By Rosie Goldsmith
BBC Radio 4's Crossing Continents
Michel entered a Czech hospital when he had a breakdown
One of the conditions of the Czech Republic joining the EU was that it stop using caged beds to restrain the mentally ill, but as one former patient explains, this has not yet happened.
"It is like a cage in a zoo. Like a small prison."
Thirty-year-old Michel Celetka described his week locked in a caged bed in a psychiatric clinic in Brno, his home town.
The cage was one and half metres high and two metres long; covered by dense netting attached to metal bars, and padlocked at the top on one side.
Michel felt "confused and trapped" and was not allowed out to eat or use the toilet.
"I had to pee through the cage once because I could not hold it in. My mouth was so dry I even attempted to drink my own urine," he told BBC Radio 4's Crossing Continents.
Michel was having a breakdown and was hallucinating. He had checked himself into the clinic, desperate for help.
Legacy of neglect
With no doctor or lawyer present he was immediately tranquillized and restrained in a caged bed. He was in hospital for five weeks and eventually diagnosed with paranoid schizophrenia.
The use of caged beds goes back 100 years in Czech Republic
"During my time there, I never saw a psychologist or any therapist. They just gave me pills. I just wanted someone to touch and someone to talk to," he said.
This all happened in 21st Century Czech Republic, now part of the European Union, and a popular tourist destination.
But the country is still dealing with the legacy of failure and neglect it suffered under communism, a time when "lunatics" were kept off the socialist streets and hidden away in enormous psychiatric hospitals.
Britain had its straitjackets, locked wards and vast Victorian asylums. Czechoslovakia - as it was called - had its caged beds, their use going back over 100 years to the time of the Austro-Hungarian Empire.
According to the Prague psychiatrist and campaigner Dr Jan Pfeiffer, at the time the beds were considered "progressive" and "more humane than strapping someone down".
Dr Pfeiffer believes there are hundreds of cases like this
Today Dr Pfeiffer leads the way in trying to ban the beds in his country.
Despite being condemned as a violation of human rights by the EU, The Council of Europe, Amnesty International and the UN, caged beds continue to be used in the four new EU accession countries, Slovakia, Slovenia, Hungary and The Czech Republic.
Dr Pfeiffer believes there are "at least hundreds" of these beds in the Czech Republic. Statistics are hard to find as journalists and campaigners rarely gain access to the hospitals and care homes where they are in routine use.
However, the Dobrany hospital, near Pilsen, was co-operative. It is one of the largest in the country with 1300 beds, of which 10% were allegedly caged.
But the director and chief psychiatrist, Dr Vladislav Zizka, proudly proclaimed that "only last week several were destroyed".
Standing in front of one such bed however, he said they are still necessary:
"There is no law forbidding us to use cages. The patients are put in them when they are uncontrollable and disturbed.
The hospital in Dobrany justified its use of the beds
"It is for their own safety and for the safety of the other patients and staff, and for when we do not have enough nurses to keep them quiet."
These arguments were heard often during the programme's journey through the Czech Republic. And Czech lawyers and politicians have confirmed that mental health services are unregulated and under-funded.
A Commission for Mental Health Reform has been set up and guidelines issued but the basic problems remain. Community after-care is negligible; patients have few rights, and prejudices against mentally ill people abound.
"Caged beds do not belong in a civilized society," Michel Celetka said.
When Michel left hospital the experience left him feeling "suicidal" and "totally messed up".
He had no job prospects, no benefits and had to live at home with his parents. But today, through medication, weight-lifting and a positive outlook, he keeps stable and cheerful. He also has a voluntary job with a mental health charity.
"The Czech system is old-fashioned and authoritarian and I feel I have a mission to talk about it," Michel said.
"I visit hospitals, hear complaints and try to help other patients articulate what they need. No one ever listens to the patients. We want to lead normal lives like everyone else."
BBC Radio 4's Crossing Continents, Crossing Europe was broadcast on Thursday, 8 July, 2004 at 1100 BST.
The programme was repeated on Monday, 12 July 2004, at 2030 BST.