air walks depending on their treatment regimens. The only exception in this regard was the SPH in Pazardzhik, where psychosocial activities were adequately developed. Further to this year’s inspections, the NPM addresses the following recommendations to the Minister of Health:  It needs to be determined which SPHs meet the Mental Health Standards requirements and the failing ones should be restructured into long-term care SPHs or into long-term care and rehabilitation SPHs;  There needs to be well-regulated procedures in place to establish the levels of competence of residential SPH structures. Information on SPH activities should advise of those levels with a view to assuring the quality of the medical care provided and assuring that the rights of patients are protected;  It is necessary and appropriate to extend the possibilities for the funding of SPHs with a view to ensuring decent wages for both medical and non-medical specialists and ensuring also adequate staffing levels in state-run mental health services;  capital expenditure funding should be provided to the SPHs on a regular basis for building repairs and maintenance and to ensure the physical safety and good living conditions in healthcare establishments;  The Ordinance provided for in Article 151 of the Healthcare Acts needs to be issued. The NPM addresses the following recommendations to the Minister of Labour and Social Policy:  Expand activities related to the provision of social services to persons with mental illness in conformity with the needs of society and discontinue encumbering SPHs with social care functions;  Support economic activities of healthcare establishments as per the National Employment Plan. The NPM calls also on local governments to provide high quality road infrastructure connecting healthcare establishments. The NPM has established once again in this reporting period the need for better interaction between the various institutions and for their representatives’ involvement in the process of delivering mental healthcare services. There is a pressing need to set up support mechanisms for the families or guardians of persons with mental illness. These issues will remain in the focus of the NPM’s activities in the coming year. 71