Visits to places of deprivation of liberty with dementia on secure wards of special social care institutions is not negligible. The observations of our discussion partners revealed that these residents were frequently incompatible with other residents which (may) lead to misunderstanding, disputes, even physical violence; we heard about cases of harassment. The foregoing points to consideration to open wards intended only for such residents. Such ward had already been operating in a certain institution for some time and it was being constructed in another one, while the other two institutions are considering or planning to open them. We commended such decisions because we are certain that wards with dementia patients would prevent bad experience due to incompatibility of residents with dementia with other residents. The staff in such wards would find it easier to adjust work and activities to particularities of dementia patients and thus enable them and their disease an optimally adjusted and suitable environment. On the basis of the thematic visits, we submitted a systemic recommendation to the MDDSZ to promote arrangement of secure wards intended exclusively for residents with dementia in special social care institutions. We are certain that suitably trained staff will be able to adjust activities on these wards according to the residents’ disease (cognitive training), while the risk of escalated agitation due to the incompatibility of residents with various forms of mental disorders will be reduced or eliminated. 3.3 VISITS TO PSYCHIATRIC HOSPITALS In 2018, we made a regular unannounced visit to two psychiatric hospitals, i.e. Ormož Psychiatric Hospital and Begunje Psychiatric Hospital, and an unannounced control visit to Idrija Psychiatric Hospital. An external expert was present during regular visits, who submitted their expert opinion on the basis of their findings. A representative of the Serbian NPM and two representatives of the Armenian NPM attended the visit to Begunje Psychiatric Hospital as external observers. At the visits, we gave 54 recommendations; all of them were general and referred to the conditions in each individual hospital. We submitted no systemic recommendations when visiting psychiatric hospitals in 2018. During the visit to Ormož Psychiatric Hospital, we provided 24 general recommendations and established several cases of good practice. According to the hospital’s response to the preliminary report, we noted that the hospital had accepted and realised most of the recommendations given relating to the living conditions, activities, legal protection and complaints channels, special protection measures, deficiencies when keeping documentation and also contacts with the outside world, which is also very important (when preparing the NPM Annual Report in the beginning of January 2019, we had not yet received a reply from the Ministry of Health). It is exceptionally important for psychiatric patients to maintain contact with the living environment from which they come and their social network. One of the recommendations referred to a large number of patients accommodated on the gerontopsychiatric ward based on their own consent or even consent by their guardian (which is contrary to a clear provision of the ZDZdr). A question arises whether dementia patients, frequently also with associated mental disorders, can actually give their consent to be accommodated on a secure ward. Are they aware of their will, what are they signing and what consequences such signing will have for them? And in particular, can they really understand the legal notice on the right to revoke the consent, which may be the most important element of the given consent? Due to the lack of space, we unfortunately also discovered in this hospital that the use of special protection measures cannot be avoided in a room where other patients are present. On the other hand, we were pleased to determine many cases of good practice which we particularly commended during the visit and also later in the report. When visiting Begunje Psychiatric Hospital, we gave 21 general recommendations. While drafting this report (beginning of January 2019), we are still waiting for the hospital’s response from which we will be able to ascertain which recommendations were realised, which accepted, but not yet realised, and with which the hospital perhaps disagreed. We visited Begunje Psychiatric Hospital several times and noted that the type of recommendations repeats. We again pointed out that patients should be provided with daytime clothes, and that they should particularly be reminded of the possibility to not stay in pyjamas throughout the day. We stressed the need for activities to also be implemented on weekends and for suitable privacy to be provided when speaking on the phone. Since temporary beds were placed on men’s and women‘s secure wards, we pointed out that these should be used only when there is no other option available and for the shortest time possible. We proposed suitable updating of the form with which a person agrees to be accommodated on a secure ward because we noticed that the applicable form lacked a legal notice. In the women’s section of the secure ward, it was determined that special protection measures were still implemented in a multi-bed room, which meant that a patient could be IMPLEMENTATION OF THE DUTIES AND POWERS OF THE NPM IN 2018 NATIONAL PREVENTIVE MECHANISM UNDER THE OPTIONAL PROTOCOL TO THE UN CONVENTION AGAINST TORTURE AND OTHER CRUEL, INHUMAN OR DEGRADING TREATMENT OR PUNISHMENT 37