ANNUAL REPORT 2019-OMBUDSMANNATIONAL PREVENTIVE MECHANISM and antisocial behaviour, the children are more often referred to a psychiatrist for lack of psychosocial treatment and rehabilitation by professionals in the educational-correctional facility; The NPM team also established that the psychiatric examination usually does not take place in a confidential atmosphere, alone with the psychiatrist. Namely, during the examinations, a person from the Security Department who accompanies the child is present and who, in fact, usually gives information to the psychiatrist about what is happening to the child and what its behaviour is like. Very rarely does the child itself have the opportunity to express its experiences and feelings about its condition. Thus, the dosages of prescribed drugs and the regulation of therapy depend to a large extent on the information that the psychiatrist has received from the child’s escort. The child alone is not able to agree or disagree with the prescribed therapy, and there is no psychological-counselling activity where the child can be further treated. Children who are users or addicts of psychoactive substances, that is, opiates are placed on a replacement therapy with Methadone, which is regularly supervised by health professionals from the Ohrid Addiction Centre. The most commonly prescribed therapies are anxiolytics - Diazepam and Demetrin, hypnotics (sleeping pills) - Sanval, which can be prescribed by a doctor who is on duty, and antipsychotics - Prazine, which is prescribed by a psychiatrist. From the conversation with the doctor, the NPM team learned that most of the children are already coming to the institution with prescribed therapy by a psychiatrist. Children do not have access to opioid analgesics (which they often abuse) because there are no such drugs in the clinic. From the inspection of the individual files, it was concluded that most of the children in the Institution, according to the records of the Institution, are children with “behavioural disorder, antisocial behaviour, personality disorder, low threshold of tolerance of frustration, impulsivity and aggressive actions, followed by deviant behaviour, as well as low social and educational status.” Such disorders are often the result of years of neglect, physical and emotional abuse in their primary families, but also in institutions where they were previously housed. In this regard, it was concluded that the doctor in the Institution acts primarily in terms of healthcare for the somatic health, without special training to approach the experiences of stress and trauma in childhood and adolescence, which these children have most often experienced. The doctor is not part of a multidisciplinary medical-psycho-social team and a care and protection programme. 144