difficulties they could face when exercising their right to appeal. Therefore, it is important to establish a simple and accessible complaints procedure concerning psychiatric assistance and human rights violations with due regard to patients’ special needs and determining the mandatory and uniform internal complaints and feedback procedure for all psychiatric establishments by adopting a normative act to that effect. The recommendation made in the 2017 parliamentary report concerning this issue is still unfulfilled.229 The Public Defender and the Special Preventive Group believe that it is necessary to ensure an assessment by independent experts of the effectiveness of state supervision over psychiatric assistance, the monitoring system of patients’ rights and to ensure the development of appropriate recommendations. In this regard, we were informed by the Ministry of Internally Displaced Persons from the Occupied Territories, Labour, Health and Social Affairs of Georgia that, with the technical assistance of the Council of Europe, efforts are underway to develop a mechanism of internal inspection and monitoring of the facilities. According to the ministry, the questionnaire of the WHO Quality Rights Toolkit230 will serve as a basis for the development of the mechanism of internal inspection and monitoring of the facilities, which is commendable. Unfortunately, the ministry has not supplied information as to what has been accomplished with the CoE’s assistance, whether the existing mechanisms were assessed, whether the relevant best practices were researched and what steps are planned to be made in the near future. Therefore, the recommendation concerning the assessment of the effectiveness of the state supervision over psychiatric assistance and the monitoring system of patients’ rights by independent experts cannot be considered to have been fulfilled. In terms of enhancing regular, systemic and proactive state supervision of psychiatric facilities, certain efforts by the LEPL Agency of State Regulation of Medical Activity are noteworthy. In particular, in 2018, this agency assessed 5 psychiatric facilities231 in terms of the compliance of their inpatient services with the licensing terms and concluded that none of them fully met the licensing terms. Therefore, it is important to ensure strict control over redeeming the shortcomings identified in these facilities and to conduct periodic examinations of all psychiatric facilities. The Special Preventive Group maintains that the examination of compliance of inpatient services with licensing terms is only one element of regular, systemic and proactive monitoring of psychiatric facilities and the capacity of a facility to provide inpatient services is examined under this head. After this, it should be proactively assessed as to what degree patients receive psychiatric care based on the 229 The 2017 parliamentary report by the Public Defender, p. 76. In November 2018, 5 staff members of the ministry participated in the training session on the use of WHO Quality Rights Toolkit questionnaire. 231 The following facilities were inspected: The Centre for Mental Health of East Georgia (incorporates the Surami Psychiatric Clinic and the Bediani Psychiatric Clinic); the Kutaisi Mental Health Centre; the National Centre for Mental Health (the village of Kutiri); the Senaki Inter-District Psycho-Neurological Clinic and the Rustavi Mental Health Centre. 230 83