housing and a psychiatric hospital is the fact that the living conditions are improved, brought closer to the family environment and the beneficiaries have the opportunity to move freely in the inner courtyard of the dwelling. In the assessment of the Public Defender, this housing is a small, closed type institutio,470 where beneficiaries have the same limited freedom as those placed in a hospital. In particular, beneficiaries are not allowed to leave their dwellings independently, with permanent surveillance and control by staff and video cameras. Beneficiaries do not have a private environment and are not allowed to lock their own bedroom door. They are obligated to follow the housing routine and regime, are unable to use the telephone independently, and no rehabilitation work is underway that will ultimately provide the beneficiaries with the skills needed for independent living. The Public Defender considers that the transfer of beneficiaries from one institution to another is not compatible with the deinstitutionalization policy and therefore, beneficiaries should be redirected to out-of-hospital services that will maximally contribute to the independent life of persons with disabilities. 4.10. Somatic (physical) health Patients who have been taking antipsychotic medications for a long time should undergo regular physical health examinations.471 The National Guideline472 for the Management of Schizophrenia emphasizes the importance of monitoring antipsychotic medications for early detection of somatic problems, assessment of severity, and correct selection of antipsychotic treatment strategies. There is also a table of the estimated frequency of the examination of patients' physical and biochemical parameters. When being placed in the hospital, patients undergo common blood and urine tests, hepatitis C and glucose tests, and if necessary, these tests are repeated. Common blood and urine tests alone can not ensure proper management of side effects and it is important for effective management of the clinical side effects to ensure clinical-laboratory, dynamic assessment and control of the risk of developing agranulocytosis, metabolic processes.473 It should be positively noted that the Center for Drug Addiction and Mental Health, the Senaki Mental Health Center and the Tbilisi Mental Health Center have contracted therapists.474 The therapist's work in these institutions is limited to counseling and symptomatic treatment. It is noteworthy, however, that in some cases475 the patient either was not provided with the treatment prescribed by the therapist or was provided with it partially. This does not ensure a complete cure for According to Article 19 (5) of the UN Convention on the Rights of Persons with Disabilities (CRPD/C/18/1), although institutions may differ in name, size and arrangement, there are still several elements for differentiating the institutions, including isolation and segregation from independent life, a paternalistic attitude when it comes to service delivery. It is possible for an institution to provide some degree of independence to the beneficiaries, although this independence is within the frames and reinforces the segregational nature of the institution.CRPD Committee (2017), General Comment No. 5 – Article 19: Living independently and being included in the community, CRPD/C/18/1, 29 August 2017, para. 16 (c). 471 Treatment and Management of Schizophrenia in Adults National Recommendation for Clinical Practice (Guideline), Chapter 4.2. 472 Treatment and management of schizophrenia in adults - Clinical Practice Recommendation (Guideline), Chapter 4.7. 473 Treatment and management of schizophrenia in adults - National Recommendation for Clinical Practice (Guideline) 474 Patients at the Senaki Mental Health Center and the Center for Drug Prevention and Mental Health are consulted by a therapist routinely when they are being admitted to the facility. At the Tbilisi Mental Health Center, the consultation with a therapist is not routine and is held only when necessary. 475 In "Tbilisi Mental Health Center". 470 136