43 6.4. Detention of people with mental problems in psychiatric hospitals In the previous NPM Annual Report125 it was concluded that large psychiatric hospitals are mostly of asylum nature where a great number of persons are having mental problems and are inappropriately placed in for a prolonged period of time of which many for social reasons. The NPM suggests that long-term retention of patients in dislocated psychiatric hospitals, especially when the housing conditions in itself do not meet current standards – as a system it can be a source of individual cases of torture however in any case, it represents inhuman and degrading treatment. In accordance with the recommendation submitted to the Ministry of Health in the Report on the NPM performance of duties for 2012126, to create a legal framework for mental health care in the Republic of Serbia in accordance with the rules of the international law, applicable standards and Strategy for Development of Mental Health Care127, stating that treatment and care for people with mental problems should take place within the community and as closer to the family of ill person, during the reporting period, specific legislations were enacted to establish the legal framework for deinstitutionalization in the treatment of people with mental problems. In May 2013, Law on protection of persons with mental problems128, followed with the Ordinance on the type and specific conditions of structuring organizational units and performing duties in the mental health care in the community129. The NPM expressed its satisfaction that during the public hearing on the Draft Law on Protection of Persons with Mental Problems130, its commitment to introduce mandatory rather than non-compulsory nature of structuring special units responsible for mental health care in the community. However, the NPM has been pointing out131, and once again on this occasion, to deficiencies in the provisions of the Law on protection of persons with mental problems, which stipulates that the units for mental health care are organized as a supplementary activity of the existing psychiatric hospitals and health centers. A disadvantage is the fact that every kind of care and support for people with mental problems cannot be performed as a side activity of the existing entities whose scope of work is of a completely different character. It is necessary to foresee the establishment of centers for mental health as autonomous multidisciplinary services, next to regulate their organization, jurisdiction and scope of work, all in order to create conditions for effective treatment, care and support for all kinds of people with mental problems in the community. In addition to other numerous concerns as regards the Act on Protection of Persons with Mental Problems132, the NPM indicates that the provisions governing the seclusion measure are not in accordance with current standards. The isolation of persons with severe or acute mental problems is not allowed133, seclusion of such persons, for any period, represents a cruel, inhuman or degrading treatment.134 In particular, the use of seclusion measures is not practiced in psychiatric institutions in Serbia. Accordingly, the Act should be amended so as to remove the provisions related to isolation of persons with mental problems. In the previous annual report, the NPM pointed to the deficiencies noted in the performance of psychiatric hospitals in terms of binding of disturbed / violent patients, as well as in the records maintained on this matter. In order to eliminate the aforementioned irregularities and the absence of clear procedures, during the reporting period the NPM adopted Ordinance on the detailed conditions for applying physical restraint and seclusion on persons with mental problems who are being treated in psychiatric institutions135. The NPM is of the view that the adoption of this Ordinance was a necessity, and that a part that regulates the physical restraint, except that the measure should be reduced to a minimum, bearing 125 126 127 128 129 130 131 132 133 134 135 NPM Annual Report for 2012. 72-160/12, NPM Annual Report for 2012. Official Gazette of the Republic of Serbia, No. 08/2007. Official Gazette of the Republic of Serbia No. 45/13. Official Gazette of the Republic of Serbia No. 106/13. Official Gazette of the Republic of Serbia No. 45/13. Opinion addressed to the Ministry of Health on the draft Law on Protection of Persons with Mental Problems. Official Gazette of the Republic of Serbia No. 45/13. The report of the UN Committee against Torture, sessions 47 and 48, UN Doc A / 67/44 (2012), Canada (62). Report of the Special UN Repporteur on Torture for 2012, UN Doc A / 22/53 (2013). Official Gazette of the Republic of Serbia, No. 94/2013.