41 6.4. Detention of persons with mental disorders (psychiatric hospitals and departments) During 2012 NPM conducted four visits to psychiatric hospitals, three announced day visits and one unannounced night visit. 25 recommendations were sent in order to balance current condition with valid regulations and standards. During the visits, a number of negative consequences resulted from a long-term detention of people with mental disabilities within dislocated psychiatric hospitals were noted. According to the doctors, patients are not discharged from the hospital after their hospital treatment is no longer needed, given that there is no system established in the community to provide the necessary health care and social support in line with their needs. In one of the largest psychiatric hospitals in Serbia more than a half is being treated for more than one year, and more than a hundred for more than 10 years86. The question is whether this is considered to be a treatment if it lasts ten years or for life, or it is rather a sort of asylum. Patients who spent various years in psychiatric hospitals, completely isolated from the regular social environment, of which many are locked in, they gradually lose social and other skills, and become less capable of living independently. Long-term detention of patients as a system within dislocated psychiatric hospitals, especially in accommodation conditions which do not meet current standards as such - can be a source of individual cases of torture, and whatever the case may be, it represents inhuman and degrading treatment. The accommodation conditions in psychiatric hospitals are different, both within a hospital and among hospitals. Some accommodation facilities are in a relatively good condition, new or renovated, maintained, clean, bright, ventilated, with toilets in decent condition, dormitories are decorated, but not too large, there is enough space between the beds, bedding is clean, and there are spaces for disposal of personal items. However, in other facilities, compared to all described aspects, the situation is completely different. The staff efforts to create more favorable living conditions are notable, regardless of the available resources and the general state of the facilities. A lack of expert medical staff was noted; gaps in education of nursing staff, lack of adequate criteria for securing suitable financing of labor in hospitals; deficiencies of the labor engagement of patients and their monetary compensation for the work completed; patients are not encouraged to participate in decisions relevant to their 86 About 800 patients are situated in the Psychiatric Hospital in Vrsac of whom 460 for more than a year, and over 110 for more than 10 years. Of particular concern is the fact that only in the psychiatric wards in that hospital from 350 to 400 patients die every year.