the implementation of SPM, at least until the act has been amended and a unified form is used. We therefore repeat the recommendation which we made during our visit in 2014. In its response to the preliminary report, the Department explained that, on 23 May 2017, the Department began monitoring and recording aggressive behaviour and the de-escalation techniques used in Unit A1 for Intensive Psychiatric Treatment – Men (forms LOA and BVC were attached). The use of the forms is expected to be implemented in other intensive treatment units as well by the end of the year. If used, the forms are attached to the patient’s medical documents. The Department explained that it was not changing form SPM, as its content was stipulated by the ZDZdr. In the autumn, the Department will commence a research study on the effect of using de-escalation techniques during agitation and aggressive behaviour in the context of the doctoral studies of one of its employees. An article by the department’s staff on managing agitation and aggression is also being prepared (they expect its publication in the Slovenian Medical Journal in the autumn of 2017). According to the Department, the article could provide a partial basis for the updating of Slovenian guidelines on the use of SPM, with the EEC on psychiatry already convening a working group on this topic. n its response, the Ministry of Health stated that it agreed with the position of the NPM that, with regard to changes to the form, there was no need to wait for amendments to the ZDZdr. The Ministry of Health wanted to actively encourage the unification of these forms and, on the basis of the form from the Ljubljana Psychiatric Clinic, they prepared a proposal which included de-escalation techniques to be used prior to using SPM. The form was sent to the Expanded Expert Council for Psychiatry (EEC) on 29 September 2015, and the Council was asked to approve the form at its next session or amend and update it if necessary. At its session held on 15 October 2015, the EEC adopted the position that the prepared form was not fully appropriate and that it should be amended. It therefore proposed that the Ministry of Health called a Targeted Development Programme to obtain appropriate information and to record the situation in Slovenia. The Ministry further stated that the protection of human rights should be improved and the manner of implementing SPM should be unified. The Ministry is therefore awaiting new recommendations and guidelines for the use of SPM in psychiatry, which are being prepared by the EEC, with interest. According to the EEC, the new guidelines were expected in 2016. As is evident from the EEC report of 29 September 2017, the working group has completed their preparation and they expect them to be confirmed at the next EEC session. • As the D1 form did not always include the reason why physical restraint was reintroduced, we recommended that the Department pay attention to the correct and complete filling in of forms, both at the time of implementation and during re-implementation (prolongation) of SPM, and to point this out to the staff who are responsible for the completion of these forms. With regard to the completion of the forms, in its response to the preliminary report the Department said that all staff had been repeatedly warned of this fact and the Department’s management would warn the Inspectorate of the Ministry of Health of any irregularities at the time of the regular annual inspections, as fines were anticipated for irregularities. The staff have already been warned of the fines. The completion of forms is monitored though the Department’s health administration. • The NPM recommends that once the use of SPM is no longer justified, the staff remove the belts from the bed. In its response to the preliminary report, the Department explained that the employees would remove the belts, except on one bed where the restraint belts are fixed and cannot be removed. The Ministry of Health believes that the NPM recommendation is one that the department could implement without any major problems. IMPLEMENTATION OF THE DUTIES AND POWERS OF THE NPM IN 2017 NATIONAL PREVENTIVE MECHANISM UNDER THE OPTIONAL PROTOCOL TO THE UN CONVENTION AGAINST TORTURE AND OTHER CRUEL, INHUMAN OR DEGRADING TREATMENT OR PUNISHMENT 65