(CN) - Latvia kept a mentally ill woman in prison long after judges told them to send her to a hospital, and on Thursday, Europe's top human rights court said that was a clear violation of her freedom.

In a unanimous decision, the European Court of Human Rights ruled that Latvia had violated the basic right to freedom and personal security under Europe's human rights treaty. Once national courts decided that M.A. was mentally unfit and needed medical care, the judges said, keeping her in an ordinary prison was a violation.

M.A., a Latvian woman born in 1967, had battled serious mental health problems for years. Diagnosed with organic personality disorder and epilepsy, she was officially recognized as having a second-degree disability in 2016. Two years later, she was sentenced to four years in prison for fraud and forgery and sent to the Iuciema women's facility in Riga.

In October 2020, prosecutors opened a second fraud case against her, and a Riga court ordered a psychiatric evaluation to see if she was fit to stand trial. The following spring, she was transferred to the Riga Psychiatric and Narcology Center for examination.

Doctors soon concluded that her condition had worsened to the point where she could no longer take part in legal proceedings or serve a prison sentence. They urged that she be moved to a psychiatric hospital for long-term treatment. In July 2021, a district court agreed and formally ordered her transfer for six months of treatment.

But the order never took effect. Instead of being moved to a hospital, M.A. was sent back to Iuciema and kept there for nearly half a year while different courts argued over her overlapping cases. It wasn't until February 2022 that another court finally stepped in, ended her prison term and ordered her transfer to psychiatric care.

European judges said the delay went far beyond what could be considered acceptable. The state should have acted immediately, the judges said, once doctors and judges agreed she was too ill for prison. Instead, officials left her behind bars for months without the specialized treatment she needed, turning a legal safeguard into a prolonged failure of care.

During that time, the court noted, the prison gave her medication and basic supervision, but "the medical treatment for her mental health did not go beyond basic care and no individualized treatment program was put in place."

The court acknowledged that Latvian authorities tried to follow the proper legal steps, which required a separate ruling to release M.A. from her original sentence before she could be moved to a hospital. But the process stalled as two district courts failed to coordinate. One had already found her unfit and ordered treatment, while the other called for yet another psychiatric assessment even though doctors had already confirmed her condition. 

The resulting overlap and pandemic delays led to what the judges said was "a significant delay in admission to such institutions," which they added "will obviously affect the prospects of the treatment's success."

The court also stressed that when people with mental disorders are deprived of their liberty, it must be for treatment, not just confinement. As the judges put it, "Irrespective of the facility in which those persons are placed, they are entitled to be provided with a suitable medical environment accompanied by real therapeutic measures, with a view to preparing them for their eventual release."

Charlie Brooker, honorary professor of law and criminology at Royal Holloway, University of London, said that at its core, human-rights law affirms that prisoners do not lose their fundamental rights simply because they are incarcerated.

"If a prison lacks the capacity to deliver appropriate psychiatric treatment, authorities have a legal and ethical duty to transfer the individual to a facility equipped to provide it," he said. Access to mental health care, he added, "is not a privilege but a right" and a crucial safeguard to ensure that punishment does not turn into neglect.

Beyond the legal arguments, others said the case shines a light on a deeper problem - how justice systems treat people living with mental illness. Theo Gavrielides, a legal philosopher and founder of the Restorative Justice for All International Institute, said the case should push governments to rethink how they treat people in custody with mental health conditions. "Prisons are not equipped to support complex mental health needs," he said, warning that neglect often makes conditions worse and derails any chance of recovery.

He added that nonpunitive approaches like restorative justice can provide "individualized solutions to harm," making the justice process "an individualized experience that reflects possibilities but also barriers, including mental health."

Concluding that M.A. had been held unlawfully, the court sided with her and found Latvia at fault, ordering the government to pay 9,000 euros (about $10,384) in compensation. 

M.A.'s lawyer, Jelena Averinska, welcomed the ruling, telling Courthouse News that the authorities' inaction went against both medical evidence and common sense. She said once psychiatric experts had recommended hospital treatment, "the ordinary prison ignored all my requests to take steps to fulfil the expert's indications." 

She added, "the prison's own doctors were not experts - they could not disregard or contradict the expert's conclusion or provide inappropriate medical aid. They should have acted quickly and in accordance with the law, but they didn't."

Latvia's Ministry of Justice said it is still reviewing the ruling and considering whether to ask for a referral to the Grand Chamber.

The ruling is set to become final in three months unless either side seeks review by the Grand Chamber.

Courthouse News reporter Eunseo Hong is based in the Netherlands.

Source: Courthouse News Service