3.1.2 NATIONAL FRAMEWORK CONCERNING DEPRIVATION OF LIBERTY lenge is the unreasoned stay in psychiatric hospital of drug abusers whose assessments while in compulsory treatment are made every 6 months (and not earlier). There are increasing cases of patients who have fallen into a psychotic state as a result of drug abuse. These people stabilize after about a week and are completely asymptomatic, but have no choice but to wait for the 6 months to expire. Patients under compulsory treatment are often transferred from one hospital to another for years. Although SPHs treat people who have committed severe crimes such as murder, they cannot be separated and supervised differently. No funds are provided for security in psychiatric wards and the function of the SPH is not of a prison. The location of the SPHs leads to patients being distanced from their relatives. According to a forensic psychiatrist178 in Bulgaria the main challenges are: the pseudo-humane tendency to discharge undertreated patients that is perceived as beneficial to the treated, but poses a high risk to those around them (such practice is often observed in the Mental Health Centres in regional cities) and the practice of placing people who have already committed a crime under an involuntary treatment procedure (under the Health Act) in psychiatric hospitals. He gives an example of good practice with a judge‘s practice of consulting with a doctor, a social worker and the mayor of the locality before discharging a patient in order to build a care network around the him/her. In most cases such network is missing and/or is not researched at all. According to the only social service provider for persons with IPD the biggest problem is the lack of clarity who is the leading figure/institution in the process of establishing and reporting the disability and providing support in compulsory treatment cases.179 The manager of the services states that one side of the study of each person’s case, of formal factors and of relations in general, is problematic because it invariably involves intervention. The other is whether this study of a person’s social functioning could become part of the pretrial forensic assessment. The Criminal Code and the Social Services Act do not have any intersection and thus there is none to take responsibility for persons currently under outpatient compulsory treatment (especially those who are not placed under guardianship). Independent monitoring in psychiatric facilities is performed by the National Preventive Mechanism (Ombudsman institution) and the Committee for Prevention of Torture. It was specifically because of poor psychiatric care why the CPT visited Bulgaria in 2017, 2020, 2021 for monitor- needed to be hospitalised but who allegedly remained in the hospitals as there was no alternative place for them to live nor sufficiently robust community care to allow for their care in the community. The Committee reiterates its view that for persons to remain in a psychiatric hospital purely as a result of the absence of appropriate community facilities is highly regrettable. Further, such patients who are not de jure but de facto detained should be free to leave. If their condition places them at risk of danger to themselves or others, the patient must be assessed to establish if an involuntary hospitalisation should take place.” 178 Bulgaria, Statement of a psychiatrist on 28 April 2022 at the National Advisory Board discussion. 179 Bulgaria, Interview with the manager of community-based social services for persons with intellectual and psychosocial disabilities K.I on 8 June 2022. She gives an example with the work on cases of persons undergoing compulsory treatment, placed under guardianship. When the social workers talk to the relatives who refused to be the guardians of the person who is blocked in the hospital for years of compulsory treatment, the relatives’ motives are heard, but there are invariably opportunities to agree something with them, because otherwise there is no one else to do this job. But for advocacy to be successful, appropriate support services need to be developed which are unavailable yet. Bulgarian Helsinki Committee 49