Mongolia: Violence in Mental Health Facilities

The report provides an examination of the conditions, treatment, and regulatory frameworks affecting persons in mental health institution with a particular focus of LGBTIQ+ individuals. The report reveals severe inadequacies in infrastructure, service delivery, and protective measures for patients’ rights in the The National Center for Mental Health (NCMH), the only psychiatric facility offering inpatient treatment that handles involuntary hospitalisations.

The physical standards of the NCMH are notably substandard and incapable of meeting the basic needs of patients. Despite limited renovations, the facility’s origins as a former prison still influence its structure, with narrow corridors and iron doors that evoke a punitive environment rather than a therapeutic one. Overcrowding is a persistent issue. The acute psychiatric ward, with a nominal capacity of 50 patients, frequently holds over 60, forcing individuals to share rooms—and in some cases, even beds. The overcrowded conditions compromise patient dignity, create unhygienic situations, and obstruct proper medical care. The lack of gender-separated wards results in women and men sharing close quarters, further undermining the security and comfort of patients.

The report also highlights the problem of verbal and physical abuse by healthcare providers, particularly targeting LBTI patients who face added layers of discrimination. Instances of mistreatment range from derogatory comments about sexual orientation and gender identity to recommendations for “conversion therapy”. LGBTIQ+ patients are often advised to “normalize” themselves by conforming to heteronormative expectations, such as marriage or childbearing, rather than being provided with supportive and understanding mental health services.

Another critical issue is the lack of regulation and oversight on the use of restraints and isolation measures. Mongolian law mandates that such interventions be tightly controlled, with strict supervision by physicians and proper documentation. However, interviews reveal that health providers often lack awareness of these regulations, leading to unchecked, unmonitored use of restraints. This gap underscores an urgent need for improved training and a standardised protocol for emergency interventions in mental health settings..

To address these challenges, the report recommends substantial reform, beginning with the improvement of material conditions within the NCMH and other facilities. Reducing overcrowding, separating genders in wards, and providing personal space to each patient are essential steps to protect their dignity. It calls for financial and logistical investment in community-based care models that reduce the reliance on institutionalisation, as well as enhanced staffing levels with professionals trained to meet the unique needs of vulnerable populations.

In terms of regulatory action, the report advocates for stricter legal and procedural safeguards within health-care facilities to protect patient rights, including routine judicial reviews and appeals for involuntary placements. It stresses the importance of training health-care providers in gender-sensitive and inclusive care. The report further encourages collaboration between the government and civil society organisations to monitor health facilities and ensure that they comply with human rights standards.