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Despite the government's vow in 2004 to ban the use of caged beds in social-care homes and psychiatric hospitals, facilities confirm that they still continue to use them.

Now, an advocacy group for the mentally ill based in Hungary plans to sue the government for human rights violations on behalf of an undisclosed number of patients.

The Mental Disability Advocacy Center (MDAC) has been building its case since 2003, and says there could be as many as 1,400 caged beds still in use in the Czech Republic.

"We think that in some hospitals, the number of caged beds has been limited on the initiative of the directors, but that is not a general trend," says Jan Fiala, legal officer for the MDAC. "There are hospitals in which the number of beds has even increased," Fiala said, though he declined to name specific facilities.

The Health Ministry, which banned the beds in June 2004, denies that any institution under its control still uses them.

"The use of caged beds that was discussed in the media falls under the Labor and Social Affairs Ministry; it wasn't about the psychiatric hospitals," says Jana Kopecká, spokeswoman for the Health Ministry.

Kateřina Beránková, spokeswoman for the Labor and Social Affairs Ministry, says, "As far as I know, there are no caged beds in psychiatric hospitals."

But Ivan David, director of Bohnice Psychiatric Hospital in Prague, says two caged beds are still in use there.

Asked why, David says, "The Health Ministry is incapable of saying, of expressing something. The ministry is incompetent, so why should we adjust to it?"

MDAC officials would not comment specifically on their legal challenge — including whether they have actually filed a lawsuit yet — or say how many patients are believed to be involved. The group says that it has compiled evidence through site visits, but declined to say which facilities it has toured.

The J.K. Rowling effect

The use of caged beds in the Czech Republic drew international attention in 2004 when J.K. Rowling, author of the Harry Potter novels, led a campaign to eradicate them after reading a news report about caged beds in the The Times of London in June of that year. She fired off scores of letters to UK politicians, the Czech ambassador to the UK, and to the Czech prime minister and president, among others.

The result appeared immediate.

Not long after Rowling sharply criticized the treatment of the mentally disabled in the Czech Republic — the article she had read showed a young boy in a caged bed at the Ráby care home east of Prague — then-Health Minister Jozef Kubinyi announced he was banning caged beds.

It now appears that any planned ban was lost amid a large shake-up in the government that followed soon after: Kubinyi, a Social Democrat, was sacked after Prime Minister Vladimír Špidla stepped down.

There have been two health ministers since then, and it seems that all the government has managed to do, according to the MDAC, is eliminate caged beds that use metal bars, while instituting new rules regulating the use of caged beds made of netting (the MDAC wants both forms of restraints outlawed).

"The usage of restrictive means is justified only when all other possibilities fail, and when it's impossible to find removable cause of the patient's behavior," the Health Ministry's Kopecká says.

In an essay in The Times in February, Rowling said she had her doubts about the Health Ministry's sincerity in 2004. "I knew this was a bad joke," she wrote. "I doubted that a single caged bed had been scrapped."

The Czech government invited Rowling to Prague earlier this year to tour mental health facilities. Although she reportedly accepted, a date for the visit has not been set, and Rowling was unavailable to comment for this story.

Getting the issue wrong

Caged beds were common throughout the former Eastern bloc, and the MDAC says other countries — including Slovakia and Hungary — still used them in 2003.

Some say that critics of caged beds misunderstand the reasons why they are needed.

"It has a positive effect," says David of Bohnice. "There are patients with mental disorders ... they bite or eat anything ... so this is when the caged beds are used. The conditions for using [caged beds] are strict."

David calls the MDAC "an extreme organization with extreme views."

The MDAC says eliminating caged beds in the Czech Republic would go a long way to changing how the elderly and people with mental illness and substance addictions are treated in this country.

"A more important goal is to transform the current system of social care and psychiatric care to community-based settings," Fiala says. "The current system is institutionalized, which is the main reason such grave human rights abuses are taking place."

Any legal action would first take place within the Czech judicial system before potentially moving on to the European Court of Human Rights in Strasbourg, France, a process that could take years, Fiala says.

Sylvie Dejmková contributed to this report.