NATIONAL LEGAL AND POLICY FRAMEWORKS CONCERNING DEFENDANTS AND PERSONS DEPRIVED OF LIBERTY WITH INTELLECTUAL AND/OR PSYCHOSOCIAL DISABILITIES IN LAW AND IN PRACTICE ry treatment for years. Social residential services exclude these patients from the list of their potential users under the on-going implemented Plan for Long-term Care 2018-2027 which deinstitutionalises persons from state psychiatric hospitals and social care institutions for disabled persons. According to the National Preventive Mechanism there are around 200 “social” patients who live in the hospitals. They do not have their own homes, their relatives do not wish to take care of them and they had been on compulsory and involuntary treatment many times during the past years in different hospitals.165 Challenges of the compulsory treatment cases Deprivation of liberty solely due to unfavourable social factors The interviewed District Court judge who has rich experience with compulsory treatment cases shared her main concerns about the effect of compulsory treatment in conjunction with Art. 5 of the ECHR. In her view in only a few cases persons who had been compulsory treated for years in psychiatric hospitals still pose a high risk because of which the treatment should be continued. In 90 % of the cases she hears a stable remission due to medicine therapy has been achieved. According to the judge the third requirement (under Art.5 “e” of the ECHR - the treatment to be absolutely necessary) is disputable in Bulgaria. The risk factors in these cases are entirely social ones related to the lack of support, family, job, housing which lead to interrupting the treatment, worsening the condition of the person and pose a danger to others or for self-harm.166 Thus this group of persons are detained illegally under compulsory treatment in order to prevent them from committing crimes or self-harm solely due to unfabourable social factors. This phenomenon made several judges to propose to the Supreme Judicial Council to create a specialised unit in its administration, in which judicial officers with social work competence to be appointed to coordinate and direct to appropriate social and health services the vulnerable persons who are participants in the judicial proceedings, according to the decision of the court.167 The same judge described the rest of the challenges of cases with persons with 165 Bulgaria, Ombudsman, 2020 Annual report of the National Preventive Mechanism, p.38, https://www.ombudsman.bg/pictures/ Annual%20Report%20NPM%202020(1).pdf. 166 Bulgaria, Interview with District Court judge V.C on 13 May 2022. From a medical point of view, there is no risk - neither with the course of the disease, nor with the patient’s personality itself. But in fact risks are entirely in the social sphere. Risks because of lack of supportive family, home, job, conditions for social functioning. And this, according to the regulations, increases the risk, because when he goes out of the hospital, he has no shelter, nothing to eat, the probability that he will interrupt the medical treatment is very high, and after a short time the disease will conquer him again. Thus there is a risk for both the person and others. So in the Bulgarian context it is a big challenge not to detain persons illegally. I have often had dilemmas and in the end I choose the right to life when I am convinced that this process outside without social support will inevitably lead to a worsening of the condition and may cause death. There are people, especially in winter conditions, if they go out and don’t have loved ones or a social system to replace them, they are doomed to freeze to death or be beaten by someone else or do something which would cause harm to them or others. 167 Bulgaria, Judges asked the Supreme Judicial Council to help them help the most vulnerable, 5 May 2022, https://news.lex.bg/съд ии-поискаха-всс-да-им-помогне-да-пом/?fbclid=IwAR1Vp1YSkz2DMYlygfp-lyuWMvvRyQnqYVOwlDW6ltJDuWNDP42S1YcIc1M. 46 SLAVKA KUKOVA