IMPLEMENTATION UNDER NATIONAL LAW 2.5.3. FORMS OF SECURITY MEASURES AND COMPULSORY TREATMENT 2.5.3.1. FORENSIC PSYCHIATRIC INSTITUTIONS All six partner countries have legislation providing for the committal to a closed institution based on the absence of criminal legal capacity, for compulsory treatment as some form of security measure. Throughout the research and across all countries, grave concerns have emerged regarding the conditions of detention, coercive treatment and possibilities of unlimited detention within forensic psychiatric institutions (see Section 2.6.1). In Lithuania, Slovenia, Bulgaria and Italy, when a defendant is determined to be not criminally responsible, compulsory treatment/compulsory medical measures are ordered by a court which can be implemented either as an inpatient confinement or in an outpatient manner in the community. It is important to mention, if treatment is ordered in an outpatient fashion, it is still compulsory. In Lithuania, different options of compulsory medical treatment measures may be ordered by the court:188 (i) out-patient observation under the conditions of primary mental healthcare; (ii) in-patient observation under the conditions of a general observation at a specialised mental healthcare establishments; (iii) in-patient observation under the conditions of an enhanced observation at specialised mental healthcare establishments; and (iv) in-patient observation under the conditions of a strict observation at specialised mental healthcare establishments. In Slovenia, the security measure of compulsory psychiatric treatment and care in a healthcare institution may be enforced in the forensic psychiatric wards of the healthcare institutions that meet special professional and security conditions prescribed by the law.189 Currently there is only one such facility in Slovenia, the Forensic Psychiatry Unit of the University Clinical Centre Maribor. All persons subjected to the security measure 58 of compulsory psychiatric treatment and confinement and those detained during the proceedings for the application of the security measures are placed in this facility.190 In Bulgaria, compulsory treatment (inpatient and outpatient) may be ordered for persons who were found to lack criminal legal capacity due to an intellectual and/ or psychosocial disability at the time of the commission of the offence, defendants who have developed mental incapacity before the judgement was delivered and detainees who developed mental incapacity while serving their sentence. This order of compulsory treatment may take the form of (i) outpatient treatment under the supervision of a psychiatric clinic and in the care of relatives; (ii) inpatient treatment in a general psychiatric facility; or (iii) inpatient treatment in a specialised psychiatric hospital or in a specialised ward in a general psychiatric facility.191 The court-ordered compulsory treatment may be discontinued or amended when this is required by changes in the patient’s condition or if it is necessitated by the course of his/her treatment. In Italy, defendants who are found to be either not criminally responsible or to have diminished criminal legal capacity, may receive a court-ordered committal to a Residence for the Execution of Security Measures (Residenze per l’Esecuzione delle Misure di Sicurezza (REMS)). As of 2021, there were 36 REMS facilities across the country, with considerable waiting lists. In Germany, compulsory treatment can be ordered as "forensic psychiatric detention", which describes the execution of custodial measures of correction and incapacitation.192 Forensic psychiatric detention purports to protect the general public from serious unlawful acts, as the committal is coupled to an assessment of the person’s dangerousness, as well as to provide treatment. The detention aims to treat the person concerned until inpatient detention no longer proves necessary, which may be indefinite. In Austria, persons with an intellectual and/ or psychosocial disability who have com-