3.1.2 NATIONAL FRAMEWORK CONCERNING DEPRIVATION OF LIBERTY According to the National Strategy for Mental Health 2021-2030 there are only four forensic psychiatrist departments and only 8 forensic psychiatrists for the whole country. It underlines the significantly smaller number of assessments for termination of involuntary treatment which “shows a lack of patient follow-up and practically turns placement under involuntary treatment into a sentence – after the “punishment” has expired, the patient is discharged without follow-up care.” Another finding of the Strategy is that “significant proportion of people who have committed a crime and are recognised as criminally irresponsible are being treated in a general psychiatric hospital. The stay of these patients is usually long, and they also pose a greater danger to other patients and staff. There are no psychiatrists in the prisons”.119 In practice, the interviewed judges and expert witnesses mention several problems related to forensic assessment and expert witnesses. Below they are enlisted and illustrated with quotes from the interviews. If any identification of the disability is done by the pre-trial investigative authorities – police, prosecutors – it is delayed and appointment of the forensic assessment is also delayed.120,121 Another issue is the scarcity of expert witnesses122 and forensic psychiatrists. The investigative bodies and the court still have the option to appoint as expert witnesses any psychiatrists who are not specifically forensic psychiatrists. A disputable issue in this regard is whether the task of the forensic psychiatrist is only the assessment without treatment while some practicing psychiatrists are of the opinion that treatment whenever needed should be applied together with the assessment. The interviewed judges share that they select the expert witnesses who they appoint on compulsory treatment cases by reading case-law and assessments and by searching in academic literature databases available on the Internet. The expert witnesses entered into in the court directories are persons who formally meet the education requirements in the field Bulgaria, Council of Ministers, National Strategy for Mental Health of the Citizens of Republic of Bulgaria 2021 – 2030, adopted on 23 April 2021, p.9 and 16, available in Bulgarian at: https://www.mh.government.bg/bg/politiki/strategii-i-kontseptsii/strategii/ nacionalna-strategiya-za-psihichno-zdrave-na-grazhdanite-na-repu/. The Strategy also notes that there is a lack of a system for forensic psychiatric assessments, a system for staff development and programs for tracking patients with socially dangerous behaviour. The Strategy envisages establishment of a specialised forensic psychiatry clinic independent of the penitentiary system with sufficient capacity to provide assessment and treatment of forensic psychiatric cases and opening of small and compact (between 30 and 40 beds) inpatient psychiatric facilities for every 150 000 persons of the general population to serve psychotic crises, to be in continuous communication with the network of day centres and mental health outpatient clinics. 120 Bulgaria, Interview with Regional Court judge M.T. on 13 May 2022. In practice, in the cases in which an indictment was already filed, i.e. criminal responsibility is not excluded; it is noticed that a considerable period of time passes before it is established that the detainee or defendant has a disability. I.e. immediate identification mechanism and an algorithm for what should be done and how, are lacking, the disability is neglected. Otherwise, the investigating authorities must notice this and give indications to the prosecutor. Most often, initially the person is on his own in the proceedings, then on a later stage a lawyer is involved. An expert assessment is appointed and it is relied upon it. Although in a significant part of the cases, the disability, which requires mandatory legal defence/aid, is clear. But in any case, social protection measures of some kind should be applied from the beginning and they are not. The effort of the pre-trial authorities consists only of appointement of assesssment and a defense attorney. 121 Bulgaria, Interview with District Court judge V.C. on 13 May 2022. Another judge underlines a different aspect: The small percentage of pre-trial disability assessments should be noted. It takes place mostly when the accused tried to avoid criminal responsibility, pointing out that he had some disabilities. At the defense lawyer’s insistence an assessment is usually conducted. Police officers and prosecutors are not trained to recognise symptoms of impairment and therefore do not order assessments. 122 Bulgaria, Interview with Regional Court judge M.T. on 13 May 2022. Even in the capital - Sofia, there is also a big problem the psychiatrists to agree to be expert witnesses, except for those who are usually appointed in pre-trial proceedings - experts from the Mental Health Centres or already retired experts, former psychiatrists from the Mental Health Centre and psychologists. But psychiatrists with specialized competence, for example in addictions to drugs, have a hard time agreeing. 119 Bulgarian Helsinki Committee 37

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