- Legal loophole which to regulate the storage of items, objects, money and
valuables during the stay of persons in the premises of the stage convoy basis.
XII. PROTECTION OF PERSONS WITH MENTAL DISORDERS
In 2014, follow up inspections were made of three psychiatric institutions: State
Psychiatric Hospital (SPH) - village of Tserova Koria, Centre for Mental Health (CMH) city of Veliko Tarnovo and CMH - city of Haskovo. During the repeated inspections of the
above hospitals the NPM found that the only changes compared to the previous
inspections are limited to the repairs, by which the material and technical conditions in
these particular hospitals (CMH- city of Veliko Tarnovo and CMH - city of Haskovo) were
significantly improved.
Changes that are amongst the competence of the Ministry of Health and the
legislature were not established by the NPM. The Ministry of Health has not taken
any measures to eliminate the shortcomings established in the reports of the NPM
in 2012 and 2013.
Reiterating the common problems and shortcomings associated with the
provision of psychiatric care, the NPM insists on making right decisions and taking
actions to start a process to resolve them. Problems and shortcomings in the network of
health care facilities for the treatment of patients with psychiatric diseases established
in all inspections are, as follows:
1. All SPHs continue to operate solely on the basis of Decree No 20 / 22.02.2000
on determining a medical institution under art. 5 para 1 of the Law on Medical
Institutions (LMI) and their specific function, but they do not have the document with a
certain level of competence required for all medical establishments for hospital care
under Art. 6 para 1 of LMI. No valid assessment of the level of competence as required
by Ordinance No 24 / 07.07.2004 for establishing medical standard "Psychiatry" has
been performed. The conditions for the implementation of medical activities related to
available and operable medical equipment and furniture, the number and distribution of
medical specialists, hygiene and living conditions in which patients are placed, etc. are
not fulfilled.
2. Most of SPHs do not have adequate conditions in accordance with the medical
standard "Psychiatry", such as: possibility to use the X-ray scanner, EEG, MRI and clinical
laboratory of II or III level of competence (all of the above with access provided to the
hospital 24 hours a day), as well as the possibility to perform medical consultations with
other specialists - all of the above on the territory of the settlement, as well as with ECG,
ECT and an installation for oxygen supply to the hospital.
3. The composition of some medical establishments for psychiatric care include
units that have not been registered under the existing legislation, but nevertheless they
operate. These are most of the hospital pharmacies and clinical laboratories in the
structures of SPHs.
4. Problem for the normal operation of the medical institutions for psychiatric
health services, and in particular - hospitals, is the lack of sufficient staff - physicians,
nurses, psychologists and paramedics. This hampers the timely and quality treatment of
patients and poses a risk in terms of monitoring and care of patients with aggression
and self-aggression. The access regime to hospitals is also hampered, and part of the
patients have criminal records. Due to the limited quantity and quality of human
resources in the psychiatric hospitals night shifts are performed by a minimum number
of staff, which creates a danger both for the staff and the patients. The main reasons for
this insufficiency of trained specialists are the low pay and the poor working conditions.
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