Institutions for persons with disabilities XX  Knowledge about pain diagnoses and the treatment of persons with disabilities must be enhanced for both the care staff and the medical staff. XX  Stable relationships between the staff and the persons being cared for are necessary to be able to perceive when these are in pain. High fluctuation rates and staff shortages have thus to be avoided. XX  The use of supported communication when required is urgently necessary as communication barriers have to be removed. 2.4.6 Discrimination of persons with chronic mental illnesses Since its establishment in 2012, the NPM has repeatedly ascertained structural deficits in building up needs-based social and health services for persons with chronic mental illnesses. The consequence is that the affected persons are denied social inclusion, and a deterioration in health is accepted (see NPM Report 2015, p. 85 et seq.). The life situation of many persons with chronic mental disorders is characterised by poverty and dependence on institutions. Housing in remote farmsteads In Carinthia, there are about 30 centres for psychosocial rehabilitation in which some 650 persons with mental or psychiatric diseases live. In these centres they have no access to professional occupational and social rehabilitation or to leisure facilities. However, they also have no other alternative. Many of the centres are remote farmsteads in which the residents have often been living for decades and sometimes work on the farm for a mere pocket money. Due to a lack of alternatives, the younger chronically ill persons are housed in medium-sized remote institutions and facilities. There they have no chance of ever being able to build up outside contacts, entering sponsored employment, starting a family or choosing other types of housing. The criticism of the care structures approved by the regional government of Carinthia as formulated in the NPM Report 2016 (see NPM Report 2016, p. 97 et seq.) was enhanced by a number of additional and concrete recommendations. Commitment to implement the UN CRPD On Land level, the regional government committed unanimously to implement the UN CRPD by 2020. For that reason alone, the Land has to rectify the structural shortfalls of recent decades in this area. The discrimination of persons with chronic mental illnesses in institutions such as centres for psychosocial rehabilitation is possible because unlike other facilities for persons with disabilities, their housing is not subject to the Carinthian Equal Opportunities Act (Kärntner Chancengleichheitsgesetz). The consequences are inadequate support of those affected and of the centres for psychosocial rehabilitation. The NPM achieved that outpatient care structures close to the local community and the financial provisions for establishing a Land monitoring office were agreed with the implementation of the Psychiatry Plan 2017. The implementation of the UN CRPD at the Office of the Carinthian Ombudsman 96