3.1.2 NATIONAL FRAMEWORK CONCERNING DEPRIVATION OF LIBERTY All judges talked about different combinations between compulsory treatment under the Criminal Procedure Code and civil involuntary treatment under the Health Act which are applied to offenders due to various reasons (duration of the proceedings/the authority which reacted first to a signal about the offence/the funding of the different psychiatric facilities and the measures/the legislative gaps between criminal and healthcare legislation/overcrowded psychiatric facilities/lack of clear guidance to all actors about their functions in the process of urgent placement, etc.). According to the law the compulsory treatment is applied in case a crime under the Criminal Code has already been committed while involuntary treatment is applied as a prevention measure in case the disabled person is assessed as at risk to perform a crime or to self-harm. However, depending on the concrete circumstances in each case persons who had committed crimes may end up in involuntary treatment. According to one of the interviewed judges the majority of the disabled persons who had committed petty crimes are placed under involuntary instead of under compulsory treatment. This is mainly because the civil proceedings under the Health Act are more speedy.153 One judge explained also an illegal practice of psychiatrists in psychiatric hospitals who misuse the consent of the disabled persons to treatment154 and illegally (without court permission) detain patients.155 There are cases in which once a court decision for compulsory/involuntary treatment is issued, the appointed psychiatric hospital refuses to implement it. Then the relatives or other persons notify the court about this and then a case law is now being elaborated on imposing fines to the hospital for non-implementation of a court’s decision.156 In practice, persons on for themselves what therapy and what medicines to take, how much to take, they complain, for example, that medicines made them sick, irritated them, made them sleep... 152 Bulgaria, Interview with Sofia District Court judge V.K. on 9 June 2022. But they always have experience with previous treatments, and it shows when I ask questions about what therapy and medicines they are prescribed, what they take and what they should not take, and they list the specific names of the drugs, how many times a day, how many milligrams a day they take. There are different types of medicines and they know them very well. Predisposed by the court, they also talk about how they stopped taking medication and why, how they felt when they took it. 153 Bulgaria, Interview with District Court judge in Sofia, 9 June 2022. They are urgent, they are allocated to a judge on duty and are quickly decided, within about 15 days maximum. The first phase is scheduled a day or two after the case enters the court and after seven days, maximum 10 a second phase is scheduled. That is, up to 10 days (maximum 15) in view of the specific judge’s workload, we have already pronounced an act. 153 Bulgaria, Interview with District Court judge in Sofia, 9 June 2022. They are urgent, they are allocated to a judge on duty and are quickly decided, within about 15 days maximum. The first phase is scheduled a day or two after the case enters the court and after seven days, maximum 10 a second phase is scheduled. That is, up to 10 days (maximum 15) in view of the specific judge’s workload, we have already pronounced an act. 154 Bulgaria, Interview with Sofia District Court judge V.K. on 9 June 2022: It happens in practice that when a person commits a public dangerous act (not a crime under the Criminal Code) falling under the scope of the Health Act, the police team arrives at the scene of the accident, they escort him/her to the psychiatric hospital and in practice the doctors motivate the person to voluntarily sign an informed consent to treatment, and subsequently during the treatment, the person refuses it. It turned out that when the person is treated voluntarily in the psychiatric hospital, the clinical path is less paid than when he/she is compulsory treated. 155 Bulgaria, Interview with Sofia District Court judge V.K. on 9 June 2022: When a person is escorted to a psychiatric hospital by the police and admitted, the person is held for more than 24 hours in the hospital. Within these 24 hours, the doctor fails to complete all the documentation and notify the court for extension of the treatment period. This is involuntary detention for more than 24 hours without judicial permission. The person is treated voluntarily, but later the doctors submit a request outside this period for involuntary treatment under the Health Act. 156 Bulgaria, Interview with Sofia District Court judge V.K. on 9 June 2022: In Sofia, in our case law, we observe rather a practice of medical facilities not implementing the court decisions for the treatment of the specific person under the Health Act, since they have no available places, no beds and cannot make a commitment to treat the person. However, in my case with the “Aleksandrovska” hospital, for three months, it was inactive and this mentally ill person was not treated, although the hospital had Bulgarian Helsinki Committee 43