bio-psycho-social model,232 with due respect for patients’ rights. In this regard, the activities carried out in 2018 cannot be considered to be satisfactory. We were informed by the LEPL Agency of State Regulation of Medical Activity that, in 2018, the agency only drew 4 revision reports233 with regard to 8 patients and all of those cases concerned medical assistance provided in 2017. Such work cannot be considered as either regular or systemic since it does not allow generalising the situation. Stemming from the above, it is important to determine in the Law of Georgia on Psychiatric Care the external supervision/monitoring grounds for supervision over psychiatric assistance and the monitoring system of patients’ rights. This should be done based on the assessment of the existing system of state supervision over psychiatric assistance and the monitoring system of patients’ rights as well as the best international practices. In the opinion of the Special Preventive Group, this should, at least, incorporate regular, systemic and proactive nature of supervision and monitoring, the biopsycho-social model and a human rights-based approach, as well as accountability to the public. 5.8. THE PROBLEM OF LENGTHY HOSPITALISATION Similar to the previous years, there are also problems with regard to lengthy hospitalisation of patients. Despite the fact that often patients do not need active treatment, they cannot leave the hospital as they have nowhere to go or their family avoids taking them back. This is caused by the lack of support services in the community.234 In this regard, the Public Defender’s recommendation – given in the 2017 parliamentary report regarding needs assessment of patients placed in psychiatric establishments for more than 6 months for discharging and referring them to community-based services – remains unfulfilled. Unfortunately, the only shelter in the entire country is in the Academician B. Naneishvili National Centre for Mental Health, which can house 100 beneficiaries. The shelter is arranged within the premises of the establishment and is isolated from the community. The Special Preventive Group believes that placing patients with mental health problems in large institutions contradicts the Convention on the Rights of Persons with Disabilities. Stemming from the above-mentioned, the Public Defender calls upon the relevant state agencies to take effective steps in 232 Under Article 4.c) of The Law of Georgia on Psychiatric Care: “Psychiatric care - a set of measures aiming at the examination and treatment of a person with a mental disorder and the prevention of exacerbation, and the facilitation of social adaptation and community reintegration of a person with a mental disorder.” 233Resolution no. 638 of the Government of Georgia of 30 December 2016 on Approving State Programmes of Health Care in 2017, Article 18. 234 During conversations with the Special Group members, some of those patients who were fully aware of their mental condition, expressed the wish to be discharged from the inpatient facility and continue treatment at home could not understand why they were not discharged without their family member’s signature, considering they were placed in the hospital on a voluntary basis. 84