Karlukovo SPH and 30 persons in Kardzhali SPH. The NPM believes that it is extremely important to work for bringing out this group of patients from their isolation and provide them community-based health and social care. In consideration of the aforementioned, the NPM again notes that a priority in the governmental mental health policy should be the successful deinstitutionalization of mentally ill people and their socialization. The NPM makes annual recommendation to the Ministry of Labour and Social Policy (MLSP) to establish new social services to meet the needs of the population and to improve the interaction between MoH and MLSP in the field of mental health. Mental Health Centres In 2019, the NPM made two unannounced on-site visits to Plovdiv MHC and Sofia region MHC in regard to accidents that had occurred there, having exposed to risk the life and health of patients. On 28 March 2019 a fire broke out in the Men’s ward for active treatment of persons with severe mental disorders in Plovdiv MHC in one of the patient rooms. Three patients died and one staff member was admitted to hospital. The other patients from this ward, numbering 20 persons, according to the prosecutor’s office data, were evacuated. The patients who died had Paranoid Schizophrenia and were placed under strict protective regime. After the fire, antifire smoke detectors are to be installed in the patient rooms of all wards. The NPM considers it necessary to note that in 2016 there was a fire in the Psychiatric Clinic of University Multi-Profile Hospital for Active Treatment “St. Marina” in the city of Varna and in 2015 there was a fire in the Psychiatric and Neurological Clinics of Alexandrovska Hospital. This indicates the higher risk of fire in medical establishments for psychiatric care due to the nature of the patients’ diseases, despite the securities measures enforced therein. The NPM considers that the security measures, in this case anti-fire measures, should be extended in the medical establishments for mental care across the country and defines the initiative of Plovdiv MHC for installing anti-fire smoke detectors as good practice that should be applied in other medical establishments for mental care. All the more, given the fact that many state psychiatric hospitals are located in remote places, far from the cities, with bad road infrastructure and understaffed. In this connection the NPM made recommendations to the Minister of Health to stipulate the requirement for installation of anti-fire smoke detectors as a criterion for the quality of the medical care in order to improve the security of mentally ill patients in inpatient medical establishments for psychiatric care. The other recommendation is to the manager of Plovdiv MHC who should improve the control over the care for patients and the organisatioin of the workflow in Plovdiv MHC. The NPM visited Sofia region MHC in relation to a fire that broke out on 31 December 2019, which destroyed the administrative building of the centre and the roof of the adjacent Sofia Regional Specialised Hospital for Active Treatment of Pneumatic Lung Diseases. The inpatient unit of the MHC was not affected, but all patients were relocated to other medical establishments. The operation of the MHC was temporarily suspended. It should be noted that the inpatient unit of the MHC comprises old and dilapidated ground premises (sheds), with very poor sanitary and hygiene conditions for patients, which is inadmissible for modern requirements to a medical establishment. In this regard, back in 2017 the NPM made a recommendation to the MoH to relocate Sofia region MHC to an empty hospital building which is situated in the same yard space. The recommendation was not implemented. The NPM considers that after the burning of the administrative building of Sofia region MHC the MoH 36