National Preventive Mechanism The commissions visited numerous institutions, where their size alone gives rise to doubt that the right to make choices and community-based support are ensured and that concepts of deinstitutionalisation are being implemented. Deinstitutionalisation has not been realised The impression is reinforced due to the fact that residents are often placed far away from their home towns. Even though a centralisation of homes provides certain selective advantages in the overall management of care, in any case “normality” for clients is lost as a result. Placement in rooms with multiple beds, a lack of privacy, pocket money that is “managed”, care and outdoor walks that are scheduled are just some of the restrictions that must be accepted in large-scale facilities. But also personal contacts and supportive relationships that might have been possible in the vicinity are – at the very least – made more difficult when residents are transferred to homes that are further away. As a result of the size of the facilities, the way that individual needs and wishes are addressed becomes inferior. It is an intrinsic quality of large-scale institutions that the basic attitude vis-à-vis persons with disabilities is primarily protective rather than an attitude that is based on resources and strengths. In many conversations with the commissions, care staff reported that some clients could have moved to training apartments, etc. long ago if there had been vacant places. Individual needs are not addressed Often sexual needs in homes are viewed as disruptive. This is particularly the case when there are no private rooms or pedagogical concepts relating to sexuality. For example, a commission observed that at least one resident of a large-scale institution was administered psychotropic drugs to reduce his sexual urge to masturbate. The commission viewed this as a violation of his privacy. This resident was not able to practice his sexuality with sufficient self-determination. A female resident told another commission that she wanted to have a child; upon enquiry by the delegation, the staff stated that this wish was not considered possible in the facility. UN expert committee demands increased efforts In its final document on the country review of Austria, the UN Committee on the Rights of Persons with Disabilities articulated its concern regarding reports that the number of persons with disabilities in institutions and facilities has risen in the past 20 years and demanded increased efforts to drive deinstitutionalisation forward. Therefore, the Committee explicitly recommends deinstitutionalisation to the regional governments as well. Overall concepts are lacking Although there still are numerous facilities of significant size, during the year under review, some of these facilities were closed or concrete plans developed to create smaller, decentralised living units. Nevertheless, the NPM found that there is a particular lack of comprehensive overall concepts for deinstitutionalisation and that personal assistance for persons with disabilities as an alternative to institutional care has not been expanded. In the pursuit of the goals of the National Action Plan on Disabilities, the concept for personal assistance must be developed in cooperation between the Federal Government and the Laender. Increased deinstitutionalisation 124