4. Psychiatric institutions 4.1. Introduction During 2020, the Special Prevention group paid 5 preventive visits to 3 psychiatric institutions. Special Prevention Group visited Center for Mental Health and Prevention of Addiction377, Senaki Mental Health Center378 and Tbilisi Mental Health Center.379 Special Prevention Group also conducted monitoring visit in Batumi housing designed for 24 beneficiaries.380 It should be noted that prior to the monitoring visits, the Special Prevention Group adapted the working methodology to the existing challenges. The rules for conducting a safe monitoring visit during a pandemic were defined and members were given appropriate instructions. Individual protection means were purchased while the rules for their use were explained to members. The adoption of these measures aims at reducing the risk of new coronavirus spreading during monitoring visits and protection of staff and persons in the facilities. It should be further noted that psychiatric facilities assisted monitoring groups in carrying out their activities safely and without undue restrictions. The visits conducted during 2020 also focused on examining whether the patients were treated in an epidemic-protected environment and studying the impact of undertaken epidemic prevention measures on their rights. In addition, the Special Prevention Group methodically, thematically studied the state of protection of patients' rights in psychiatric institutions, in particular, the patients’ protection from violence, inhuman or degrading treatment; the practice of using restraint methods; sanitary-hygienic conditions; safe and therapeutic environment; psycho-social rehabilitation; legal protection safeguards; somatic and mental health of patients; contact with the outside world, etc. During the visits, the Special Prevention Group examined the documentation produced in the institutions and physical environment, conducted individual and group interviews with both patients and staff of the institution. The report below systematically describes the situation in the institutions, analyzes the problems identified during the monitoring visits and their causes. The normative framework and the progress of the implementation of the Public Defender’s recommendations issued in 2019 are assessed. 4.2. The Status of recommendation implementation This subchapter aims at reviewing the recommendations issued in the report of the National Prevention Mechanism and the state of their implementation. Information on these issues is additionally presented in the relevant thematic subchapters. In the 2019 report of the National Prevention Mechanism, the Public Defender of Georgia issued 20 recommendations for the prevention of ill-treatment in the psychiatric institutions. 18 of them were Monitoring visits were conducted on 7 May and 12 June, 2020. There were 99 patients in the facility at the time of the first visit and 94 patients during the second visit. 378 Monitoring visit was conducted on 30 July 2020, 15 patients were in the facility at the time of the visit. 379 Monitoring visits were conducted on 15-16 September 2020. 210 patients were in the facility at the time of the visits. 380 Monitoring visits were conducted on 12-13 July, 2020. 377 116