NATIONAL LEGAL AND POLICY FRAMEWORKS CONCERNING DEFENDANTS AND PERSONS DEPRIVED OF LIBERTY WITH INTELLECTUAL AND/OR PSYCHOSOCIAL DISABILITIES IN LAW AND IN PRACTICE compulsory treatment are placed in all mental health centres and state psychiatric hospitals in the country and live predominantly together with patients on civil involuntary and voluntary treatment. The choice of the facility is done by the court upon proposal by the expert witnesses. Overview of the inpatient psychiatric care In 2019-2020, Bulgaria has 12 state psychiatric hospitals (SPH), 12 mental health centers (MHC), 5 psychiatric clinics (in university hospitals) and 17 psychiatric departments at multi-specialty hospitals.157 The total bed base is about 4 000 beds (4 072 beds for 2020), with additional about 1 000 daycare places. Most of the state psychiatric hospitals are located outside the populated areas and thus patients are accommodated and treated at a considerable distance from their place of residence, which disrupts the relationship with their loved ones and hinders their resocialisation. Most of the hospitals are of the pavilion type with buildings (and barracks) with different functions - acute closed wards separated by sex, geriatric wards, rehabilitation wards, occupational therapy. Recently day care centers for adults with IPD have been opened in a number of primary care centers and clinics at the multi-disciplinary hospitals, which offer psychosocial rehabilitation.158 Psychiatric institutions do not have a defined clinical profile, but as a practice, patients with severe psychosocial disabilities such as schizophrenia, affective disorders and addiction to alcohol/psychoactive substances are hospitalised in the SPH; patients with somatic comorbidity and severe psychosocial disabilities - in university clinics and those with acute psychotic conditions, incl. and exacerbation of chronic psychoses – mainly in the MHC.159 The inpatient treatment of addictions is carried out in one specialised hospital in Sofia and narcological or psychiatric departments at the SPH, MHC, multi-disciplinary hospitals, psychiatric clinics at university hospitals with a total of 169 beds for addiction treatment (115 in the SPH, 22 in the MHC and 32 in psychiatric clinics). The mental health centers were structured to ensure the transition from institutional/inpatient to outpatient treatment for the persons with psychosocial disabilities. Until the end of 1999, their activity was limited to the distribution of patients from the community to the hospital, maintaining a database for the treated persons from a certain area and performing outpatient activities. After the decentralisation of outpa- sufficient number of beds, staff, funding provided and did not point out any motive for non-implementation of the court decision. The court was approached with a request from the mother of the mentally ill person that his condition had worsened and he had not been treated. The care of the execution of the court decision for treatment under the Health Act or the Criminal Code always rests with the psychiatric hospital. It is obliged under the Health Act and the Criminal Code to comply with a court order. 157 Bulgaria, Council of Ministers, National Strategy for Mental Health of the Citizens of Republic of Bulgaria 2021 – 2030, adopted on 23 April 2021, p.7-8, 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 largest number of beds are in SPH, followed by MHC, clinics and psychiatric wards in multidisciplinary hospitals. The territorial distribution of psychiatric hospitals is extremely uneven - there are 6 regions where there is only one psychiatric department at the local multidisciplinary hospital. 158 Bulgaria, Council of Ministers, National Strategy for Mental Health of the Citizens of Republic of Bulgaria 2021 – 2030, adopted on 23 April 2021, p.7-8. There is also a reform in the field of deinstitutionalization of care for the disabled and the elderly people, within which it is planned a number of new social services and integrated health and social services to be set up. 159 Bulgaria, Council of Ministers, National Strategy for Mental Health of the Citizens of Republic of Bulgaria 2021 – 2030, adopted on 23 April 2021, p.7-8. 44 SLAVKA KUKOVA