5906 were with a family and 419 – in a group home.[5] The average cost of monthly care per institutionalized child in 2012 was 2530 LTL (around 733 EUR).[6] The main reasons for placing the children in care were that they were being improperly cared for, neglected or suffered physical or mental abuse.

 The number of institutionalized disabled children is particularly egregious – out of 15.5 thousand disabled children, around 1 thousand live in institutions: in one of five specialized care institutions for children with disabilities or in children's care homes managed by various entities.[7]

 Even though statistical data demonstrates that the birth rate in Lithuania is on the decline, the number of institutionalized infants and small children remains almost unchanged (344 in 2011, 316 in 2012, 288 in 2013). [8] These numbers are evidence that the network of foster families is not being developed properly; no effective system for encouraging family care and professional care in families had been put into place that would allow to completely abandon residential care for infants and children under 3 years of age, and in cases of children with special needs. As noted by the National Audit Office, there are no professional foster carers in Lithuania that would be able to, at any time of day and on short notice, accept children for short-term care or take over the care of infants, take over a child from his carers for a "breather", or provide any other short-term social services.[9]

 The poor child rights protection policy in Lithuania leads to gross violations of children's rights: in the beginning of 2013, a five-year old girl had to be rushed to the clinics in Kaunas from the Venta Social Care Home; due to neglect, she only weighed 5 kilograms.[10]

 It must be noted that while the number of planned places in state child care institutions has been reduced in 2013,[11] the number of placements in municipal institutions has increased.[12] Considering that in many cases the buildings of state child care institutions are very large, the declining number of children has created a situation whereby the residents were afforded up to 31.04 m2 in living quarters, and their share of the overall area of the building was a whopping 206.98 m2.[13] These numbers show that the stated goal of the state to provide institutionalized children with an environment closely resembling that of a family was untruthful, since residential space was limited and only made up a small portion of the overall area of the building.

Even though statistical data demonstrates that the birth rate in Lithuania is on the decline, the number of institutionalized infants and small children remains almost unchanged. The poor child rights protection policy in Lithuania leads to gross violations of children's rights: in the beginning of 2013, a five-year old girl had to be rushed to the clinics in Kaunas from the Venta Social Care Home; due to neglect, she only weighed 5 kilograms.

Institutionalized children feel worse about their privacy, i.e. they have less say in how their room should look like, their toys are more often touched by others without their permission, these children often do not have a place where they could safely store their stuff or do their homework, or even lock the door.[14] Often the younger children have no personal articles of clothing – all existing clothes are shared within the group; if visiting foster families buy clothes, toys or other items for a child, it is within the care home staff’s personal discretion to determine if and how that child will be able to enjoy them.[15] Every other inmate is not able to eat when he wants to, or there is very little regard given to what the children want to eat. Meanwhile, children placed in foster families are not faced with these issues. While institutionalized children dream of living with their own (biological), adoptive or foster families, children in foster families are happy with them and practically have no desire to be returned to their parents or be adopted.

 The UN Committee on the Rights of the Child gave its assessment of the Lithuanian child care system on 4 October 2013, with recommendations for Lithuania.[16] The Committee welcomed the adoption of the Strategic Guidelines for Deinstitutionalization,[17] but was also concerned by the large number of institutionalized children under 3 years of age, poor living conditions and limited area within institutions, as well as the lack of monitoring for children's care homes not managed by the state. The Committee recommended that Lithuania ensure that children are offered enough family or community-based care alternatives, monitor all cases of institutionalized children and establish a strict system for monitoring care institutions, especially those that are not managed by the state.

Institutionalized children have less say in how their room should look like, their toys are more often touched by others without their permission, these children often do not have a place where they could safely store their stuff or do their homework, or even lock the door. Often the younger children have no personal articles of clothing – all existing clothes are shared within the group; if visiting foster families buy clothes, toys or other items for a child, it is within the care home staff’s personal discretion to determine if and how that child will be able to enjoy them.

 While claiming that the state's aim is to institutionalize as few children without parental care as possible, the Ministry of Social Security and Labour at the same time admits that the state's ability to place children with families is often limited.[18]

 Although the overhaul of child care was launched back in 2007, it is yet to be completed. There was a lack of political will to implement essential reforms of the child rights protection system: from the very beginning, the process embraced political interests in lieu of the best interests of the child. The conclusions of the national audit that was carried out by the National Audit Office on 31 January 2014 show that the existing child care system is ineffective and does not ensure the best interests of the child.[19]

 In 2014, the Ministry of Social Security and Labour took more resolute action to deal with the issue of establishing alternatives to institutional care that were necessary for the reform, adopting the Action Plan for the Transition from Institutional Care to Family and Community-Based Care for Disabled Children and Children Deprived of Parental Care 2014-2020 (the Action Plan for Deinstitutionalization).[20] The Ministry indicates that one of the primary aims of this document is to ensure a harmonious environment for and ability of all children (and disabled children) to be raised in their own families, and the ability of children deprived of parental care to be raised in foster families, adoptive families or group homes, as well as to receive support within the community.[21]

 Although the text of the document may appear progressive, the assessment criteria for the Action Plan for Deinstitutionalization are a cause for concern – the aim is to ensure that institutionalized children make up only 20% of all children in care by 2020. Considering that the number (around 4 thousand) and percentage (39%) of children in residential care have remained pretty much the same for a number of years, the aforementioned criterion is contrary to the stated goals of the reform and is insufficient for achieving meaningful change. 

 Furthermore, the Action Plan for Deinstitutionalization states the institutionalization of children, especially those under 3 years of age, will be limited by establishing family-model (specialized) homes for children in the community – that is, in essence retaining the institutional framework.[22] According to the Children's Rights Ombudsperson, the overhaul of infants' homes, homes for children left without parental care and care homes for children with disabilities, as well the directions for completing this task, do not prioritize returning children to their biological family (providing real, high-quality services to families in the community that are capable of meeting their needs) or placing them in the care of another family.

The assessment criteria for the Action Plan for Deinstitutionalization are a cause for concern – the aim is to ensure that institutionalized children make up only 20% of all children in care by 2020.  The aforementioned criterion is contrary to the stated goals of the reform and is insufficient for achieving meaningful change.

During the reported period, the Ministry of Social Security and Labour presented the Parliament with draft amendments to the Law on Fundamentals of Protection of the Rights of the Child, the Civil Code, the Code of Civil Procedure, the Law on Benefits for Children, the Law on Group Homes and the Law on Social Services. They propose clarifying the concept of foster families, providing for the status of a social (professional) caregiver, changing the legal regulation of group homes. In essence, these draft proposals are seen as positive, but it should be noted that the deliberation of the changes envisaged in these documents, necessary to the reform of the care system in Lithuania, has been going on for a very long time (since 2012). The UN Committee on the Rights of the Child also lamented the delay in adopting the Law on Fundamentals of Protection of the Rights of the Child.[23]

The amendments to the Civil Code submitted by the President in October 2014 aim at tightening the regulation of the institutionalization of children (especially those under 3 years of age). The proposed draft law is particularly relevant and necessary to actually change the situation and reduce the number of institutionalized children under 3 years of age, but it will only be possible to reach its stated goals if the wide-ranging exceptions to the institutionalization of children contained in the bill are abandoned.

In order to stop the practice of institutionalization, it is necessary to invest more human and financial resources into work with families at social risk and the children being raised by them, to review the existing system for placing children in family care and providing help to foster parents, as well as to promptly legalize the alternatives to institutionalization, such as professional foster care.

 -          Findings and Recommendations 

  • In improving process for the organization of child care, priority should be given to timely, competent and effective work with families and their children, providing comprehensive assistance to caregivers, developing alternative forms of care and educating the public about them.
  • To develop an infrastructure of social, psychological, legal, relaxation and other required services that are differentiated according to need, are effective, affordable and accessible to all families – including equipping Children's Rights Protection Services and social workers with effective tools for diagnosing the situation of the family and providing assistance; establish a system for assessing the need for services, as well as for monitoring the provision and quality of said services.
  • To create an effective system for the promotion of both care within the family and professional care. In child care reform, priority must be given to addressing the issue of children under the age of 3, i.e. de facto stopping the institutionalization of children under the age of 3.
  • To ensure that financial resources, especially coming from EU structural funds, are firmly allocated to the reform of the care system, monitoring its effectiveness as well as the whole deinstitutionalization process.

Care Homes for People with Disabilities

 At the initiative of the European Commission, the Common European Guidelines on the Transition from Institutional to Community-Based Care were developed in 2012.[24] Furthermore, in 2013 the European Parliament adopted the Regulation on the European Social Fund[25] as well as the Common Provisions Regulation,[26] two regulations that, for the first time in EU history, specified that the structural funds must be used for the development and expansion of community-based services, i.e. as an alternative to institutional care, promoting the transition from institutional care to community-based services.

Deinstitutionalization is not limited to just closing down institutions. Deinstitutionalisation (De-I) is understood to be the process of creating and developing various community-based services, prevention among them, in order to eliminate the need for institutionalized care.

The General European Guidelines define an institution as any place of residential care, where the residents are isolated from the broader community and are forced to live together; do not have sufficient control over their own lives and over decisions which affect them; where the requirements of the organization itself tend to take precedence over the residents' individual needs.[27]   

Deinstitutionalization is not limited to just closing down institutions. Deinstitutionalisation (De-I) is understood to be the process of creating and developing various community-based services, prevention among them, in order to eliminate the need for institutionalized care.[28] De-I is the relocation of persons living in institutions (social care institutions, psychiatric hospitals) to live, receive medical treatment or be cared for by the community. At the same time it also means changing the traditional model for psychiatric care by transitioning from paternalistic 24-hour supervision that restricts human rights to providing individualized social, psychological or medical services close to the person's home that promote his/her independence.[29]

The Macikai social care home. In 1948-1955, up to 3000 persons were imprisoned in the Macikai concentration camp, 365 prisoners had died there, out of which 312 were Lithuanians; 70 of them were children, with 44 Lithuanian children among them. In 1955, at the order of the Ministry of Welfare of the Lithuanian SSR, the Pagryniai home for the disabled was established in the premises. A new three-storey residential building was built in 1982. In 1988, a residential building for children with disabilities, capable of accommodating 70 residents, was built. Currently, nearly 500 children and adult are living in this institution. There are 233.5 staff postings at the care home; 135.5 postings for the Social Work Service; and 50 personal health care and nursing service postings.[30]

 The right to live independently and be included in the community, as well as to access services within it, was established by the UN Convention on the Rights of Persons with Disabilities, which Lithuania ratified in 2010. The Convention clearly states that all persons with disabilities have the right to live in the community, to choose their place of residence, to get stationary and accommodation services, as well as other community-based services; the state must promote the full and effective inclusion and participation of people with disabilities in the community; and finally, community-based services and institutions must be accessible not only to the general population, but also to persons with disabilities.[31]

In Lithuania, the coordination of deinstitutionalization, on the basis of the Action plan for 2014-2020, is left to the Ministry of Social Security and Labour.[32] The projected results of the De-I process in Lithuania, as provided for by the action plan, are too small and lacking in ambition – for example, it is only planned to reduce the number of institutionalized adults with disabilities by 40%; to overhaul only 5 residential social care institutions for disabled adults.[33]  These expected results are not enough to ensure that the desired social inclusion rate will be achieved by the end of the 2014-2020 EU funding period for investment and structural programmes.

More than 150 million Euros from EU structural funds were used in 2007-2013 to modernize and build residential care institutions for people with disabilities in Central and Eastern Europe, including Lithuania – despite the need to carry out deinstitutionalization and develop community-based services.[34] In other words, the structural funds have been used improperly, i.e. instead of promoting the availability of common services to the disabled, providing families with support services or carrying out the integration of disabled people into the community, the state used the funds to renovate the buildings of institutions.

The Common European Guidelines provide that the improvement of physical living conditions in the institutions and the premises does not satisfy the needs of persons with mental disorders or intellectual disabilities, since it does nothing to change the hierarchy of relations, does not promote integration into the community or the guarantee of other human rights. On the contrary – the improvement of external features may lead to stagnation, the preservation of the existing system and systemic obstacles to the development of community-based services.[35]

There is a lack of political will in Lithuania to consistently pursue deinstitutionalisation: today, the dominant model of institutional care is practically the only way to help persons with mental disorders or intellectual disabilities; institutional care is awarded the lion's share of the funds allocated for social care.

It should be noted that large closed-type institutions are a great environment for human rights violations, which is why institutionalization itself violates the human rights of persons with disabilities provided for in the UN Convention on the Rights of Persons with Disabilities. As noted by UN Committee on the Rights of Persons with Disabilities member Jonas Ruškus, no matter how much you try to reform large specialized care or educational institutions they are an evil in and of themselves, which, regardless of the will of the people, imprisons the people living and working here, consigning them to doomed relationships and hopelessness. Everyone – both the residents and the specialists – becomes an agent in the ensuing human rights violations.[36] In addition, life in institutions that are isolated from society damages the personalities of the people raised or cared for within and precludes life opportunities. Regardless of the will of the people, these institutions in and of themselves demand obedience from the inmates, break their will and crush their dreams, standardize individual life rhythms and personal environments, firmly entrench the "conveyor belt" model for services, eliminate the ability to express oneself, isolate from contact with the public, give rise to the inevitability of being stuck in the institution forever.[37]

Back in 2006, amendments to the Law on Social Services established the procedure for licensing social care institutions, according to which all the social care institutions in the country had to obtain an extension of their license from the Department of Supervision of Social Services by the end of 2014 to continue their work. The requirement to license sought to ensure that social services users and their family members would know that the social care services provided are of a high quality and meet the needs of the people who use them. There are 405 institutions providing social care services in Lithuania. Of these institutions, 360 have already obtained licenses to continue providing social care services from 1 January 2015 onwards.[38]

As noted by UN Committee on the Rights of Persons with Disabilities member Jonas Ruškus, no matter how much you try to reform large specialized care or educational institutions they are an evil in and of themselves, which, regardless of the will of the people, imprisons the people living and working here, consigning them to doomed relationships and hopelessness. Everyone – both the residents and the specialists – becomes an agent in the ensuing human rights violations

However, it should be noted that nowadays the licensing requirements of 2006 no longer comply with new trends towards deinstitutionalization and providing community-based services: today, these requirements are easier for large residential social care institutions to fulfil, as they have a sufficient number of rooms and more staff. Meanwhile small institutions providing community-based services are unable to meet the licensing requirements, most often because they lack staff, and as such would be unable to get licensed. It should be noted that it is doubtful whether the  requirement in relation to staff is actually reasonable, since some full-time employees are simply not necessary in small institutions – should the need arise, the required services can be procured from outside.[39]

Since 2010, a total of over 100 million LTL (around 29 million Euro) from both the national budget as well EU structural funds has been allocated to overhauling the infrastructure of institutions in order to have them comply with licensing requirements.[40]  Taking into consideration the unavoidable flaws of institutional care listed above – the inevitable violation of the fundamental human rights and freedoms of the recipients of such services – the licensing process for institutional care raises serious doubts: it is obvious that, instead of going towards the development of much-needed individualized services, funds will once again be invested into reinforcing a flawed system.

-          Findings and Recommendations 

  • The institutional care system is very prevalent in Lithuania and, conversely, deinstitutionalisation processes are too slow.
  • Many more human rights violations occur in large closed-type institutions. Furthermore, institutionalization itself – i.e. placement of people in large closed-type care institutions – violates the human rights of persons with disabilities, and as such it is necessary to reform institutional care and education systems, basing them on human rights.
  • The projected results of the ongoing De-I process in Lithuania are far too insignificant, lack ambition and do not ensure that the desired rate of social inclusion will be achieve by the end of the 2014-2020 EU funding period for investment and structural programmes.
  • It is vital to ensure that funds for EU investment programmes in the new 2014-2020 period are not allocated to the renovation or construction of institutions, and instead are focused on the development of community-based services. In order to ensure the timeliness and effectiveness of the reform coordinated by the Ministry of Social Security and Labour, the processes must be independently monitored, i.e. with the help of experts, specific regional pilot projects must be selected and developed, and tangible steps towards reform must be taken.

Mental Health Care Institutions

 Among other key priorities listed for mental health policy, the Mental Health Strategy, approved by Parliament in 2007,  emphasizes the need to ensure that the rights of persons with mental disorders are actually protected and that they are able to get full-fledged assistance where they live, to develop an effective mechanism for the protection of the rights of persons with mental disorders in both medical and care institutions, as well within the community.[41]

The essential problem faced when trying to implement modern mental health principles in Lithuania is the lack of human rights protection mechanisms and the lack of independent human rights monitors in the mental health care system

Unfortunately, we continue to see the paternalistic biomedical model and pharmacotherapy dominate in the field of psychiatry in Lithuania, making persons with mental disorders or disabilities dependant on drugs and reducing their ability to integrate into society. The repeated urgings of NGOs working with human rights in mental health care – to take heed of the urgings of the World Health Organization and UN human rights bodies to abandon the outdated biomedical model and, in its place, to develop the infrastructure for outpatient psychosocial services, less restrictive of a person's freedom and conductive to his or her integration – have been ignored.

The mental health and human rights experts that were invited to the working group set up by the Ministry of Health for drafting the Action Plan for the Implementation of Mental Health Strategy and Suicide Prevention expressed criticism regarding the latter in January 2014. The experts wanted to see the implementation of modern mental health policy and suicide prevention principles that are enshrined in the documents of the World Health Organization and the European Union, as well as in the Mental Health Strategy approved by the Lithuanian Parliament in 2007; all measures, including public education on mental health, a wide range of preventive and clinical interventions and comprehensive monitoring, should comply with these principles. Unfortunately, the plan prepared by the Ministry of Health lacks such strategic coherence; it can be said to be a list of loosely-related measures, the effectiveness of which is difficult to assess – the results are therefore disappointing. Despite said criticisms, the plan was approved on 28 March 2014.

Psychiatry in Europe and the rest of the world adheres to the principle that any provision of psychiatric services – especially when they are provided in closed-type establishments (which includes psychiatric hospitals and psychiatric wards in public hospitals, since these institutions often limit personal freedom) – must be supervised by several monitoring mechanisms, both internal and external. This practice became established after analysing history of the science and practice of psychiatry and coming to an understanding that even those treatment and care methods that carried with them the best of intents were quite often later on recognized as instances of human rights violations, often being likened to torture.

In 2013, the UN Special Rapporteur on Torture presented a report on torture in health care institutions.[42] The report included recommendations on how to avoid harmful practices in psychiatric institutions: it is obvious that one of the most important prevention principles is to overcome the tradition of everything taking place behind closed doors and provide for permanent independent monitoring of human rights in psychiatric practice.

The essential problem faced when trying to implement modern mental health principles in Lithuania is the lack of human rights protection mechanisms and the lack of independent human rights monitors in the mental health care system.[43] All attempts to establish effective human rights protection and monitoring mechanisms in the field of mental health care in Lithuania have so far been fruitless.

It should be noted that international human rights monitoring bodies have many times recommended that Lithuania commit to fundamental changes in protecting human rights in the mental health care system: Lithuania has been repeatedly visited by experts of the European Committee for the Prevention of Torture and Other Inhuman or Degrading Treatment, who in all cases have highlighted the need to implement essential human rights safeguards within the Lithuanian mental health care system.

Unfortunately, Lithuanian authorities have chosen to either ignore or otherwise only react formally to these recommendations: in December 2013 the Ministry of Health formed a working group to review the Law on Mental Health Care. It should be noted that the new edition of the law did not take into account the recommendations of the European Committee for the Prevention of Torture and Inhuman or Degrading Treatment or Punishment.

 Greater opportunities for regular monitoring of mental health institutions became available in 2013, after Lithuania ratified the Optional Protocol to the UN Convention against Torture and Other Cruel, Inhuman or Degrading Treatment or Punishment. With reference to the provisions of the Protocol, the Parliamentary Ombudspersons Office was given the mandate at the beginning of 2014 to carry out the national prevention of torture in places where liberty is restricted. This means that the Ombudsperson may now at any time of day enter facilities where people are kept around the clock.

The monitoring mechanism established by the Protocol was first used in the field of Lithuanian mental health care in 2014, during an inspection of the psychiatric clinic of the Šiauliai Hospital carried out by the Parliamentary Ombudspersons Office.

While it would initially appear that the beginning of independent monitoring process of psychiatric institutions, which is common in developed states with strong democracies, is a reason for celebration, the events following the publication of the report of the Parliamentary Ombudspersons Office raise questions as to whether Lithuania is ready to ensure human rights in mental health institutions.

The report of the Parliamentary Ombudspersons Office recorded human rights violations discovered in the psychiatric clinic of the Šiauliai Hospital and also provided recommendations on how these violations should be eliminated.[44] The Ombudsperson noted that patients in the clinic were not given information about their treatment or its effectiveness. They were also denied information on their medication and were not informed that they could refuse medical intervention; forcibly hospitalized patients were unable to appeal court decisions, since they were not invited to court hearings. The patients were also not guaranteed access to medical documents and the right to receive excerpts from them. The institution had no separate premises for meetings with family and close ones, which would have ensured privacy of their communications; there were also restrictions on walking outside the premises.[45]

In response to the above report of the Parliamentary Ombudspersons Office, the psychiatric clinic of the Šiauliai Hospital held a press conference where it unanimously and publicly disqualified the conclusions and recommendations of the report, claiming that human rights were not being violated in the psychiatric clinic of the Šiauliai Hospital. Participants of the conference claimed that the Ombudspersons are potentially lacking the specialized knowledge, since only a specialist in possession of psychiatric knowledge would understand that communications with people, who are afflicted with mental disorders and have a skewed perception of their surroundings, have a distinctive character. The participants expressed the need to protect mental health care institutions that will be inspected in the future from such "naive conclusions".[46]

This publicized position of the psychiatric clinic of the Šiauliai Hospital has yet to draw attention of or be considered by the authorities. It clearly demonstrates not only the lack of state support for the Ombudsperson supervising human rights issues, but also improper implementation of the mental health care policies in Lithuania, allowing for managers of mental health institutions to oppose the establishment of human rights protection standards in psychiatric practice.

The Lithuanian mental health care system finds itself stuck in a system vicious circle.[47] This links in this circle are poor indicators for public mental health, widespread intolerance of vulnerable people and groups, state policies that continue practices that propagate stigma and social exclusion, the diversion of financial and human resources to the provision of ineffective services that breach human rights; at the same time, innovative services are not being developed, with no attempts to instil a culture of appreciation for indicators and constant monitoring; new investments are only used to further reinforce a system that had not been reformed, contributing to poor mental health indicators and supporting a negligent approach towards human rights.

 -          Findings and Recommendations 

  • Modern human rights protection and monitoring principles must be established within and adhered to by the Lithuanian mental health care system – to achieve this aim, it is necessary to consolidate efforts of civil society, the legislature and the executive branch, psychiatrists, psychologists and other professional groups, in order overcome the tendency of Lithuanian psychiatry to oppose modern mental health principles.
  • After ratification of the Optional Protocol to the UN Convention against Torture and Other Cruel, Inhuman or Degrading Treatment or Punishment, a possibility arose to entrench these principles by involving the authorities. 2014 saw the first instance of independent human rights monitoring of a closed mental health care facility initiated by the authorities.
  • The common position that influential mental health system representatives (heads of psychiatric hospital administrations, academic psychiatry, mental health and state institutions responsible for mental health) publicly expressed in 2014 in an effort to disqualify a report of the Parliamentary Ombudsperson Office and the principles of independent human rights monitoring, are a symptom of a serious ongoing systemic crisis within the Lithuanian mental health system. 

Places of Detention

 At the end of 2011, Lithuania sported the greatest number of prisoners since 2003, when the new Criminal Code came into force. The number decreased very slightly in 2012-2013. By the end of 2013, there were over nine thousand prisoners in Lithuania,[48]  with 315 prisoners for every 100 thousand residents – the highest such rate in the European Union and the third highest rate (following Russia and Belarus) among all European countries.[49] It is interesting to note that the level of crime registered in Lithuania is among the lowest in the European Union, including overall violent crime.[50]

In 2013, the average length of a custodial sentence for persons in custody by the end of the year reached 76 months.[51]  This is the largest such figure since the restoration of independence, although the level of criminal activities registered per 100,000 residents in 2013 and 2014 remained the same, i.e. approximately 2.8 thousand. Furthermore, the number of registered serious and very serious crimes in this period reached approximately 4.3 thousand, with respect to the fact that the Criminal Code recognized more offences as being serious or very serious. The number of the most serious violent crimes, as well as theft and robbery, decreased.

By the end of 2013, there were over nine thousand prisoners in Lithuania, with 315 prisoners for every 100 thousand residents – the highest such rate in the European Union and the third highest rate (following Russia and Belarus) among all European countries. It is interesting to note that the level of crime registered in Lithuania is among the lowest in the European Union, including overall violent crime

At the end of 2013, the largest detention facility in Lithuania, where almost 3000 convicts are serving prison sentences, was 12% overcrowded (i.e. 112 inmates for 100 places), with overcrowding also occurring at the Kybartai correctional facility (3.7%) and the Šiauliai remand prison (18.6%).[52]

48 people died in Lithuanian places of detention in 2013 – once again, the highest such figure since the restoration of independence. Out of this number, 34 died due to illness and 12 committed suicide (one of the highest figures seen in the last 10 years, 3 times higher than the relative number of suicides in public).[53]

Employment rates in places of detention remained very low, not having improved since 2010: at the beginning of 2014, 16.4% convicts worked in manufacturing, 12.3% did farm work, 35.4% were in education and an equal number were unemployed.[54] There is still a lack of transparency in organizing the work of prisoners, with cases of exploitation still coming to the fore,[55] and a lack of work places for prisoners wishing to work.[56]

48 people died in Lithuanian places of detention in 2013 – the highest such figure since the restoration of independence. Out of this number, 34 died due to illness and 12 committed suicide (one of the highest figures seen in the last 10 years, 3 times higher than the relative number of suicides in public).

The prisoner caste subculture, prevalent in Lithuanian prisons, continues to present a very serious problem.[57] Moreover, in recent years, even the rhetoric of prison administrations demonstrates that this subculture is acceptable and normal.[58]

Due to extremely poor detention conditions,[59] courts in some European countries now refuse to surrender defendants to Lithuania,[60]  with the European Court of Human Rights and national courts increasingly ordering the Lithuanian state to compensate convicts for poor detention conditions.[61]

On 19 February 2014, the Optional Protocol to the UN Convention against Torture and Other Cruel, Inhuman or Degrading Treatment or Punishment came into force in Lithuania,[62] under which the Parliamentary Ombudspersons Office began to carry out the national prevention of torture in places of detention,[63] now being obliged to visit them regularly.[64] With the number of prisoners on the rise, and detention and staff working conditions deteriorating,[65] violence between prisoners,[66] cases of prisoners resisting officers[67] and recorded crimes in places of detention are becoming more frequent. In May 2014, the Parliamentary Ombudspersons, in carrying out the prevention of torture, visited the Marijampolė Correctional Home and came to the conclusion that neither the convicts nor the staff were able to enjoy a safe environment.[68]

The daily sum allotted to the maintenance of a single convict remained roughly the same since 2010 (48 LTL (around 13,9 EUR)),[69] although the number of prisoners and staff workload have both increased. Out of this sum, about 80% goes to staff wages, their social insurance and other related expenses. Nevertheless, the Prison Department still seeks to lessen the costs per convict.

Lithuania has not yet built any new detention facilities, although the plans were drawn up way back in 2008. The public tender for relocating the Lukiškės prison was announced in 2012, but the process was drawn out and gave rise to suspicions of corruption and opaque public procurement practices.[70] On 22 July 2014 the government adopted the new Programme for the Modernization of Places of Detention, which set 2022 as the final date for modernizing detention facilities.[71]

 -          Findings and Recommendations 

  • The Lithuanian prison system continues to move away from European standards; existing problems are not being addressed and only deepen. This was also confirmed by the report on the 27 November – 4 December 2012 visit of the European Committee against Torture and Other Cruel, Inhuman or Degrading Treatment or Punishment, published on 4 June 2014,[72] which pointed even more shortcomings of the Lithuanian prison system than in the 2011 report. The prison system in Lithuania is in need of cardinal and radical change, starting with the implementation of the recommendations of the European Committee against Torture.

Places of Administrative Detention for Children

 The UN Convention on the Rights of the Child obliges states to ensure that no child is subjected to torture or other cruel, inhuman or degrading treatment or punishment.[73] There is a very high risk of this happening in institutions, which restrict the liberty of children pursuant to a court or an administrative decision.[74]

In Lithuania, children are sent to administrative detention if they have behavioural and emotional problems, which are expressed through delinquent behaviour – failure to attend school, consumption of alcohol or drugs, offending, violence or committing a crime (but below the age of criminal responsibility).[75] There are seven such institutions in Lithuania – six socialization centres and a special education centre in Švėkšna for children with behavioural and emotional problems. At the end of 2014, there were 246 children living in these institutions. A large part of them come from children's care homes or families experiencing difficulties. [76]

Vilnius children socialisation centre, Delfi.lt photo

 Early psychosocial assistance could help children overcome the causes of delinquency and prevent them from winding up in these institutions. Although the law provides for the so-called "minimal supervision measures", for example, specialist consultations, the obligation to attend day-care centres or take part in social education, rehabilitation, integration, prevention, education or other programmes,[77]  in practice the institutions applying them perceive them to be punitive and corrective measures, not individualized social assistance for the child; the system of measures is build by focusing on behaviour, its forms, nature and level or danger posed, not to the child's personality or needs.[78] In addition, the application of minimal supervision measures does not depend on the personality and individual needs of a specific child, but on whether these services are actually provided by the municipality.[79]

Vėliučionys children socialisation centre, “relaxation room”

The placement of children in institutions should be a measure of last resort, used when all other measures have failed. Practice shows, however, that quite often minimum supervision measures are employed not with the aim of really helping the child rehabilitate, but just so that there would be no obstacles to the next step – the child's placement in one of the aforementioned institutions.

However, without a well-developed network of community-based services, children bereft of necessary and effective specialist assistance[80] are sent to institutions, where their problems only increase. In 2013, an audit of socialization centres conducted by the National Audit Office found that children do not actually receive specialized rehabilitation services that meet their individual needs,[81] with the institutions instead acting as general schools operating under a strict regime. The prevailing culture of control and punishment, as well as the "the law of the jungle", leads to numerous violations of children's rights.

In 2014, the exceptionally poor situation of children dealing with socialization problems in Lithuania drew the attention of the UN Committee against Torture. In its concluding observations, the Committee recommended a review of Lithuania "socialization centres", where minors are de facto being held in administrative detention, ensuring that such institutions are effectively monitored to prevent any breach of the Convention. [82]

In the fall of 2014, representatives from the Parliamentary Ombudspersons Office visited all of the children's socialization centres. The report published in January 2015 found numerous violations of human rights – children were locked in "relaxation rooms" to punish them for disobedience, kept there for up to 24 hours, with no proper records being kept of this measure, while the Kaunas socialization centre would use handcuffs, batons and tear gas to subdue children.[83] However, even when the ghastly living conditions in these institutions became publicized, the reaction of the authorities was sluggish at best.

At the beginning of 2015, the public was left reeling by a case of child trafficking and exploitation for the purposes of prostitution discovered in the Švėkšna Special Education Centre, which the staff and police officers were aware of for a long time but did not take adequate action to prevent these crimes from happening and to ensure the safety of the children. [84]

Only following an urgent consultation convened by the President did the Ministry of Education set up a special commission to investigate the incident at Švėkšna and decide the fate of the institution. However, the state exhibits a lack of strategic approach and political will to fundamentally reform the child care and psychosocial rehabilitation system, ensuring that children are safe from violence, exploitation, inhuman and degrading treatment.[85]

 -          Findings and Recommendations

  •  To develop a strategy for reforming administrative detention institutions for children, providing for the ultimate closure of such institutions.
  • To invest in prevention and the provision of services in the community, as well as into the availability of these services to poorer children or children living in remote areas.
  • To create new services, such as psychotherapy or the individual supervision of a child by a social worker, who regularly visits the home of the child and counsels him and his family, as well as crisis centres providing short-term temporary accommodation and crisis intervention services to children and minors.
  • If it is in the child's best interests to have his liberty restricted in order to give him access to psychosocial rehabilitation, it is recommended to create small, community-type centres, where a small number of children would live and receive services at the same time, taking into account each child's individual characteristics and needs. The restriction of a child's liberty should be used as an exclusive measure of last resort, and only for the shortest possible duration.

Foreigners Registration Centre

 The Foreigners' Registration Centre of the State Border Guard Service is an institution for the accommodation of asylum seekers and detention of foreigners.[86]  There were 486 foreigners and stateless persons living the Foreigners' Registration Centre in 2013,[87] with 363 foreigners and stateless persons having been detained for longer than 48 hours.[88]  In 2013-2014, the Foreigners' Registration Centre managed to attract the attention of quite a few state institutions – the Parliamentary Ombudspersons Office, the Equal Opportunities Ombudsperson Office and the Children's Rights Ombudsperson Office.[89]

 2013 saw an increase in the number of reported violent incidents among foreigners in the Foreigner's Registration Centre,[90] as well an increase in reports of violence between foreigners and members of staff.[91] After investigating foreigners’ complaints regarding the disproportionate use of force by officers during preventative inspections, conditions of detention and the quality of the services provided by the Centre, the Parliamentary Ombudspersons Office found that the security measures employed at the Centre were inadequate; documents regarding cases of violence were not being registered appropriately; in cases where special measures were used, the rights of persons could have been infringed as a result of the disproportionate use of special measures, inappropriately drawn up official reports and lack of medical examinations of persons subject to these measures, conducted by health care professionals following each and every instance they were used.[92]

The photograph was taken following the inspection of the residential premises of the Foreigners' Registration Centre on 17 October 2013, carried out by SBGS and Foreigners' Registration Centre officers

Following an inspection of the residential premises of the Foreigners' Registration Centre on 17 October 2013, carried out by both State Border Guard Service (SBGS) and Foreigners' Registration Centre officers, foreigners submitted complaints regarding the disproportionate use of force. SBGS officers claimed that they had to resort to physical force because the foreigners refused to cooperate – the  had to twist the arms of unruly foreigners behind their backs and make them stand against the wall.

According to one Georgian national, during the inspection SBGS officers forced their way into his room at 7 o'clock in the morning and took him outside. "At first, I was taken out of the room and made to stand against the wall in the corridor with my hands behind my head, then two masked officers dragged me into a room; I received two blows to the head and was knocked down on the floor, following which one of the officers kept jumping on my back for 3-4 minutes," said the victim. It is highly doubtful that the bruises visible in the picture of the victim's back resulted just from his arms being twisted behind his back.

In January 2014, following an investigation into foreigners being fed pork regardless of what religion they practiced, the Equal Opportunities Ombudsperson's Office found that not a single piece of legislation pertaining to the feeding of foreigners contained an obligation to take foreigners' religious beliefs into account when organizing meals, and therefore, persons fed food that was prohibited by their religion were subject to discrimination based on their religious beliefs.[93] The Equal Opportunities Ombudsperson noted that making special diets available to part of the population of the Foreigners' Registration Centre may lead to further inconveniences when preparing food, but also that the state's financial burden or inconvenience should not be considered as a sufficient and proportionate reason to deny the persons' fundamental right to religion, especially considering the fact that state support can come in various forms.[94]

To implement the recommendation of the Equal Opportunities Ombudsperson, the Ministry of the Interior established that, in cases of persons living at the Centre refusing to eat certain food products due of their religious beliefs, these food products are to be replaced with others, observing the established physiological nutritional norms.[95]

Foreigners currently have two meal options – "traditional (with pork)" and "vegetarian (contains no meat). This means that persons practicing Islam who eat meat are in all cases forced to choose vegetarian food.

Unfortunately, the way the above order of the Ministry of the Interior was implemented is not sufficient to remedy the infringement found by the Ombudsperson – foreigners currently have two meal options – "traditional (with pork)" and "vegetarian (contains no meat).[96] This means that persons practicing Islam who eat meat are in all cases forced to choose vegetarian food. As a result, non-governmental organizations keep receiving complaints from foreigners regarding proper dietary arrangements not being put in place so that individuals who do not eat pork are offered alternative food products.[97]

In May 2014, following an assessment of the implementation of the Equal Opportunities Ombudsperson's recommendations, the Parliamentary Ombudspersons found that the Foreigners' Registration Centre menus did not state what dishes were available for persons wishing to replace an item listed or another item that they found unacceptable due to religious or other reasons, and also found that no food was being prepared and served in accordance with the established dietary menu.

The accommodation conditions at the Foreigners' Registration Centre have long been criticized by various organizations and institutions for a number of shortcomings. In 2012, the International Organization for Migration indicated that the existing practice in Lithuania, where asylum seekers are accommodated in the same Centre where illegal migrants are kept, has been criticized by representatives of non-governmental organizations. The measures used in the Foreigners' Registration Centre to enforce order and maintain security, such as the area being surrounded with a barbed wire fence and guarded by uniformed officers, negatively affect the psychological state of asylum seekers.[98]

In September 2013, following a visit to the Foreigners' Registration Centre, the representatives of the Children's Rights Ombudsperson Office found that conditions were poor for both detainees and persons placed in the asylum-seekers' dormitory – they did not ensure the rights and legitimate interests of vulnerable people, human dignity and the requirements of children.[99] 

The representatives also criticized the guarantees applicable to children during detention, such as education or leisure activities in the asylum seekers dormitory. According to them, from a child rights perspective, these measures cannot be seen as sufficient to reduce or eliminate the damage and impact caused by the detention itself as well as detention conditions.[100] It was decided to propose to the Government to address the issue of funding the improvement of living conditions for vulnerable people and families with minor children accommodated at the Foreigners' Registration Centre, in order to comply with the recommendations of international organizations and eliminate causes for continuing violations of children's rights resulting from conditions that do not meet child rights protection standards.[101]

Studies conducted in 2012-2013 on the reform of asylum policy in Lithuania revealed the shortcomings in the implementation of Lithuania's obligations under the EU asylum acquis. [102]  One of the recommendations given to the Government was to reconsider issue of determining the place of accommodation for asylum seekers, keeping in mind that accommodation centres must ensure adequate living standards and the fact that the Foreigners' Registration Centre is not a social institution. It is recommended to consider the possibility of accommodating asylum seekers at either the Refugees Reception Centre or another social institution capable of ensuring adequate living standards.[103]

 -          Findings and Recommendations 

  • Inappropriate documentation of the use of special measures with respect to foreigners allows officers to act arbitrarily and reduces the institutional transparency of the Foreigners' Registration Centre. It is recommended to have more detailed regulation of the grounds for and terms of the application of special measures, with reference to the principles for the correct use of special measures stated by the Parliamentary Ombudspersons Office.
  • Despite a new legal provision, which sets out the obligation to replace food that foreigners refuse to eat due to their religious beliefs with other products, in practice the state's duty to not discriminate against people because of their religious beliefs is not being realized properly. It is recommended to ensure that the right of foreigners to eat according to their religious beliefs is respected in all cases in practice, ensuring that pork products can be replaced by alternative meat products.
  • Considering that the Foreigners' Registration Centre is not a social institution capable of receiving asylum seekers who had suffered persecution, torture or inhuman or degrading treatment, particularly children, alternative accommodation for asylum seekers should be considered and provided for, with appropriate redistribution of projected funding.

[1] UN Convention on the Rights of the Child, 2 September 1990 , Article 20, http://www3.lrs.lt/pls/inter3/dokpaieska.showdoc_l?p_id=19848&p_query=&p_tr2=

[2] 14 March 2014 ruling of the Supreme Court of Lithuania in civil proceedings No. 3K-3-92/2014 (S)

[3] Regional Office for Europe of the UN High Commissioner for Human Rights, "The rights of vulnerable children under the age of three: ending their placement in institutional care", 2011, http://www.europe.ohchr.org/Documents/Publications/Children_under_3__webversion.pdf 

[4] National Audit Office, national audit report "Does the child care system comply with the best interests of the child?", 31 January 2014, No. VA-P-10-3-1, http://www.vkontrole.lt/audito_ataskaitos.aspx?tipas=2

[5] State Child Rights Protection and Adoption Service, Activity Report 2013, 2014, No. 5-4, http://www.vaikoteises.lt/media/file/ataskaitos/2013metuataskaita.pdf

[6] National Audit Office, national audit report "Does the child care system comply with the best interests of the child?", 31 January 2014, No. VA-P-10-3-1, http://www.vkontrole.lt/audito_ataskaitos.aspx?tipas=2

[7] Children Rights Ombudsperson, Activity Report 2013, published on 31 March 2014, No. 4-4, http://www3.lrs.lt/docs2/ATMQTAUA.PDF

[8] State Child Rights Protection and Adoption Service, Activity Report 2013, 2014, No. 5-4, http://www.vaikoteises.lt/media/file/ataskaitos/2013metuataskaita.pdf

[9] National Audit Office, national audit report "Does the child care system comply with the best interests of the child?", 31 January 2014, No. VA-P-10-3-1, http://www.vkontrole.lt/audito_ataskaitos.aspx?tipas=2

[10] Rugilė Audienienė, ”Children were tortured in the care of home of the girl weighing 5 kilos", alfa.lt, 7 February 2013, http://www.alfa.lt/straipsnis/15082652/5.kilogramus.sverusios.septynm

[11] The Ministry of Social Security and Labour is responsible for the establishment of state children's care homes

[12] State Child Rights Protection and Adoption Service, Activity Report 2013, 2014, No. 5-4, http://www.vaikoteises.lt/media/file/ataskaitos/2013metuataskaita.pdf

[13] Children's care home "Putinas" in Marijampolė, summary of the assessment criteria for the action plan, 2014,

http://www.vgnp.lt/uploads/Planavimo%20dokumentai/Vertinimo%20kriteriju%20suvestine%202014%20m.pdf

[14] SOS Children's Villages, "Comparative analysis of the human rights of children in institutions and in families", 30 April 2014, http://www.sos-vaikukaimai.lt/ka-mes-darome/globejai-seimose

[15] Interview with a visiting caregiver (personal details withheld to protect the interests of the minors in her care), 11 December 2014

[16] UN Committee on the Rights of the Child, concluding observations on the third and fourth period reports of Lithuania, 4 October 2013, http://www.socmin.lt/download/6111/f153_crc_c_ltu_co_3-4.pdf

[17] Order No. A1-517 of the Minister of Social Security and Labour "On the Adoption of Strategic Guidelines for the Deinstitutionalization of Residential Care for Children with Disabilities, Children Deprived of Parental Care and Adults with Disabilities", dated 16 November 2012, No. A1-517, http://www3.lrs.lt/pls/inter3/dokpaieska.showdoc_l?p_id=437781&p_query=&p_tr2=2

[18] Ministry of Social Security and Labour, Social Report for 2013-2014, published in 2014, p. 64, http://www.socmin.lt/lt/socialinis-pranesimas.html

[19] National Audit Office, national audit report "Does the child care system comply with the best interests of the child?", 31 January 2014, No. VA-P-10-3-1, http://www.vkontrole.lt/audito_ataskaitos.aspx?tipas=2

[20] Order No. A1-83 of the Ministry of Social Security and Labour "On the Adoption of the Action Plan for the Transition from Institutional Care to Family and Community-Based Care for Disabled Children and Children Deprived of Parental Care 2014-2020", dated 14 February 2014, No. A1-83, https://www.e-tar.lt/portal/legalAct.html?documentId=c90d41f097de11e3bdd0a9c9ad8ce1bf

[21] Ministry of Social Security and Labour, Social Report for 2013-2014, published in 2014.,

 http://www.socmin.lt/lt/socialinis-pranesimas.html

[22] Children Rights Ombudsperson, Activity Report 2013, published on 31 March 2014, No. 4-4, http://www3.lrs.lt/docs2/ATMQTAUA.PDF

[23] UN Committee on the Rights of the Child, concluding observations on the third and fourth period reports of Lithuania, 4 October 2013, http://www.socmin.lt/download/6111/f153_crc_c_ltu_co_3-4.pdf

[24] European Expert Group on the Transition from Institutional to Community Based Care, "Common European Guidelines on the Transition from Institutional to Community-based Care", November 2012, http://deinstitutionalisationguide.eu/wp-content/uploads/Common-European-Guidelines-on-the-Transition-from-Institutional-to-Community-based-Care-English.pdf  

[25] Regulation No. 1304/2013 of the European Parliament and of the Council of 17 December 2013, http://eur-lex.europa.eu/legal-content/EN/TXT/HTML/?uri=CELEX:32013R1304&from=LT

[26]Regulation No. 1304/2013 of the European Parliament and of the Council of 17 December 2013, http://eur-lex.europa.eu/legal-content/EN/TXT/HTML/?uri=CELEX:32013R1304&from=LT

[27] European Expert Group on the Transition from Institutional to Community Based Care, "Common European Guidelines on the Transition from Institutional to Community-based Care", November 2012, p. 24,

., http://deinstitutionalisationguide.eu/wp-content/uploads/2013/04/Common-European-Guidelines_Lithuanian-version_EDITED.pdf

[28] European Expert Group on the Transition from Institutional to Community Based Care, "Common European Guidelines on the Transition from Institutional to Community-based Care", November 2012, p. 26, http://deinstitutionalisationguide.eu/wp-content/uploads/2013/04/Common-European-Guidelines_Lithuanian-version_EDITED.pdf

[29] Eglė Šumskienė, “Deinstitutionalization of mental health care in Lithuania: minimal changes in "maximalist" organizations”, 2013, http://www.zurnalai.vu.lt/files/journals/180/articles/2659/public/sveikatos_prieiros.pdf

[30] Macikai Social Care Home, http://www.macikaigloba.lt/1-apie-mus; Macikai Concentration Camp Site and Graveyard Project, 5 August 2011, https://www.google.fr/url?sa=t&rct=j&q=&esrc=s&source=web&cd=1&ved=0CCAQFjAA&url=http%3A%2F%2Farcheologijosdb.kpd.lt%2Frinkmenos%2FProjektas%2520Macikai.doc&ei=sKn5VOiyJsPpaP3qgPgK&usg=AFQjCNGBThfByAX1G8r7kOkOQWk3A7wh4A&bvm=bv.87611401,d.d2s&cad=rjt

[31] UN Convention on the Rights of Persons with Disabilities, 3 May 2008, Article 19, http://www3.lrs.lt/pls/inter3/dokpaieska.showdoc_l?p_id=335882

[32] Order No. A1-83 of the Ministry of Social Security and Labour "On the Adoption of the Action Plan for the Transition from Institutional Care to Family and Community-Based Care for Disabled Children and Children Deprived of Parental Care 2014-2020", dated 14 February 2014, No. A1-83, http://www3.lrs.lt/pls/inter3/dokpaieska.showdoc_l?p_id=466003

[33] Order No. A1-83 of the Ministry of Social Security and Labour "On the Adoption of the Action Plan for the Transition from Institutional Care to Family and Community-Based Care for Disabled Children and Children Deprived of Parental Care 2014-2020", dated 14 February 2014, No. A1-83, Annex No. 2, http://www3.lrs.lt/pls/inter3/dokpaieska.showdoc_l?p_id=466003

[34] Lithuanian Forum for the Disabled, "New requirements for the use EU structural funds provide that only community-based services are to be funded as an alternative to institutional care", 11 December 2013, http://www.lnf.lt/index.php/apie-lnf/apie-lnf-2/490-nauji-reikalavimai-europos-sajungos-strukturiniu-fondu-lesu-naudojimui-nurodo-finansuoti-tik-bendruomenines-paslaugas-neigaliesiems-kaip-alternatyva-institucinei-globai?showall=&start=5

[35] Gintaras Šumskas, "Recommendations on the need to transition from institutional care to sheltered homes for persons with disabilities", 2014, www.giedra.eu/wp-content/uploads/2015/01/Rekomendacijos.docx

[36] Jonas Ruškus, “J. Ruškus. Both children and staff break down in care institutions", delfi.lt, 10 February 2015, http://www.delfi.lt/news/ringas/lit/j-ruskus-dideles-globos-institucijos-yra-blogis.d?id=67115346

[37] Jonas Ruškus, “J. Ruškus. Both children and staff break down in care institutions", delfi.lt, 10 February 2015, http://www.delfi.lt/news/ringas/lit/j-ruskus-dideles-globos-institucijos-yra-blogis.d?id=67115346

[38] Ministry of Social Security and Labour, "Almost 90% of social care institutions operating in Lithuania are licensed", 17 December 2014,  http://www.socmin.lt/lt/naujienos/pranesimai-spaudai/beveik-90-proc.-pbgk.html

[39] Kazys Kazakevičius, "Licensing of care institutions proceeding at a snail's pace", lzinios.lt, 1 July 2014, http://lzinios.lt/lzinios/lietuvoje/globos-istaigu-licencijavimas-vezlio-greiciu/182771

[40] Kazys Kazakevičius, "Rush to be licensed at the last minute", lzinios.lt, 13 December 2014, http://lzinios.lt/lzinios/print.php?idas=193061

[41] Resolution No. X-1070 of the Parliament "On the Adoption of the Mental Health Strategy, 3 April 2007, No. X-1070, http://www3.lrs.lt/pls/inter3/dokpaieska.showdoc_l?p_id=295147&p_query=&p_tr2=

[42] Report of the UN Special Rapporteur on torture and other cruel, inhuman or degrading treatment or punishment Juan A. Méndez, 1 February 2013, http://www.ohchr.org/Documents/HRBodies/HRCouncil/RegularSession/Session22/A.HRC.22.53_English.pdf

[43] NGOs, Letter on the shortcomings of the mental health care system in Lithuania, 7 May 2013, http://www.perspektyvos.org/photos/2013/05/Kreipimasis_20130507.pdf

[44] Parliamentary Ombudsperson Office, report "On the human rights situation in the Psychiatric Clinic of the Republican Šiauliai Hospital (a public entity)", 28 August 2014,  No. 2014/1-60(18), http://www.lrski.lt/images/dokumentai/iauli%20psichiatrijos%20klinika%20Nr.%2018.pdf

[45] Parliamentary Ombudsperson Office, "Human rights violations found in the Psychiatric Clinic of the Republican Šiauliai Hospital", 2 September 2014, http://www.lrski.lt/lt/naujienos/220-konstatuoti-zmogaus-teisiu-pazeidimai-respublikines-siauliu-ligonines-psichiatrijos-klinikoje.html

[46] Republican Šiauliai Hospital, "Human rights are not being violated in the Psychiatric Clinic", 8 October 2014, http://www.siauliuligonine.lt/lt/visos-naujienos/865-psichiatrijos-klinikoje-zmogaus-teises-nepazeidziamos

[47] Group of VU scientists, "Challenges to implementing the mental health policy of Lithuania", 2013, http://www.fsf.vu.lt/fakulteto-ivykiai/mokslo-naujienos/962-isleista-mokslo-studija-issukiai-igyvendinant-lietuvos-psichikos-sveikatos-politika

[48] Prison Department, Activity Report 2013, p. 3, http://www.kalejimudepartamentas.lt/lt/kalejimu-departamentas/veikla/ataskaitos/metines.html

[49] International Centre for Prison Studies, "World Prison Brief", http://www.prisonstudies.org/world-prison-brief

[50] Eurostat, "Crime and Criminal Justice, 2006-2009", 2012,  p. 7, http://ec.europa.eu/eurostat/documents/3433488/5584360/KS-SF-12-006-EN.PDF/bcad1ec8-5b81-4e82-a582-5390fec5effd?version=1.0

[51] Prison Department, "Brief on the number of prison sentences, their contents (according to the offence committed, age, length of sentence et al.) and their changes", 28 January 2014, http://www.kalejimudepartamentas.lt/download/4605/nuteistuju%20skaiciaus,%20sudeties%20%20suvestine%202013.pdf

[52] Prison Department, Activity Report 2013, p. 5, http://www.kalejimudepartamentas.lt/lt/kalejimu-departamentas/veikla/ataskaitos/metines.html

[53] Prison Department, "Report on unlawful communications uncovered, banned items confiscated and the criminal situation in places of detention", 28 January 2014, http://www.kalejimudepartamentas.lt/download/3869/isaiskintu%20neteisetu%20rysiu%20ataskaita%202013.pdf

[54] Prison Department, "2013 Activity Report of Social Rehabilitation Services", 28 January 2014, http://www.kalejimudepartamentas.lt/download/3875/socialines%20reabilitacijos%20suvestine%202013.pdf

[55] Nerijus Povilaitis, "Prosecutors interviewed vice-minister A. Vitkauskas in a case concerning prisoner exploitation", lrytas.lt, 27 March 2013, http://www.lrytas.lt/lietuvos-diena/aktualijos/kaliniu-isnaudojimo-byloje-prokurorai-apklause-finansu-viceministra-a-vitkauska.htm

[56] Genovaitė Rafinavičienė, "Prisoners more eager to work than the unemployed", lrytas.lt, 28 May 2013, http://www.lrytas.lt/verslas/rinkos-pulsas/kaliniai-dirbti-nori-labiau-nei-bedarbiai.htm

[57] Nerijus Povilaitis, "Death of a prisoner revealed the terrifying rules of the Pravieniškės colony", lrytas.lt, 25 March 2013, http://www.lrytas.lt/lietuvos-diena/kriminalai/kalinio-mirtis-atskleide-siaubingas-pravieniskiu-kolonijos-taisykles.htm;  Paulius Garkauskas, "Prison from within: once you're a "loser" or a bitch, there's no chance of going up anymore", delfi.lt, 27 April 2013, http://www.delfi.lt/news/daily/crime/kalejimas-is-vidaus-tapus-duchu-arba-gaidziu-galimybes-pakilti-nebelieka.d?id=61243913

[58] Rita Gečiūnaitė, "Prison from within: castes exist on both sides of the barbed wire", delfi.lt, 13 April 2013, http://www.delfi.lt/news/daily/crime/kalejimas-is-vidaus-kastos-egzistuoja-abiejose-spygliuotos-vielos-pusese.d?id=61138347

[59] "Panevėžys correctional facility inmates are suffocating from the heat", lrytas.lt, 5 August 2014, http://www.lrytas.lt/-14072502231407004266-panev%C4%97%C5%BEio-pataisos-nam%C5%B3-kalin%C4%97s-d%C5%ABsta-nuo-kar%C5%A1%C4%8Dio.htm; Artūras Jančys, "Imprisonment in free Lithuania is just like in Stalin's Gulags", lrytas.lt, 12 October 2014, http://www.lrytas.lt/lietuvos-diena/aktualijos/laisvoje-lietuvoje-nelaisve-kaip-stalino-lageriuose-201410121404.htm

[60] "Court of Appeal of Northern Ireland affirmed the decision to not surrender an Irishman accused of supporting terrorism to Lithuania", 23 February 2013, http://www.delfi.lt/news/daily/crime/siaures-airijos-apeliacinis-teismas-patvirtino-sprendima-neisduoti-lietuvai-parama-teroristams-kaltinamo-airio.d?id=60757973; Milda Kuizinaitė, "Lukiškės now also terrify Denmark", lrytas.lt, 22 August 2014, http://www.lrytas.lt/-14086556421407957978-luki%C5%A1k%C4%97s-jau-%C4%97m%C4%97-kelti-siaub%C4%85-ir-danijoje.htm

[61] Dainius Sinkevičius, "Sums of money that will infuriate taxpayers: the state putting "money in prisoner's pocket", delfi.lt, 7 November 2014, http://www.delfi.lt/archive/article.php?id=66325452

[62] Optional Protocol to the UN Convention against Torture or Other Cruel, Inhuman or Degrading Treatment or Punishment, 18 December 2002, http://www3.lrs.lt/pls/inter3/dokpaieska.showdoc_l?p_id=446126

[63] Law Amending Article 3 of and Including Article 191 in the Law on the Parliamentary Ombudspersons, 3 December 2013, No. XII-629, http://www3.lrs.lt/pls/inter3/dokpaieska.showdoc_l?p_id=461563

[64] "What's hidden behind the walls of Marijampolė correctional facility: violence, or lies?", delfi.lt, 21 May 2014, http://www.delfi.lt/news/daily/crime/ka-slepia-marijampoles-pataisos-namu-sienos-smurta-ar-mela.d?id=64841269

[65] "Prisoners dissatisfied with prison conditions are storming the courts", delfi.lt, 10 April 2013, http://www.delfi.lt/news/daily/crime/kalejimo-salygomis-nepatenkinti-kaliniai-atakuoja-teismus.d?id=61114323

[66] "A Romanian beat to unconsciousness was left to lie in bed half-dead for 6 hours in Pravieniškės", delfi.lt, 26 March 2013, http://www.delfi.lt/archive/article.php?id=60999753; "Two severely beaten prisoners delivered to Kaunas clinics from Pravieniškės", delfi.lt, 7 June 2013, http://www.delfi.lt/news/daily/crime/i-kauno-klinikas-pateko-du-stipriai-sumusti-kaliniai-is-pravieniskiu.d?id=61573754; "Dead prisoner suspected of being beaten found in a prison hospital", delfi.lt, 30 May 2013, http://www.delfi.lt/news/daily/crime/laisves-atemimu-vietu-ligonineje-rastas-negyvas-itariama-sumustas-kalinys.d?id=61505900; Dainius Sinkevičius, "Stories of sex between men in Vilnius correctional facilities recounted by famous prisoners in court", delfi.lt, 13 February 2014, http://www.delfi.lt/archive/article.php?id=64010552

[67] Dainius Sinkevičius, “Prison from within: if they don't like the prisoner, the wardens will "devour" him", delfi.lt, 28 August 2013, http://www.delfi.lt/archive/article.php?id=62697513; "Officers: the slothfulness of the Ministry of Justice threatens the lives of prison wardens", 15min.lt, 9 July 2014, http://www.pareigunai.lt/c-5/p-907-teisingumo_ministerijos_tinginyste_kelia_gresme_kalejimu_priziuretoju_gyvybems_papildyta; "Inmates of the Marijampolė correctional facility hung up a sign: officers are killers", delfi.lt, 14 February 2014, http://www.delfi.lt/news/daily/crime/marijampoles-pataisos-namu-kaliniai-iskabino-uzrasa-pareigunai-zudikai.d?id=64122758

[68] Parliamentary Ombudspersons Office, report "On the human rights situation in the Marijampolė correctional facility", 29 May 2014, No. 2014/1-60(15), http://www.lrski.lt/images/dokumentai/1014003106_Marijampols%20pataisos%20namai%20-%20vis.pdf

[69] Prison Department, "Brief on the average cost of upkeep of a person in prison in 2013", 28 January 2014, http://www.kalejimudepartamentas.lt/download/3877/vieno%20asmens%20islaikymas%20%202013.pdf

[70] Arvydas Kavaliauskas, "40 million is a trifle to the Prison Department", lrytas.lt, 23 September 2014, http://www.lrytas.lt/verslas/rinkos-pulsas/kalejimu-departamentui-40-milijonu-litu-mazmozis.htm; “"Imprisonment in free Lithuania is just like in Stalin's Gulags", lrytas.lt, 12 October 2014, http://www.lrytas.lt/lietuvos-diena/aktualijos/laisvoje-lietuvoje-nelaisve-kaip-stalino-lageriuose-201410121404.htm

[71] Resolution No. 740 of the Government "On the Adoption of the Programme for the Modernization of Places of Detention", dated 22 July 2014, http://www3.lrs.lt/pls/inter3/dokpaieska.showdoc_l?p_id=478875&p_tr2=2

[72] Council of Europe, Report to the Lithuanian Government on the visit to Lithuania carried out by the European Committee for the Prevention of Torture and Inhuman or Degrading Treatment or Punishment from 27 November to 4 December 2012, published 4 June 2014, http://www.cpt.coe.int/documents/ltu/2014-18-inf-eng.pdf

[73] UN Convention against Torture or Other Cruel, Inhuman or Degrading Treatment or Punishment, 10 December 1984, Article 37, http://www3.lrs.lt/pls/inter2/dokpaieska.showdoc_l?p_id=280690&p_query=&p_tr2=

[74] UN General Assembly, "Report of the independent expert for the United Nations study on violence against children", 29 August 2006, http://www.unicef.org/violencestudy/reports/SG_violencestudy_en.pdf

[75] Global Initiative on Psychiatry, "Analysis of factors in and causes of offending in children who are placed under medium supervision", 2010

[76] Global Initiative on Psychiatry, "Analysis of factors in and causes of offending in children who are placed under medium supervision", 2010

[77] Law on Minimum and Medium Supervision of the Child, 28 June 2007, No. X-1238, http://www3.lrs.lt/pls/inter3/dokpaieska.showdoc_l?p_id=301806&p_query=Vaiko%20ir%20minimalios%20ir%20vidutin%C4%97s%20prie%C5%BEi%C5%ABros%20%C4%AFstatymas&p_tr2=2

[78] Law Institute of Lithuania, "Minimum and medium child supervision measures: premises, situation and problems with implementation", 2013, p. 24, http://www.teise.org/data/Monografija.-Vaiko-minimalios-prieziuros.pdf

[79] Law Institute of Lithuania, "Minimum and medium child supervision measures: premises, situation and problems with implementation", 2013, p. 32, http://www.teise.org/data/Monografija.-Vaiko-minimalios-prieziuros.pdf

[80] Global Initiative on Psychiatry, "Analysis of factors in and causes of offending in children who are placed under medium supervision", 2010

[81] National Audit Office, national audit report "Does the work of child socialization centres bring results?", 29 July 2013, No. VA-P-50-11-10, http://www.vkontrole.lt/pranesimas_spaudai.aspx?id=17701

[82] UN Committee against Torture, and Other Cruel, Inhuman or Degrading Treatment or Punishment. Concluding observations on the third periodic report of Lithuania, 17 June 2014, http://tbinternet.ohchr.org/_layouts/treatybodyexternal/Download.aspx?symbolno=CAT/C/LTU/CO/3&Lang=en

[83] Parliamentary Ombudspersons Office, report "On the human rights situation in the Vėliučionys Children's Socialization Centre, the Kaunas Children's Socialization Centre "Saulutė", the Kaunas Children's Socialization Centre, the Gruzdžiai Children's Socialization Centre" and the "Širvėna" Children's Socialization Centre", 28 January 2015, No. 2014/1-60(30),

http://www.lrski.lt/images/dokumentai/2015-01-28_Vaiku_SOC_centrai.pdf

[84] "Child prostitution in the Švėkšna Special Education Centre: the "clever" girls were selling weaker ones", delfi.lt, 18 January 2015, http://www.delfi.lt/news/daily/education/vaiku-prostitucija-sveksnos-specialiojo-ugdymo-mokykloje-sustresnes-pardavineja-silpnesnes.d?id=66935378

[85] "Closure of the Švėkšna Special Education Centre under consideration", lzinios.lt, 20 January 2015, http://lzinios.lt/lzinios/Mokslas-ir-svietimas/svarstoma-likviduoti-sveksnos-specialiojo-ugdymo-centra/195177

[86] Law on the Legal Status of Aliens, 29 April 2004, No. IX-2206, Article 79(4), http://www3.lrs.lt/pls/inter3/dokpaieska.showdoc_l?p_id=486481

[87] Migration Department, "Migration Yearbook 2013", 2014, http://goo.gl/KYnAVb

[88] Migration Department, "Migration Yearbook 2013", 2014, http://goo.gl/KYnAVb

[89] Parliamentary Ombudspersons Office, "Report on the inspection of the human rights in the Foreigners' Registration Centre", 22 May 2014, No. 2013/1-43, http://lrski.lt/images/_URC_ataskaita_2014_05_22.pdf; Note of the Equal Opportunities Ombudsperson Office, 6 January 2014, No. (13-SN-260) (not publicized); Note of the Children Rights Ombudsperson Office, 10 September 2013, No. (6.1.-2013-113)-PR-184 (not publicized)

[90] Parliamentary Ombudspersons Office, "Report on the inspection of the human rights in the Foreigners' Registration Centre", 22 May 2014, No. 2013/1-43, http://lrski.lt/images/_URC_ataskaita_2014_05_22.pdf

[91] State Border Guard Office, "Border guards used electro-shock to subdue a Georgian illegal throwing a fit", 18 February 2013, http://www.pasienis.lt/lit/Besiskeryciojusi-gruzina-nelegala-pasienieciai-ramino-elektros-soku-foto "Georgian illegals resisting border guards during an inspection were subdued by force", 18 October 2013, http://www.pasienis.lt/lit/Patikrinimo-metu-pasienieciams-priesinesi-gruzinai-nelegalai-buvo-sutramdyti-jega-foto

[92] Parliamentary Ombudspersons Office, "Report on the inspection of the human rights in the Foreigners' Registration Centre", 22 May 2014, No. 2013/1-43, p. 16-17, http://lrski.lt/images/_URC_ataskaita_2014_05_22.pdf .

[93] Equal Opportunities Ombudsperson Office, Note No. (13-SN-260) on the investigation into the complaint of Nadim M. Musa and other residents of the Foreigners' Registration Centre, dated 6 January 2014, http://www.redcross.lt/files/Kontrolieriaus_tarnybos_sprendimas.pdf

[94] Equal Opportunities Ombudsperson Office, Note No. (13-SN-260) on the investigation into the complaint of Nadim M. Musa and other residents of the Foreigners' Registration Centre, dated 6 January 2014, http://www.redcross.lt/files/Kontrolieriaus_tarnybos_sprendimas.pdf

[95] Order No. 1V-42 of the Minister of the Interior "On Amending Order No. 1V-340 of 4 October 2007 of the Minister of the Interior "On the Adoption of the Rules and Procedure for the Temporary Accommodation of Aliens at the Foreigners' Registration Centre"', dated 31 January 2014, http://www3.lrs.lt/pls/inter3/dokpaieska.showdoc_l?p_id=465307&p_tr2=2

[96] Order No. 3K-14 of the Chief of the Foreigner's Registration Centre "On the Approval of the Survey Sheet for Accommodated Aliens", dated 10 February 2014

[97] Parliamentary Ombudspersons Office, "Report on the inspection of the human rights in the Foreigners' Registration Centre", 22 May 2014, No. 2013/1-43, p. 12, http://lrski.lt/images/_URC_ataskaita_2014_05_22.pdf

[98] International Organization for Migration, "Asylum System in Europe: Situation and Problems", 2012, p. 15, http://www.iom.lt/documents/Studija_TMO.pdf

[99] Note No. (6.1.-2013-113)-PR-184 of the Children's Rights Ombudsperson's Office, dated 10  September 2013 (not publicized)

[100] Note No. (6.1.-2013-113)-PR-184 of the Children's Rights Ombudsperson's Office, dated 10  September 2013 (not publicized)

[101] Note No. (6.1.-2013-113)-PR-184 of the Children's Rights Ombudsperson's Office, dated 10  September 2013 (not publicized)

[102] Lithuanian Red Cross Society, "The "Implementation of the European Union asylum acquis in Lithuania: legal and social aspects" project", 2013, http://www.redcross.lt/lt/veikla/pabegeliai-prieglobscio-prasytojai/2-uncategorised/175-projektas-europos-sajungos-prieglobscio-teisyno-igyvendinimas-lietuvoje-teisinis-ir-sociologinis-aspektai

[103] Institute for Ethnic Studies of the Lithuanian Social Research Centre, Studies of Ethnicity, 2013 m., p. 115