JEAN-JACQUES GAUTIER NPM SYMPOSIUM 2016 in many countries, particularly in Europe and Latin America, but also in the Asia-Pacific region (New Zealand). Since 2011, the SPT has placed greater emphasis on monitoring psychiatric institutions and systematically conducts visits to this type of establishment as part of its field missions. On a regional level, the European Committee for the Prevention of Torture (CPT) regularly monitors psychiatric hospitals and has been doing so for approximately 15 years. An integral part of the CPT’s work involves raising their members’ awareness, training them and conducting visits to psychiatric institutions. This is borne out by the statistics on visits carried out in 2015: 12 of the 17 missions in that year included visits to psychiatric hospitals. Despite this clear mandate and the monitoring bodies’ awareness of the need to visit these facilities, various internal and external obstacles to regular monitoring remain in place. Externally, limited access, in particular to private establishments, continues to present significant challenges to the monitoring bodies in some settings. Internally, some NPMs’ visiting schedules still rarely prioritise these centres. This is in part the result of the members’ lack of training and awareness on mental disability, which hinders NPMs’ capacity to treat persons deprived of liberty in these institutions in an appropriate way and to respond to their needs. Members and staff of monitoring bodies (NPMs or SPT) are often still ill at ease during these visits due to prejudices surrounding mental disability, the discrimination that has historically prevailed towards persons with disabilities and a lack of training and awareness. The aim and nature of psychiatric institutions differs from more “classic” detention centres, such as prisons. Unlike in the prison system, directors of health establishments are involved in the decision-making on involuntary placement, and are then responsible for implementing this decision, which is not always accompanied by the necessary guarantees to prevent arbitrariness and allow for review procedures in case of abuse. In addition, the attitude of care staff, who see themselves as vested with a therapeutic mission and are not used to being supervised by an independent external body may, initially, be wary. Often people do not know what these bodies do and their actions are therefore misunderstood and perceived to be an inappropriate challenge to the merit of medical decisions and interference in the therapeutic process. Against this background, it 10